Essay Sample on Over-Diagnosis: When Early Detection Can Do Harm

Introduction

Over-diagnosis is the diagnoses of an illness that will never course death or symptoms in the ordinarily expected lifetime of an individual. In other words, over-diagnosis is the side effects of screening for the early form of a disease. However, over-diagnosis is essential as it can be used to save a life in some cases. Nevertheless, it can turn people into patients unnecessarily, which may lead to some detrimental treatments. As such, over-diagnosis may occur when a disease is treated well, but the diagnosis is irrelevant. This may happen when a treatment is not wanted, not needed, or not available. As it may, since most people who are diagnosed are also treated, it is difficult to determine it during the lifetime of an individual as it can only be determined if an individual is not and never develop symptoms in his/her lifetime. Although over-diagnosis is common in the screening of some chronic diseases such as cancer, it has become common in mental disorders such as behavioral and conduct disorders. This essay tries to analyze the factors that lead to over-diagnosis of behavioral and conduct disorders and the short and long-term effects of over-diagnosis on children.

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Similar to the adults, children diagnosis is also conducted based on their symptoms and signs that may suggest a particular form of the disorder. In the case of behavioral and conduct disorders, the doctor relies on the information from the teachers and parents to determine whether a child has either behavioral or conduct disorder. If the symptoms of these disorders are present, the doctor begins starts evaluation of psychiatrist and medical histories (Merten, Cwik, Margraf, & Schneider, 2017). Example of medical evaluation may include laboratory test such as blood tests and neuroimaging to test whether those symptoms might have been caused by physical illness. Probability of other disorders that might have similar symptoms with conduct and behavioral disorder is also examined. Whenever a doctor determines that any physical diagnoses do not cause the symptoms that a child possesses, he/she will refer the child to a psychiatrist specially trained to diagnose and treat children mental disorders. Since most conduct and behavioral disorders such as ADHD has several symptoms, a specific number of symptoms must be identified for a diagnosis to take place (Rogers & Mintzker, 2016). For example, in the case of ADHD, there are 18 primary symptoms which are divided into two domains hyperactivity and inattention. For a diagnosis to take place, at least six symptoms must be identified in one of the domain.

Certain factors can lead to over-diagnosis of these types of disorder in children. One of them, if the availability of other aspects that can cause similar symptoms with these disorders. For example, aggressive nature and risk-taking attitude among boys as a method of exploring and learning the world may be mistaken with symptoms of conduct attitude. This can be ascertained by a study that was conducted by Dunlop and Newman (2016) shows that more boys are more diagnosed with both ADHD and conduct disorder with the ratio because in most cases, boys are likely to behave in a way that may suggest that they have these types of disorders which might not be accurate. The other factor that may lead to over-diagnosis of these disorders is the method of correcting information about these disorders in children. Since children can sometimes withhold information about these disorders, practitioners rely on data from parents and teachers.

In some cases, parents and teachers might give incorrect information that will lead to over-diagnosis. There is also a diagnosis of children who lacks to fulfill the criteria for diagnosis. For example, a study that was conducted by Rogers & Mintzke (2016), shows that only 7% of a psychiatrist is likely to withhold diagnoses even when all the required criteria are not met especially for boys due to assumption that boys are more affected by these disorders than girls.

The long-term and short effect of over-diagnosis of children includes psychological effects. This is because all types of diagnosis usually change the perception of the child, society, and his/her caregiver. For example, if a child is over-diagnosed with these disorders, their perception will make them withhold other interventions that can help his/her behaviors. Over-diagnoses also affect how the peer treats children. For example, a study that was conducted by Merten et al. (2017) shows that children who are diagnosed for certain mental disorders are looked down upon where 20% are likely to be exposed adverse treatment such as bullying. The other effect is financial strain where a parent is forced to continuously pay for treatment of a disorder that was never there.

Conclusion

Over-diagnosis is a common phenomenon in the United States. Due to the high rise of mental disorders such as behavioral and conduct behaviors, most of the children are exposed to particular diagnosis unnecessarily. Various factors may contribute to the over-diagnosis of behavior and conduct as discussed. Over-diagnosis is a challenge that needs to be addressed as it can have both short and long-term effects on a child.

References

Coon, E. R., Quinonez, R. A., Moyer, V. A., & Schroeder, A. R. (2014). Overdiagnosis: how our compulsion for diagnosis may be harming children. Pediatrics, 134(5), 1013-1023.

Dunlop, A. J., & Newman, L. K. (2016). ADHD and psychostimulants-overdiagnosis and overprescription. Med J Aust, 204(4), 139.

Merten, E. C., Cwik, J. C., Margraf, J., & Schneider, S. (2017). Overdiagnosis of mental disorders in children and adolescents (in developed countries). Child and adolescent psychiatry and mental health, 11(1), 5. Doi:1186/s13034-016-0140-5

Rogers, W. A., & Mintzker, Y. (2016). Getting clearer on overdiagnosis. Journal of evaluation in clinical practice, 22(4), 580-587.