In this article, a case report discussing some problems in differential diagnosis between Distymic Disorder and mixed anxiety-depressive disorder is presented. In the context of a Child Psychiatric Clinic, a multiaxial assessment provide the framework for reframing. Differences Between DSM-IV and ICD 10 for Child and Adolescent Psychiatric Disorders are discussed too. For systemic therapists, mastering the diagnostic criteria and differential diagnosis trees is required, as a consequence both of the increasing pressure by Public Agencies due to statistical needs, and the availability to the population of these information via the Internet, as well as in order to limit the tendency to sum a plenty of different therapeutic interventions both to the children and their families.
Keywords: Child psychiatry, differential diagnosis, distimic disorder, ICD 10, systemic model, diagnostic tools