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Unconscious bias
Published in Anna-leila Williams, Integrating Health Humanities, Social Science, and Clinical Care, 2018
Diagnostic overshadowing means the mental illness diagnosis eclipses the health professional’s ability to identify other potential diagnoses – or as Abraham Maslow (1966, p. 15) writes, “I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.” Diagnostic overshadowing can lead to dire oversights and health consequences when we incorrectly presume the patient’s signs and symptoms relate to their mental illness and neglect to conduct a work up for a physical illness diagnosis (Thornicroft, 2006). Epidemiologic data repeatedly demonstrate excess morbidity and mortality for people with mental illness as compared to the general population (Kisely, Sadek, MacKenzie, Lawrence, & Campbell, 2008; Laursen, Munk-Olsen, & Gasse, 2011; Laursen, Nordentoft, & Mortensen, 2014). People with mental illness have up to seven times higher mortality rate as compared to the general population (Laursen, Munk-Olsen, Nordentoft, & Mortensen, 2007). Unfortunately, research has not yet exposed the degree to which diagnostic overshadowing contributes to the increased burden of disease and premature death experienced by people with mental illness. As I said earlier in this chapter, while we wait for evidence to accrue, we can commit to do better by our patients.
Chapter 13 Overview
Published in Emily Blount, Helen Kirby-Blount, Liz Moulton, The Complete CSA Casebook, 2017
Emily Blount, Helen Kirby-Blount, Liz Moulton
‘Be aware of the concept of diagnostic overshadowing when a person’s presenting symptoms are put down to the disability, rather than the doctor seeking another, potentially treatable cause.’3
Disability
Published in Liam J. Donaldson, Paul D. Rutter, Donaldsons' Essential Public Health, 2017
Liam J. Donaldson, Paul D. Rutter
Diagnostic overshadowing is a strikingly consistent phenomenon. It occurs when healthcare professionals concentrate too much on a person’s most obvious condition, rather than on his or her other health problems. For example, people with learning disabilities who develop cancer are less likely to be informed of their diagnosis and prognosis, less likely to be given pain relief and less likely to receive palliative care. Disabled people are less likely to benefit from screening and other preventive interventions. These include vision and hearing assessments, dental care, cervical smears, breast self-examination and mammography. This particularly applies to people with learning disabilities.
Age of Autism Spectrum Disorder Diagnosis and Comorbidity in Children and Adolescents with Autism Spectrum Disorder
Published in Developmental Neurorehabilitation, 2022
Geraldine Leader, Amy Hogan, June L. Chen, Leanne Maher, Katie Naughton, Nathan O’Rourke, Mia Casburn, Arlene Mannion
Results from this study found a relationship between the presence of a medical or psychological comorbid condition and the age at which the participant was diagnosed with ASD. On average, children with a medical or psychological comorbid condition were being diagnosed thirteen months later than children without a medical or psychological comorbid condition. Consistent with previous research,22 this finding indicates that participants received a later diagnosis of ASD if they presented with a medical or psychological comorbid condition, which in turn can affect the provision of receiving early intervention. Diagnostic overshadowing bias can occur where clinicians focus on the presence and symptoms of one condition, and not another condition. A greater awareness of the co-occurrence of other conditions with ASD is vital in order for children to receive a correct diagnosis. It is also important that children receive the treatment needed for the comorbid conditions that they present with.
Stigma research in the field of intellectual disabilities: a scoping review on the perspective of care providers
Published in International Journal of Developmental Disabilities, 2021
Hannah A. Pelleboer-Gunnink, Wietske M. W. J. van Oorsouw, Jaap van Weeghel, Petri J. C. M. Embregts
A second lead for future development of interventions, concerns the potential risk on diagnostic overshadowing which is often related to stigmatization (e.g. Evans‐lacko et al., 2010). Diagnostic overshadowing concerns a tendency to overlook symptoms of mental health or physical problems and attribute them to being part of “having an intellectual disability” (Mason and Scior, 2004, Werner et al., 2013). Care providers (e.g. support staff) in the field of ID often have a signaling function of mental and physical health symptoms toward health professionals and may therefore contribute to diagnostic overshadowing by overlooking relevant symptoms. In staff coaching, the advices regarding diagnostics in relation to stigmatization as made by Pijnenborg et al. (2016) may prove relevant: (1) try to place symptoms in a normalizing framework, (2) do not insist on people accepting the diagnosis (of ID/personality disorder), but validate emotions and symptoms, (3), do not stress biomedical factors in discussing a client’s diagnosis but stress the potential to improve and learn.
Barriers and Possible Solutions to Providing Physical Health Care in Mental Health Care: A Qualitative Study of Danish Key Informants’ Perspectives
Published in Issues in Mental Health Nursing, 2021
Birgitte Lerbæk, Andrea McCloughen, Marlene Briciet Lauritsen, Jørgen Aagaard, Julie Nordgaard, Rikke Jørgensen
Several factors related to structures in health care systems have implications for the provision of physical health care to people with SMI. Inequalities related to allocation of resources in the healthcare sector, and the organisation of healthcare services are described as barriers contributing to people with SMI having poorer access to treatment of physical illness (De Hert et al., 2010; Laursen et al., 2009; Nordentoft et al., 2015). Diagnostic overshadowing is a problematic phenomenon within health care systems internationally, which contributes to delay in the detection of physical illness and in treatment of physical health conditions among those with SMI. Diagnostic overshadowing occurs when MHCPs overlook physical symptoms experienced by people with SMI by wrongfully interpreting them as related to symptoms of mental illness (Jones et al., 2008; McNamee et al., 2013; Nash, 2013). Such practices are described as a characteristic of the stigma within the health care system, that is reinforced by negative attitudes among MHCPs (Jones et al., 2008; Nash, 2013).