We Have A New Medical Problem: An Epidemic of Overdiagnosis

Two new books argue that we are not getting sicker, we are just attributing more to sickness. One danger is that if everyone’s ill, no one is. (Apologies for the rather frightening image.) GM

The line between mental disorder and normal diversity has become increasingly blurred… With overdiagnosis, the diagnosis might be correct but “does not benefit the patient and may arguably do harm”. The problem detected is at a stage or severity that doesn’t require treatment. It applies to physical as well as mental health problems, and most often occurs in two forms: overdetection – “when new technologies and more sensitive and intensive screening programmes are used to detect earlier and milder forms of disease”; and expanded disease definitions – over time, people once considered healthy are drawn into the group.

New Times
New Thinking.

New Statesman

5 days ago

Our overdiagnosis epidemic
How a marked rise in the treatment of certain conditions – physical and mental – is harming, not protecting, public health.

"In 2023, a remarkable apology was issued. In an interview with the New York Post, the psychiatrist Dr Allen Frances expressed regret for his role in the “massive, careless over-diagnosis” of autism. Frances chaired the taskforce that developed and broadened the criteria for autism in the DSM-IV – the fourth edition of The Diagnostic and Statistical Manual of Mental Disorders published in 1994. Nearly 20 years later, he said he was “very sorry for helping to lower the diagnosis bar”.

The DSM is the encyclopaedia of psychiatric and psychological conditions. 

• It’s a text of huge significance: if a condition is not mentioned in the DSM, private insurers in the US are unlikely to cover the cost of its treatment. 

But the book’s growing size – as conditions are added with each edition – is indicative of a problem confronting the Western world: overdiagnosis. 

• The manual’s first edition in 1952 listed 106 diagnoses across 132 pages.  

DSM-V, the latest full update, published in 2013, contains nearly 300 diagnoses; its 947 pages are “thick enough to stop a bullet”, according to one psychiatrist. . ."