“I still can’t forget those words”:mixed methods study of persisting impact [of] psychosomatic and psychiatric misdiagnoses, 2025, Sloan+

Discussion in 'Other health news and research' started by SNT Gatchaman, Mar 3, 2025.

  1. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights) Staff Member

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    “I still can’t forget those words”: mixed methods study of the persisting impact on patients reporting psychosomatic and psychiatric misdiagnoses
    Sloan, Melanie; Bosley, Michael; Gordon, Caroline; Pollak, Thomas A; Mann, Farhana; Massou, Efthalia; Morris, Stephen; Holloway, Lynn; Harwood, Rupert; Middleton, Kate; Diment, Wendy; Brimicombe, James; Lever, Elliott; Calderwood, Lucy; Dalby, Ellie; Dunbar, Elaine; D’Cruz, David; Naughton, Felix

    OBJECTIVES
    This research aimed to improve understanding of persisting impacts of patient-reported psychosomatic and psychiatric misdiagnoses on patients with systemic autoimmune rheumatic diseases (SARDs).

    METHODS
    Mixed methods data from two SARDs cohorts were analysed (N = 1,543 and N = 1,853). Validated instruments and patient-designed questions were used to measure self-reported depression, anxiety and mental wellbeing, in addition to medical relationships and healthcare behaviours. Comparative tests were used to evaluate differences between patients reporting a psychosomatic and/or psychiatric misdiagnoses and other patients.

    RESULTS
    Persisting adverse outcomes of perceived psychosomatic and psychiatric misdiagnoses were identified in multiple domains. This included >80% of patients reporting that it had damaged their self-worth, and 72% reporting that it still upset them. Patients reporting psychosomatic and/or psychiatric misdiagnoses had significantly lower mental wellbeing, and higher depression and anxiety levels (all p< 0.001), and lower levels of satisfaction with every aspect of medical care, compared with patients reporting no psychosomatic or psychiatric misdiagnoses. Psychosomatic and psychiatric misdiagnoses had varying associations with healthcare behaviours, including a significantly higher likelihood of under-reporting symptoms (p< 0.001) and healthcare avoidance (p= 0.012), but not with medication adherence (p= 0.2). Thematic analysis of qualitative data revealed that symptom under-reporting and healthcare avoidance often resulted from distrust and fear that symptoms would be disbelieved and misattributed again.

    CONCLUSION
    Patient-reported psychosomatic and psychiatric (mis)diagnoses are associated with persisting adverse impacts in multiple domains including mental health, medical relationships, self-worth, and some healthcare behaviours. Health services and clinicians should consider these potential adverse impacts on patients and offer support to reduce any persisting negative impacts.

    Link | PDF (Rheumatology) [Open Access]
     
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  2. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights) Staff Member

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    Selected patient quotes —

    Selected medical quotes —

    From the discussion, with some themes we have seen frequently mentioned on S4ME —

     
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  3. Utsikt

    Utsikt Senior Member (Voting Rights)

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    This is an important topic! Is the methodology robust?
     
  4. Hutan

    Hutan Moderator Staff Member

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    These people have clearly been damaged by medical systems. Unlike us, they eventually got a diagnosis with no taint of psychosomatisation. Even then it sounds as though most of them still carry the scars. There is no reprieve at all for us.

    I haven't seen my doctor for over two years after she told me I had health anxiety. Since then, I have had clear cut medical issues, a kidney stone, ear infections - I have gone to the hospital or to all hours care clinics when symptoms eventually became unbearable. (I think the care I got at the hospital was influenced by my GP's diagnosis until imaging showed that I really had a problem - but I think I was given a really low priority for that imaging, so I was continually vomiting and in a lot of pain and getting more dehydrated and with a very high blood pressure for many hours.)

    I have definitely been traumatised by my GP's casual categorisation, and I know that it has affected my health. I know I now wait too long to get medical care.

    I need to write my GP a letter of complaint. I need to find a new doctor. But I don't. Most doctors in my region aren't taking new patients, and I'm sure that, even if they are, they will see the 'health anxiety' in my records and won't take me on. I think there is one GP who takes ME/CFS patients, but she seems to offer pseudosciencey type treatments. I don't think we'd get on.

    I'm angry about the unfairness of all this. But most of the time I just don't want to think about the label applied to me and I don't want to put myself in harm's way again.

    Maybe I'll cite this paper in the letter I write to my doctor.
     
    Last edited: Mar 3, 2025
  5. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights) Staff Member

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    There's a Reddit thread in r/science with 4000 4100 upvotes. What are the odds it doesn't appear in r/medicine?
     
  6. Utsikt

    Utsikt Senior Member (Voting Rights)

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    I’m sorry to hear that, @Hutan

    I’m in a similar spot. My main concern about reaching out to new HC workers is how much gaslighting I have to deal with. Especially when my carers don’t fully understand my condition and the scientific methods.
     
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  7. Hutan

    Hutan Moderator Staff Member

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    That's a horrifying thread.
     
  8. Yann04

    Yann04 Senior Member (Voting Rights)

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    I thought you meant it’s horrifying in the sense it was taken over by psychobehaviouralists. Just to clarify for people who don’t feel like clicking the link, it’s horrifying because so many people share experiences of psychosomatic misfiagnosis.
     
  9. NelliePledge

    NelliePledge Moderator Staff Member

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    I wonder if the authors would be interested in expanding into ME/CFS, LC?
     
