Depression, one of the most commonly diagnosed psychiatric disorders,[2][3] is being diagnosed in increasing numbers in various segments of the population worldwide.[4][5] Depression in the United States alone affects 17.6 million Americans each year or 1 in 6 people. Depressed patients are at increased risk of type 2 diabetes, cardiovascular disease and suicide. Within the next twenty years depression is expected to become the second leading cause of disability worldwide and the leading cause in high-income nations, including the United States. In approximately 75% of suicides, the individuals had seen a physician within the prior year before their death, 45–66% within the prior month. About a third of those who died by suicide had contact with mental health services in the prior year, a fifth within the preceding month.[6][7][8][9][10]
There are many psychiatric and medical conditions that may mimic some or all of the symptoms of depression or may occur comorbid to it.[11][12][13] A disorder either psychiatric or medical that shares symptoms and characteristics of another disorder, and may be the true cause of the presenting symptoms is known as a differential diagnosis.[14]
Many psychiatric disorders such as depression are diagnosed by allied health professionals with little or no medical training,[15] and are made on the basis of presenting symptoms without proper consideration of the underlying cause, adequate screening of differential diagnoses is often not conducted.[16][17][18][19][20][21] According to one study, "non-medical mental health care providers may be at increased risk of not recognizing masked medical illnesses in their patients."[22]
Misdiagnosis or missed diagnoses may lead to lack of treatment or ineffective and potentially harmful treatment which may worsen the underlying causative disorder.[23][24] A conservative estimate is that 10% of all psychological symptoms may be for medical reasons,[25] with the results of one study suggesting that about half of individuals with a serious mental illness "have general medical conditions that are largely undiagnosed and untreated and may cause or exacerbate psychiatric symptoms".[26][27]
In a case of misdiagnosed depression recounted in Newsweek, a writer received treatment for depression for years; during the last 10 years of her depression the symptoms worsened, resulting in multiple suicide attempts and psychiatric hospitalizations. When an MRI finally was performed, it showed the presence of a tumor. However, she was told by a neurologist that it was benign. After a worsening of symptoms, and upon the second opinion of another neurologist, the tumor was removed. After the surgery, she no longer had depressive symptoms.[28]
^Neuroimaging: a new training issue in psychiatry? -- Bhriain et al. 2005 - [1]Archived 2010-04-27 at the Wayback Machine
^Sharp LK, Lipsky MS (September 2002). "Screening for depression across the lifespan: a review of measures for use in primary care settings". American Family Physician. 66 (6): 1001–8. PMID12358212.
^Lambert KG (2006). "Rising rates of depression in today's society: Consideration of the roles of effort-based rewards and enhanced resilience in day-to-day functioning". Neuroscience & Biobehavioral Reviews. 30 (4): 497–510. doi:10.1016/j.neubiorev.2005.09.002. PMID16253328. S2CID12525915.
^Pirkis J, Burgess P (December 1998). "Suicide and recency of health care contacts. A systematic review". The British Journal of Psychiatry. 173 (6): 462–74. doi:10.1192/bjp.173.6.462. PMID9926074. S2CID43144463.
^Adults Admitted to a Mood-Disorder Clinic Are Often Misdiagnosed by Marlene Busko [2]
^Felker B, Yazel JJ, Short D (December 1996). "Mortality and medical comorbidity among psychiatric patients: a review". Psychiatric Services. 47 (12): 1356–63. doi:10.1176/ps.47.12.1356. PMID9117475.
^Preventing Misdiagnosis of Women: A Guide to Physical Disorders That Have Psychiatric Symptoms (Women's Mental Health and Development) by Dr. Elizabeth Adele Klonoff and Dr. Hope Landrine p. xxi Publisher: Sage Publications, Inc; 1 edition (1997) Language: English ISBN0761900470
^Hall RC, Popkin MK, Devaul RA, Faillace LA, Stickney SK (November 1978). "Physical illness presenting as psychiatric disease". Archives of General Psychiatry. 35 (11): 1315–20. doi:10.1001/archpsyc.1978.01770350041003. PMID568461.
^Small GW (December 2009). "Differential Diagnoses and Assessment of Depression in Elderly Patients". The Journal of Clinical Psychiatry. 70 (12): e47. doi:10.4088/JCP.8001tx20c. PMID20141704.
^Witztum E, Margolin J, Bar-On R, Levy A (1995). "Stigma, labelling and psychiatric misdiagnosis: origins and outcomes". Medicine and Law. 14 (7–8): 659–69. PMID8668014.
^Margolin J, Witztum E, Levy A (June 1995). "Consequences of misdiagnosis and labeling in psychiatry". Harefuah. 128 (12): 763–7, 823. PMID7557684.
^When Psychological Problems Mask Medical Disorders: A Guide for Psychotherapists. Morrison J: New York, Guilford, 1997 ISBN1-57230-539-8
^Previously undetected metabolic syndromes and infectious diseases among psychiatric inpatients. Psychiatric Services Rothbard AB,et al: 60:534–537,2009 [4]
^Hall RC, Gardner ER, Stickney SK, LeCann AF, Popkin MK (September 1980). "Physical illness manifesting as psychiatric disease. II. Analysis of a state hospital inpatient population". Archives of General Psychiatry. 37 (9): 989–95. doi:10.1001/archpsyc.1980.01780220027002. PMID7416911.