Overdiagnosis in psychiatry
Hispanic Americans and 11% of Asian Americans said they felt they would be better served by a therapist/physician of a different race/ethnicity. This study shows how racial prejudice can be a factor which causes the breakdown of a doctor-patient relationship, and specifically in the United States, historical ties to racism have caused doctors to have biased opinions towards these groups, and potentially over diagnose them based on stereotypical behaviours and actions. Another effect of overdiagnosis is the direct effect on the patient. This can be related to taking medication which can cause bodily harm or social issues involved with a condition. In children being diagnosed with a mental health disorder can cause serious social problems for an individual, with the revelation of this resulting in peer rejection, potentially problems with academic achievement and higher risk of injury (Thomas et al., 2013). This difficulty through early stages of one’s life can have serious impact of the overall quality of life, as the patient may have lower self-esteem as a result and more difficulty communicating with others, all of which could contribute to more mental health issues developing later in life, particularly mood related disorders. Overdiagnosis can also negatively influence the patient’s health as well; the number of stimulants being taken for ADHD has increased majorly in the last 20 years, by 700% over the 1990s (Mackey & Kipras 2001). A study in overtreatment of ADHD in children suggests that the increase in the sale of psychostimulants – drugs used to improve mental processes and physical functions – like Ritalin have increased to the point where misuse and overdose of the drug is more widespread (Dunlop and Newman, 2016). The popularity of psychostimulants are not only limited to those with mental health issues; instead many high school and university students are using them as concentration tools for schoolwork. The inconsistency in diagnosis of ADHD has led to psychostimulants being more readily available to students in pharmacies, whether they have ADHD or not, as by limiting the diagnossi of ADHD to fewer symptoms and simpler behaviours, this allows some to be more deceptive and gain access to those drugs. Thus, we have created a system in which young people are incentivized to illicitly use and abuse drugs due to overdiagnosis and failing standards in spotting symptoms. The significant rise in clinically diagnosed mental disorders is still being explored, with some explanations having been suggested as to why this phenomenon has taken place. Firstly, healthcare professionals are using varying and different criteria to diagnose patients, leaving a very blurred threshold for those who have me ntal disorders and those who don’t Secondly, physicians may have stopped using diagnostic criteria altogether; a study conducted in United States showed that only ¼ of paediatricians in a sample used DSM diagnostic criteria (Wolraich et al., 2011). Some of these doctors may be diagnosing based off bias or prejudice, as seen by a study looking at the history of racism in mental health, which shows that overdiagnosis impinges on ethnic minority groups using stereotypes. The use of overdiagnosis is becoming an increasingly difficult problem to combat, given the effects it is having on a doctor-patient relationship by losing trust, as well as the social issues and health issues which may arise as a result of it. One of these involve teenagers more easily using psychostimulant drugs for recreational or studying purposes, which can often end in overdose or death. These serious social and health problems which arise can argue that screening tests may need to be more rigorous, or perhaps a standardized method of diagnosing for mental health disorders, particularly in children and young people.
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