IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v280y2021ics0277953621003865.html
   My bibliography  Save this article

Diagnostic slippage: Medical uncertainty and engaged patienthood in the case of atypical disorders

Author

Listed:
  • Duran, Eduardo

Abstract

This study explores how patients affected by depersonalization/derealization disorder confront clinical uncertainty by investing in their own diagnosis and prognosis. While depersonalization/derealization has been a legitimate medical category within psychiatric nomenclature for decades, those affected by this condition have traditionally embarked on a diagnostic odyssey. As a rare disorder, clinicians have repeatedly misdiagnosed depersonalization/derealization as a byproduct of illnesses such as anxiety disorder, depression, or schizophrenia. Drawing from in-depth interviews, as well the analysis of videos and online posts, I explore the trajectory through which patients affected by depersonalization/derealization, dissatisfied with traditional diagnostic routes, have transformed the process of diagnostic revelation from a clinical prerogative to a lay accomplishment. This study indicates that a multifaceted process, consisting of a dialectical relation between the material reality of information democratization and a heightening cultural orientation towards engaged patienthood, may shorten diagnostic odysseys for people affected by atypical disorders and undermine physicians’ authority to diagnose.

Suggested Citation

  • Duran, Eduardo, 2021. "Diagnostic slippage: Medical uncertainty and engaged patienthood in the case of atypical disorders," Social Science & Medicine, Elsevier, vol. 280(C).
  • Handle: RePEc:eee:socmed:v:280:y:2021:i:c:s0277953621003865
    DOI: 10.1016/j.socscimed.2021.114054
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953621003865
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2021.114054?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Armstrong, Natalie & Hilton, Paul, 2014. "Doing diagnosis: Whether and how clinicians use a diagnostic tool of uncertain clinical utility," Social Science & Medicine, Elsevier, vol. 120(C), pages 208-214.
    2. Stockl, Andrea, 2007. "Complex syndromes, ambivalent diagnosis, and existential uncertainty: The case of Systemic Lupus Erythematosus (SLE)," Social Science & Medicine, Elsevier, vol. 65(7), pages 1549-1559, October.
    3. Lupton, Deborah, 1997. "Consumerism, reflexivity and the medical encounter," Social Science & Medicine, Elsevier, vol. 45(3), pages 373-381, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ebeling, Mary, 2011. "'Get with the Program!': Pharmaceutical marketing, symptom checklists and self-diagnosis," Social Science & Medicine, Elsevier, vol. 73(6), pages 825-832, September.
    2. Epstein, Steven, 2016. "The politics of health mobilization in the United States: The promise and pitfalls of “disease constituencies”," Social Science & Medicine, Elsevier, vol. 165(C), pages 246-254.
    3. Chiu, Stephen W.K. & Ko, Lisanne S.F. & Lee, Rance P.L., 2005. "Decolonization and the movement for institutionalization of Chinese medicine in Hong Kong: a political process perspective," Social Science & Medicine, Elsevier, vol. 61(5), pages 1045-1058, September.
    4. Setti Rais Ali & Paul Dourgnon & Lise Rochaix, 2018. "Social Capital or Education: What Matters Most to Cut Time to Diagnosis?," Working Papers halshs-01703170, HAL.
    5. Stefan Stremersch & Vardit Landsman & Sriram Venkataraman, 2013. "The Relationship Between DTCA, Drug Requests, and Prescriptions: Uncovering Variation in Specialty and Space," Marketing Science, INFORMS, vol. 32(1), pages 89-110, June.
    6. Dyer, Thomas Anthony & Owens, Janine & Robinson, Peter Glenn, 2014. "The acceptability of care delegation in skill-mix: The salience of trust," Health Policy, Elsevier, vol. 117(2), pages 170-178.
    7. Ewa Malchrowicz-Mośko & Joanna Poczta, 2018. "Running as a Form of Therapy Socio-Psychological Functions of Mass Running Events for Men and Women," IJERPH, MDPI, vol. 15(10), pages 1-15, October.
    8. Heritage, John & McArthur, Amanda, 2019. "The diagnostic moment: A study in US primary care," Social Science & Medicine, Elsevier, vol. 228(C), pages 262-271.
    9. Copelton, Denise A. & Valle, Giuseppina, 2009. ""You don't need a prescription to go gluten-free": The scientific self-diagnosis of celiac disease," Social Science & Medicine, Elsevier, vol. 69(4), pages 623-631, August.
    10. Allen, Dawn & Wainwright, Megan & Hutchinson, Thomas, 2011. "'Non-compliance' as illness management: Hemodialysis patients' descriptions of adversarial patient-clinician interactions," Social Science & Medicine, Elsevier, vol. 73(1), pages 129-134, July.
    11. Greenfield, Geva & Pliskin, Joseph S. & Feder-Bubis, Paula & Wientroub, Shlomo & Davidovitch, Nadav, 2012. "Patient–physician relationships in second opinion encounters – The physicians’ perspective," Social Science & Medicine, Elsevier, vol. 75(7), pages 1202-1212.
    12. Gutin, Iliya, 2022. "Not ‘putting a name to it’: Managing uncertainty in the diagnosis of childhood obesity," Social Science & Medicine, Elsevier, vol. 294(C).
    13. Shachar, Leeor, 2022. "“You become a slightly better doctor”: Doctors adopting integrated medical expertise through interactions with E-patients," Social Science & Medicine, Elsevier, vol. 305(C).
    14. Joyce, Kelly & Jeske, Melanie, 2020. "Using autoimmune strategically: Diagnostic lumping, splitting, and the experience of illness," Social Science & Medicine, Elsevier, vol. 246(C).
    15. Gaspar, Mark & Rosenes, Ron & Burchell, Ann N. & Grennan, Troy & Salit, Irving & Grace, Daniel, 2020. "Diagnosing uncertainty: The challenges of implementing medical screening programs for minority sub-populations in Canada," Social Science & Medicine, Elsevier, vol. 244(C).
    16. Persson, Asha & Newman, Christy, 2006. "Potency and vulnerability: Troubled 'selves' in the context of antiretroviral therapy," Social Science & Medicine, Elsevier, vol. 63(6), pages 1586-1596, September.
    17. Chinn, Deborah, 2011. "Critical health literacy: A review and critical analysis," Social Science & Medicine, Elsevier, vol. 73(1), pages 60-67, July.
    18. Prussing, Erica & Sobo, Elisa J. & Walker, Elizabeth & Kurtin, Paul S., 2005. "Between 'desperation' and disability rights: a narrative analysis of complementary/alternative medicine use by parents for children with Down syndrome," Social Science & Medicine, Elsevier, vol. 60(3), pages 587-598, February.
    19. Sarradon-Eck, Aline & Sakoyan, Juliette & Desclaux, Alice & Mancini, Julien & Genre, Dominique & Julian-Reynier, Claire, 2012. ""They should take time": Disclosure of clinical trial results as part of a social relationship," Social Science & Medicine, Elsevier, vol. 75(5), pages 873-882.
    20. Advocat, Jenny & Lindsay, Jo, 2010. "Internet-based trials and the creation of health consumers," Social Science & Medicine, Elsevier, vol. 70(3), pages 485-492, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:280:y:2021:i:c:s0277953621003865. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.