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

J

JohnTheJack

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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.
 
JohnTheJack said:
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.
Click to expand...

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..
 
The paper said:
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.
Click to expand...
This is delusional. These people have no connection to reality. Self-diagnosis is a consequence of systematic failure. It should almost never happen, but because health care systems are failing, in the case of chronic illness deliberately, people are left with no choice. It's only happening because medicine is unable to meet the demands it is facing, something it is incapable of acknowledging and work to compensate for.

The lack of lived experience in medical knowledge has become a massive crisis. It is completely limiting the profession's ability to get even basic understanding of what is half of their job, illness, and that doesn't even take account that they're not even half-way to understanding everything there is to know about disease. They talk in complete ignorance of what it's like, but with the hubris and arrogance of people who think they have nothing to learn from the people who actually experience it. They work in as insulated a bubble as the Soviet politburo who oversaw their economy, deciding what the common folk needed without a scrap of knowledge about their actual needs, and making every decision about what they themselves needed to grow their influence.
 
JohnTheJack said:
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.
Click to expand...
I recognise Anthony David (particularly a lovely story i read in the times a few years back about someone with something ‘mysterious’ being given ECT - electric shock treatment, which of course didn’t work, so not sure on pot calling kettle black/ leg to stand on re point being made when I think back to that ‘professional approach’) but not as familiar with the other one
 
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