Soaring rates of diagnoses in various illnesses such as cancer and diabetes have stimulated a debate about whether medicine has an “overdiagnosis” problem. The claim is that individuals may be prematurely diagnosed with conditions that, although meeting criteria for a disease, will never cause symptoms or death during a patient’s lifetime.

Discussions of this problem in the world of physical medicine have mainly been described as compassionate, arising from concerns that many so-called diagnoses might be unnecessary (does being pre-diabetic really mean you are ill?) or even harmful (the worried well being driven to seek needless and possibly damaging surgical interventions). Now that there are ever-more sensitive screening tests, and access to predictive genetic information, are doctors handing out too many unnecessary sicknotes?

When attention turns to the possibility of overdiagnosis in the world of psychological medicine, however, the tone changes. Even those on the side of compassion display a greater level of cynicism, with subtle (or not so subtle) hints about unearned or pointless diagnoses. There is reference to “diagnostic creep” and the “medicalisation” of normal human variation. Mental illness has been described as just an inability to deal with ordinary distress and anxiety. Weighing in on the back of this are those with much more trenchant opinions. “We’ve fetishised mental illness, so we all want it,” reads one recent headline, with the associated article describing a mental illness diagnosis as a “sicknote from life”. Increases in diagnoses such as attention deficit hyperactivity disorder (ADHD) have been blamed on “sharp-elbowed, middle-class parents” trying to avoid the blame for bad parenting, and the support for children with special education needs as an “unaffordable racket”, caused by a system that is “patently easy to game”.

Autism is clearly in the........

© The Guardian