Overdiagnosis: is there anything to it?

The Black Oil

It's common enough now for people to be sceptical about some of the labels kids get. Personally, I think there might be something to it, in some instances, but certainly not as much as people say. With changing diagnostic criteria, different training/screening methods it's bound to be a little hard to keep track of dx rates. I'm on about the likes of ASD, ADHD, ADD, btw. I don't think it helps when certain conditions are part of a news story because this can create misconceptions. I'm not up on the research, but any thoughts?

JuliusCaesar

There is actually a lot of debate about this. The DSM expands criteria for diagnosis - what used not be diagnosable is now covered by a diagnosis, so that the definition of what is 'normal' (ie within the normal range) is shrinking. All you need do is get hold of different editions: DSM 2 vs DSM 3 vs DSM 5.

The National Network of Critical Voices in Mental Health, launched last year, will be the people to watch for this. I think they'll be putting out a statement in May. The UK Critical Psychiatry people might also be useful. Richard Bentall has quite a lot to say: here's a review of his book Madness Explained. And Allen Frances, who was involved in DSM3

And of course, as mentioned in another thread, there's Robert Whitaker's work.

The Black Oil

Thanks, JC. There's also things like the consensus statement on ADHD, but I presume there's been some reaction to it.

Odysseus

Just a question on the DSM, which would psychologists use most the DSM or the ICD-10?
I'm much more familiar with the ICD-10 as that was what I used on my MA when I looking at psycho-diagnostics from a psych and a psychoanalytic perspective. I did use the DSM, but I focused more on the ICD-10 as I found it more user friendly. There are some interesting differences between the two.

As well as that they seemed to use the ICD more at the case presentations in St Vincent’s at the time. I'm always surprised at the difference in size between the two; whereas there is not much difference in terms of the amount of disorders in the two, the DSM is at least twice the size.

Anytime there is a discussion on the topic here the DSM is always referenced, so is it a case of the DSM being used more or is the ICD-10 used but just not mentioned as much
?

JuliusCaesar

The ICD is mostly used in Europe; the DSM in the USA. However a lot of research comes from the USA (especially as English is the dominant language....not that many UK or Irish psychologists could read scientific articles in another language!) where the DSM criteria would be used.

For me, it's pretty much academic as I do not treat according to diagnosis but according to the individual formulation; in any case, many of the problems I treat aren't a diagnosis being anger, low self-esteem, or rumination for example.

Odysseus

JuliusCaesar wrote: »

The ICD is mostly used in Europe; the DSM in the USA. However a lot of research comes from the USA (especially as English is the dominant language....not that many UK or Irish psychologists could read scientific articles in another language!) where the DSM criteria would be used.

For me, it's pretty much academic as I do not treat according to diagnosis but according to the individual formulation; in any case, many of the problems I treat aren't a diagnosis being anger, low self-esteem, or rumination for example.

It would be similar for myself, as psychoanalytic psycho-diagnostics would not exist in either of the two.

Cheers, though that was my understanding that the ICD was used mostly in Europe, it's just that you don't see it being used that much within Irish or UK based research.