If a dozen shrinks each interview the same patient, will they arrive at the same diagnosis?
Slate Magazine has featured an article of research that has been done to examine the accuracy and certainly effectiveness of psychiatrists' diagnoses. There has been some damning results found by researchers who pretended to have delusions/voices in the head and reported them to Emergency Rooms. It was found that they were all too quickly diagnosed with schizophrenic symptoms or at best "depressive with psychotic features" (Slater, 2004).
Psychiatrists struck back at Slater's research, sending a survey out to over 400 psychiatrists again, with a 'pretend' patient, who'd had no history of mental illness but who now reported hearing a voice. Of the 74 who responded 80% said they would need more information before making a diagnosis.
Hmm. What the article does highlight is the fact that many diagnoses are made quickly and this is because of a lack of time that mental health professionals have to make the diagnosis. Also, the constraints of insurance companies who want immediate diagnosis plus a treatment plan makes the need to be quick (and therefore prone to mistakes) more likely.
The article finishes up with a worthwhile point and makes a comparison between a medical doctor and a shrink, noting that a biological basis for a diagnosis is always possible (though not always accurate) for a doctor. Since psychiatrists and psychologists are dealing with afflictions of the mind and brain, we are at a loss because of two things: the complexity of the organ and the fact we don't know all that much about it yet.
It suggests that when mental health professionals are able to access the biological data from brain research/findings, that's when accuracy will increase.
It's a good article. Read it here
Very though provoking article. Thanks for sharing that - where do you find all this good stuff?
Posted by: HealthPsych | July 12, 2006 at 04:20 PM
Isn't it interesting? Can't specifically remember how I got onto Slate Mag, but it's surely from surfing blog sites and heading out from links that I find there. Did I say I can feel an obsession coming on? Well it's hit!
Posted by: Alison Tuck | July 12, 2006 at 08:19 PM
Very interesting article, although I must say it's nothing new. I work in community mental health where the diagnosis are hit or miss at best. Despite this, it's still disturbing.
Posted by: Caleb Pearson | July 17, 2006 at 11:16 AM
Hi Caleb, Yes you're right about the 'nothing new' bit and thanks for your comment and confirmation that it is a problem!
Posted by: Alison Tuck | July 17, 2006 at 12:22 PM
Interesting, good post.
I have a friend who is currently being pushed between two different psychiatrists one saying that she is bipolar the other equally sure that she is not.
Though everyone I have seen for myself has come up with the same diagnosis.
Posted by: Jessica | August 01, 2006 at 11:44 PM
I was diagnosed once with a diagnosis based on the symptom of 'grandiosity' because I came into my psychiatrist after years of self esteem issues (horrible eating disorder) and declared that I was going to write a book and try to get it published.
He was kind and encouraging, but I could see the 'yea right' in his eyes and then when I looked up the diagnosis code, I was shocked!
He, um, removed the diagnosis code a couple of months later when he actually read a little bit of what I write. He apologized to me when the first article I submitted anywhere got published.
He is now my biggest cheerleader on my writing. HE calls it a writing CAREER and corrects ME when I call it a hobby.
*grin*
Even docs who care and know a patient can be too quick to diagnose!
Posted by: Peggikaye | August 02, 2006 at 08:14 AM
Good post, Alison. I was trained to use the least specific diagnosis until more specific info is available. There is, however, that time pressure to come up with a diagnosis. Dinah and I have bantered about my diagnosis [http://psychiatrist-blog.blogspot.com/2006/07/who-wants-diagnosis.html]. Here's another post about diagnoses in bloggers [http://psychiatrist-blog.blogspot.com/2006/05/roy-unleashed.html].
Posted by: Roy | August 02, 2006 at 09:44 AM
I see the psych I mentioned before on Tuesday ..and get to tell him I have a book deal on the book I wrote!
How funny that I wrote about this ... THIS week, and the book deal finally came through now!
(it's only been 4 years)
Posted by: Peggikaye | August 05, 2006 at 12:09 PM
Hi Jessica, Exactly!
Peggikaye, thanks for your comments and your story. Really interesting. Once again, congrats on your recent book deal - that is such a great thing to have happen.
Roy, I've tried to link to your blog via the link you've left here, but with no luck. Well now I'm really curious!
Posted by: Alison Tuck | August 06, 2006 at 08:28 PM
This is one of the most interesting sites I have ever seen http://boymedexams.ifrance.com/
Posted by: boy med exam | July 14, 2007 at 03:22 PM