Danger: Diagnosis Ahead

Last Sunday the NY Times published a sad and all too common story about overprescription of Adderall, a story that is equally applicable to any of a number of psychiatric medications. If you haven't yet read "Drowned in a Stream of Prescriptions", I urge you to do so. I have written here many times about what I see as the shortcomings of the diagnostic system we use in mental health. It would be nice to imagine that there were some scientific way to determine diagnosis, but there is none. Absent biological or chemical tests to establish diagnoses, we fall back on consensus reality and struggle with the unevenness of such a standard. What we have in the DSM IV is an attempt to develop, by consensus, descriptions of all disorders thought to be reflective of mental illness of one kind or another. Categories have been expanded and elaborated in the years since the first edition was published; yet, all but the rarest of categories still depends on the subjective judgment of the examiner. Local custom, training of the examiner, examiner biases, insurance coverage, perceived stigma carried by various diagnoses, and funding sources can all influence the diagnosis made as much as the behavior and history of the patient. And now this problem is compounded by increasing reliance on symptom checklists rather than clinical interview to determine diagnosis, diagnoses which almost always in many places result in prescriptions for one or more medications.
Source: Jung At Heart - Category: Psychiatrists and Psychologists Source Type: blogs