Dangers of self-diagnosis in neuropsychiatry, 2024, David & Deeley

Dangers of self-diagnosis in neuropsychiatry
Anthony S. David and Quinton Deeley
https://www.cambridge.org/core/jour...ropsychiatry/51029ED3B71CA62FC1085EC4A5B2E139

No abstract.


Conclusions
Like any significant intervention, diagnosis can have harms as well as benefits. Self-diagnosis is no different. We argue that the problems of self-diagnosis are that:
It is not a sufficient basis for accessing the benefits which medical diagnosis allows; it may lead to misdiagnosis and misdirect the person from care that could help them; and also, it may alter the social meaning and standing of a diagnosis, disadvantaging those most affected and who need it the most.
The benefits of self-diagnosis include a variety of social resources: admittance to the peer support of a community, a positive illness identity and perhaps access to a narrative reframing of personal struggle and disappointments in life, enjoining sympathy and even admiration.
Finally, we might speculate as to why self-diagnosis has become so common. One element may be the growth of peer-to-peer communication via social media, fuelling the notion of lay expertise, the mistrust of power imbalances associated with professional hierarchies, and perhaps also impatience and desperation with long NHS waiting lists for assessment and/or the prohibitive expense for many, of privately sought diagnoses.


Two old friends.

 

And can't help themselves:

But even outside the courtroom, an adversarial atmosphere can pervade many areas where diagnosis is contested leading to self-diagnosis. For some, the primary attribute of the condition encapsulated in the neurological-sounding diagnostic labels myalgic encephalomyelitis/encephalopathy or ‘ME’, a diagnosis preferred by some self-help and advocacy groups, is its lack of any psychosocial underpinnings. This conflicts with the more neutral ‘chronic fatigue syndrome’, favored by most practitioners, and compatible with a boarder biopsychosocial model and effective treatment approaches (White et al., Reference White, Abbey, Angus, Ball, Buchwald, Burness and Zeman2023).

 

When I was screened for asperger (ie. before it was incorporated into autism/spectrum) I was asked about if I had any interests in trains and train schedules growing up. Because that was what the questionnaire required. The fact that I come from a place without trains was not accounted for. The GP tried to switch to buses and bus schedules, and started by asking if I knew them without looking them up. Of course I did: we only had one bus and that was the school bus, and in school holidays the bus only came twice a week (once to pick people up in the morning, and then the return in the evening).

"Lay persons" with lived experience would be better able to find other examples that could be asked about to screen for special interests than health care workers or researchers who only work with questionnaires like the one I was subject to..