Friday, July 15, 2011

Diagnosis?

Depression: From Treatment to Diagnosis?:
"A diagnosis is meant to be an objective statement about the nature of your illness; treatments (if any) come afterwards. It would be odd if the treatments on offer influenced what diagnosis you got.

An interesting paper just out suggests that exactly this kind of reverse influence has happened. The authors looked at what happened in the USA in 2003 when antidepressants were slapped with a "black box" warning, cautioning against their use in children and adolescents, due to concerns over suicide in young people."

TheLastPsychiatrist responds " The symptoms were first, and then a cognitive heuristic as to what to call it and what to give:

1998: irritability = depression
2008: irritability = bipolar"

P.S. It is not clear to me whether symptoms to diagnosis is clear cut in many cases. depending on the case relief and 'or stabilization may be important before disgnosis in many cases. the diagnoses and treatments seem vary with time and what were condidered breakthroughs at some stage may become only a part of the treatments later on. This sort of examples abound in Siddhartha Mukherjee's book "The emperor of all Maladies". As TLP says in another place The Decline Effect Is Stupid:
"Medicine is not a science, and despite the white coats and antisocial demeanor doctors are not scientists. Docs and patients both need to get that into their heads and plan accordingly. That why we say doctors 'practice' medicine."

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