  10. forestglip

    forestglip Senior Member (Voting Rights)

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    It's there now: Link
     
  11. rvallee

    rvallee Senior Member (Voting Rights)

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    I mentioned it a few times before, but when the topic of medical gaslighting comes up on random discussions in forums with zero relevance to health, let alone to discriminated chronic illnesses, stories like this are very common. And they balloon out unless the first responses are from physicians who feel the need to mock it. This is a huge problem that medicine has intentionally nurturing and growing for decades, and it will only get worse over time as electronic records act as a brand on people, a mark that says "do not help". There is no escaping the mark.

    This all exposes the lie of the so-called Hippocratic oath, that it's just a bunch of words with no force behind them. It's not even ironic that it makes people's mental health worse, it's by design. It's not what they want that design to lead to, but it's what it's designed to produce. They do harm. By choice. Lots of it. Clinical psychology is decades away from being actionable. If it ever really will. The tools are too primitive and mediocre.

    And that's before you consider the criminality of how this makes good research impossible, keeping people in misery indefinitely. When the medical profession chooses to go along with delusional fantasies about some illnesses, they stop working on them. This has the same consequences, and so should have the same punishment, as outright fraud. It's also philosophically the same failure of preferring divine explanations and thus refusing to deal with reality as it is. It's wrong on so many levels: humanly, philosophically, professionally, ethically and morally. It's basically nothing but wrong with zero clear benefits.

    It's actually understood well enough that this argument has been made a lot about the lost decades on Alzheimer's research caused by fraudulent research. And in the case of psychosomatic blocks it's far more egregious, as fraud goes it's 100x worse than what Theranos did. Almost every Theranos investor got their money back. None of us get our lives back, certainly not the money and life experience we lost. That loss is permanent, and entirely intentional. The intention being 19th century delusional models based on a toxic mix of mysticism and narcissism.
     
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  12. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights) Staff Member

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    The r/science thread was posted 18 hours ago. That thread has 8000 upvotes and 503 comments.

    The r/medicine thread was posted 10 hours ago. It has 43 upvotes and 35 comments.
     
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  13. Yann04

    Yann04 Senior Member (Voting Rights)

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    I don’t dare to take a peak.
     
  14. SNT Gatchaman

    SNT Gatchaman Senior Member (Voting Rights) Staff Member

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    Well in the spirit of "it was the best of times, it was the worst of times" here are two example comment chains.

    First on the positive —



    Second

     
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  15. Utsikt

    Utsikt Senior Member (Voting Rights)

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    I’ll give you the positives!

    There are some sympathetic healthcare workers that have experienced this themselves, and even someone pointing out the fact that a high degree of healthcare avoidance in the paper is the complete opposite of the usual narrative in the sub about ‘psychosomatic patients’ that keep returning for the same issues.
     
  16. Utsikt

    Utsikt Senior Member (Voting Rights)

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    For reference, r/science has 33 million users, r/medicine has 0.5 million.
     
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  17. Yann04

    Yann04 Senior Member (Voting Rights)

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    though the upvote to comment ratio difference shows that r/medicine deems the paper far more controversial. Also thanks for the positives summary Utsikt and SNT
     
    Last edited: Mar 3, 2025
  18. rvallee

    rvallee Senior Member (Voting Rights)

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    It's really odd that some comment on health care avoidance when it's one of the main targets in psychosomatic ideology, and that, of course, this is common. The problem they are making is that they assume that people can tell psychosomatic illnesses from 'real' illnesses, and so would only avoid health care for psychological issues, not 'real' ones. Which shows how very few MDs actually believe the public-facing lies about how they 'feel' just as real. Most don't believe that, they say it anyway because it reassures themselves.

    But, no. It comes with it, it's mixed and baked in the cake mix. They never seem to get that, and of course it's a huge problem, but it's not politically possible to get reliable data on this, because no one wants to find that out. But, oh yeah, you're damn right there are millions of babies out there thrown out with the bathwater. You can't run an industrial scale pump-and-dump system without it. This is not a profession that handles uncomfortable truths well.
     
  19. Utsikt

    Utsikt Senior Member (Voting Rights)

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    Huh, the thread in r/medicine is locked now, and I believe it’s only accessible through the link. r/science is still up, but the thread has died down.

    There are a few removed comments with references to rules about ‘no personal medical stories’, and a heated debate regarding FND.

    It doesn’t seem like there was much discussion about the actual paper, which is a shame. So I assume the mods locked it down before things got even more off track. Understandable decisions IMO.

    This reminds me of why I deleted reddit and mostly spend my time here: it’s a lot easier when everyone tries to discuss the same topic. And the mods do a fantastic job by moving posts to other threads if needed.
     
  20. bobbler

    bobbler Senior Member (Voting Rights)

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    I’m sorry you are stuck being treated this way

    I think everyone used to know this is just a thin excuse for staff to provide bad treatment- and the bad treatment/bottom of list comes first , strangely except for inside medicine . It would be fascinating to have someone researching how these code terms really work and how many believe them, how many see through them completely (and take it as saying more about the person who wrote it than the patient) and how many just effectively take on someone else’s ‘grudge’ for them without being curious about the real reason whether it is warranted.

    it’s bonkers that it’s allowed these days guven data protection and FOI rights etc everywhere else . But the idea psychosomatic is real lingering as emperors new clothes seems to act as an excuse/cover up for all sorts
     
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