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

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Author: Eduardo Duran
Date: July 2021
From: Social Science & Medicine(Vol. 280)
Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 247 words

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Abstract :

Keywords Rare disorders; Self-diagnosis; Clinical uncertainty; Engaged patienthood; Derealization/depersonalization Highlights * Patients affected by rare illnesses typically confront diagnostic odysseys. * Information democratization may diminish diagnostic delays for atypical illnesses. * Patients subject to clinical uncertainty may claim possession over their diagnosis. * Under clinical uncertainty, clinicians may lose legitimacy as diagnosticians. * Diagnostic slippage gives depersonalization/derealization a new lease on life. 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. Author Affiliation: University of California, Los Angeles Department of Sociology 375 Portola Plaza, Los Angeles, CA, 90095, USA Article History: Revised 7 May 2021; Accepted 17 May 2021 Byline: Eduardo Duran [e.duran@ucla.edu]

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Gale Document Number: GALE|A664973776