Mental Illness Misdiagnosed: Increasing Awareness of Obscure Physical Illnesses

Stanford, Deb; Ling, Catherine; Rodney, Tamar; Shattell, Mona

doi:10.3928/02793695-20200814-02

Cited by 3 publications

(3 citation statements)

References 6 publications

(2 reference statements)

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“…Of note, attribution of physical illnesses to psychiatric causes affects individuals without mental illness as well. Individuals without mental illness may experience symptoms such as stroke‐related hallucinations (Castaño Ramírez et al, 2020), psychosis from Lyme disease, depression due to thyroid dysfunction (Stanford et al, 2020) and numerous other indicators appearing as psychological in nature but caused by physical illness instead (Schildkrout, 2014). Inappropriate labelling of symptoms as psychological can lead not just to unnecessary medication and psychiatric hold but also omission of life‐saving and injury‐limiting care (Castaño Ramírez et al, 2020; Schildkrout, 2014).…”

Section: Discussionmentioning

confidence: 99%

Mental health bias in physical care: An integrative review of the literature

Hallyburton

Allison-Jones

2023

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject? Individuals experiencing mental illness make up a significant portion of the world's population. Individuals with mental illness experience higher rates of morbidity and die on average at least a decade earlier than individuals without mental health disorders. What this paper adds to existing knowledge? Issues of stigma, diagnostic overshadowing, premature closure, inadequate workup, fear and lack of training negatively impact the care of individuals with mental illness. Issues impacting the care of individuals experiencing mental illness cross geographic and care setting boundaries. What are the implications for practice? Partnerships between physical and mental health practitioners are needed to thoroughly assess and accurately diagnose symptoms experienced by individuals with mental illness. Educational interventions can help prepare practitioners to care for individuals with mental illness. Nurses can better advocate for effective patient care by learning about the phenomenon of diagnostic overshadowing and calling attention to its occurrence. Abstract IntroductionIndividuals with mental illness experience significantly higher overall rates of morbidity and mortality than counterparts without mental illness. Misdiagnosis of symptoms emanating from physical illnesses as psychiatric in nature presents one important cause. AimThis integrative review explores research on healthcare professionals' misattribution of physical health symptoms to patients' comorbid psychiatric issues and seeks to identify unifying themes, shared causes, and possible strategies for addressing the issue. MethodThis review uses Whittemore and Knafl's 2005 integrative review methodology coupled with vetted quality appraisal tools. ResultsFollowing a systematic search of allied health, medical, psychological, sociological and general literature, 24 publications employing qualitative, quantitative, mixed and synthesis research methodologies were selected. Each study was appraised according to design, and relevant data were extracted. DiscussionThemes of stigmatization, diagnostic overshadowing, incomplete medical examination, insufficient training, and fears experienced by providers and patients emerged. Implications for PracticeIncreased partnering between physical and mental health practitioners, continuing education, and improving patient–provider communication are key to providing equitable care. Nurses play primary roles in empathizing with patients, advocating for appropriate care and educating others on the dangers of misattributing physical symptoms to psychiatric cause.

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Section: Discussionmentioning

confidence: 99%

Mental health bias in physical care: An integrative review of the literature

Hallyburton

Allison-Jones

2023

Psychiatric Ment Health Nurs

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“…In Iran, 18% of the health organization's budget is spent on mental health problems in mental hospitals, while mentally ill patients in hospitals are the minority of mentally ill patients (8). Two other problems associated with mental disorders are dropout during treatment by patients and misdiagnosed mental patients in the general population (9,10).…”

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confidence: 99%

The nature of psychiatric problems in Primary health Care centers: the experience of a Community Mental Health Center in northeast of Iran

Talebi

Nemati

Gholami

et al. 2023

Preprint

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Background Community Mental Health Centers (CMHCs) provide mental health services to patients at low cost, with less stigma, in a domiciliary. This is the first study to describe demographic characteristics, common mental disorders, referral status, and treatment discontinuation in patients at the only CMHC of Mashhad, northeastern Iran. Methods This cross-sectional study enrolled 662 patients who contacted this center between January 2014 and December 2021. We completed a checklist that included information on demographics, diagnosed mental disorders, referral status, and the number of psychiatric visits, all of which psychiatrists fully completed clinical records. The frequency distributions of all variables were carried out with SPSS11.5. In addition, the association between epidemiological findings and patient referral (referral system or self-referral) and the association between epidemiological findings and the number of psychiatric visits were examined by the Chi-square test. Results Of 662 patients, 472 (71%) women and 190 (29%) men were enrolled, and the mean age of all patients was 29 years. Among the 475 adult patients, 367 (77.3%) patients were married and had primary or secondary education (40.4%), and the majority of them were housewives (56.4%). Major Depression Disorder (32%), Generalized Anxiety Disorder (18.3%) were the two most common mental illnesses in patients. Large proportions of the patients (70.7%) were referred to this center via the referral system. Moreover, non-working patients (housewives and unemployed patients) and the female gender were associated with more referrals to this center through the referral system. 431 patients (65.1%) did not return for a second visit, and the higher number of psychiatric visits was associated with a lower level of education. Conclusions Based on the results of this study, most of the patients in this center had a low socioeconomic level. Most of them were referred through the referral system, and gender and employment significantly contributed to referral via the referral system. The majority of patients discontinued treatment after the first psychiatric visit, and this was associated with the level of education.

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“…Similarly, many times individuals suffering from Lyme disease get misdiagnosed as having unrelated psychiatric illnesses 8. It is quite conceivable that pride is causing some doctors to overestimate their personal knowledge, and therefore, lead them to ignore what their patients are telling them.…”

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confidence: 99%

Amanitvam: a concept from the Bhagavad Gita applicable in medical ethics

Simha

2022

J Med Ethics

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Mental Illness Misdiagnosed: Increasing Awareness of Obscure Physical Illnesses

Cited by 3 publications

References 6 publications

Mental health bias in physical care: An integrative review of the literature

Mental health bias in physical care: An integrative review of the literature

The nature of psychiatric problems in Primary health Care centers: the experience of a Community Mental Health Center in northeast of Iran

Amanitvam: a concept from the Bhagavad Gita applicable in medical ethics

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