MITIGATION OF DIAGNOSTIC UNCERTAINTY IN PSYCHIATRY AND MENTAL HEALTH IN PRIMARY CARE: A SCOPING REVIEW

Nelson Pinto Gomes; Sadi Antonio Pezzi Junior; Elisabete Soares de Santana; Beatriz Souza Leal; Alexandre Edu Rassy; João Vitor Gomes Braga; Milena Fernandes da Silveira; Daniel Gomes Fialho; Ticiano Magalhães Dantas; Pedro Ernesto Teles Barbosa; Islandia Maria Rodrigues Silva; João Paulo Lopes da Silva; Renata Trindade Gonçalves

doi:10.18623/rvd.v23.n4.4838

Authors

Nelson Pinto Gomes Université Catholique de Louvain (UCL) https://orcid.org/0009-0000-2549-7402
Sadi Antonio Pezzi Junior Universidade Federal do Ceará https://orcid.org/0000-0001-6606-5112
Elisabete Soares de Santana Universidade Federal de Pernambuco https://orcid.org/0009-0000-5773-3879
Beatriz Souza Leal Pontifícia Universidade Católica de Campinas https://orcid.org/0009-0009-6022-5993
Alexandre Edu Rassy Universidade de Santo Amaro https://orcid.org/0009-0002-9470-8335
João Vitor Gomes Braga Pontifícia Universidade Católica de Goiás (PUC-GO) https://orcid.org/0009-0008-1086-9267
Milena Fernandes da Silveira Centro Universitário Max Planck (UNIMAX) https://orcid.org/0009-0002-2061-9129
Daniel Gomes Fialho Universidade de Mogi das Cruzes (UMC) https://orcid.org/0009-0005-2249-0658
Ticiano Magalhães Dantas Universidade Regional do Cariri https://orcid.org/0000-0002-9527-5722
Pedro Ernesto Teles Barbosa Universidade Federal Fluminense https://orcid.org/0009-0006-3466-4982
Islandia Maria Rodrigues Silva Secretaria de Saúde do Estado do Piauí (SESAPI) https://orcid.org/0000-0002-2451-4749
João Paulo Lopes da Silva Universidade Federal da Paraíba https://orcid.org/0000-0003-0018-9897
Renata Trindade Gonçalves Universidade Federal de Juiz de Fora https://orcid.org/0000-0001-8748-1238

DOI:

https://doi.org/10.18623/rvd.v23.n4.4838

Keywords:

Diagnostic Uncertainty, Mental Health, Primary Health Care, Clinical Decision-Making, Psychiatry

Abstract

OBJECTIVE: To map and analyze recent scientific evidence on the mitigation of diagnostic uncertainty in psychiatry as a core element of clinical decision-making in primary mental health care, identifying diagnostic strategies, care practices, and organizational approaches. METHODS: Scoping review conducted between December 2025 and January 2026, following Joanna Briggs Institute recommendations and reported according to PRISMA-ScR. The research question was structured using the PCC framework. Studies published in the last five years, in any language, addressing diagnostic uncertainty in primary mental health care were included. Searches were performed in PubMed, Medline, Scopus, Embase, and Cochrane Library, with complementary searches in Google Scholar. Data selection and extraction were performed independently by two reviewers. RESULTS AND DISCUSSION: Twelve studies were included. Findings indicate that mitigating diagnostic uncertainty relies on integrating diagnostic tools, collaborative and measurement-based care practices, and organizational strategies. Care practices predominated, while organizational interventions were less frequently addressed, highlighting important gaps. CONCLUSION: Reducing diagnostic uncertainty in primary mental health care requires sustained, integrated strategies combining longitudinal follow-up, structured communication, standardized assessment tools, and collaborative care models to improve clinical decision-making and diagnostic safety.

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MITIGATION OF DIAGNOSTIC UNCERTAINTY IN PSYCHIATRY AND MENTAL HEALTH IN PRIMARY CARE: A SCOPING REVIEW

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