Saturday, 3 March 2012

How can some people be so far out of touch?

Psychiatric diagnoses have always been difficult to develop and to implement.  Primarily this is because as of yet (though things may be changing soon) we have not had robust independent biomarkers to help us validate them.  For example: in the diagnosis of chest pain, a doctor can use an EKG and blood tests to help determine if the patient’s symptoms are more likely to be caused by a heart attack or not.   

While psychiatric diagnoses are built on some good validation criteria for the most part, some are less well buttressed with this evidence than others, and for some, opinion, economics or social influences have quite a measure of impact.

 For example, a recent story in the National Post indicated that some physicians in Alberta were still making a psychiatric diagnosis of homosexuality. Not only does this not make any sense (homosexuality is not a psychiatric diagnosis), but it is offensive and simply wrong-headed.
Frankly, I could not follow the article, and did not understand what the reporter was trying to say – was the problem due to a billing code or was a doctor(s) using that as a diagnostic code (which makes no sense as neither the current ICD-10 nor the DSM diagnostic criteria contain that as a diagnosis)?  Or is Alberta simply so far behind that it is using a medical diagnostic system that is over 25 years out of date?

Whatever the real story here, it is time that psychiatric diagnoses were demanded by the profession and public alike to be more based on the best available science than on opinion, insurance payments or public pressure.  My goodness, if one of the current candidates wins the GOP nomination in the USA who knows what silliness will make its way into diagnostic codes.


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