Why Schizophrenia May Be Overdiagnosed in America

By | April 24, 2019

Schizophrenia is a chronic and severe mental illness characterized by disordered thoughts, feelings and behavior. The condition affects less than 1 percent of the American population. But a new study published in the Journal of Psychiatric Practice reveals that the mental illness may, in fact, be overdiagnosed, reports Johns Hopkins Medicine.

For the investigation, researchers examined the data of 78 patients who were sent to a specialty clinic at Johns Hopkins Bayview Medical Center in Baltimore from 2011 to 2017. Referrals came from general psychiatrists, outpatient psychiatric centers, primary care physicians, nurse practitioners, neurologists and psychologists.

About 69 percent of these patients were men with an average age of 19. The majority (74 percent) were white. Consultations usually averaged three to four hours. The sessions included interviews with the patients and their families, physical exams, questionnaires and medical and psychosocial histories.

Fifty-four of the patients arrived at the clinic with a predetermined diagnosis of schizophrenia spectrum disorder. After meeting with clinicians, only 26 of these individuals received a confirmed diagnosis of schizophrenia spectrum disorder. Of the 54 cases, 51 percent were eventually re-diagnosed as having anxiety or mood disorders. In addition, symptoms of anxiety were notable in 14 of the misdiagnosed patients.

“The big take-home message from our study is that careful consultative services by experts are important and likely underutilized in psychiatry,” said Russell L. Margolis, MD, a professor of psychiatry and behavioral sciences and the clinical director of the Johns Hopkins Schizophrenia Center at the Johns Hopkins University School of Medicine.

Researchers suggested that hearing voices is another symptom that has contributed to the misdiagnosis of schizophrenia. Although this is a common expression of the disorder, it is also associated with many different conditions, Margolis cautioned.

Margolis recommends that for patients with confusing, complicated or severe conditions, general mental health practitioners get a second opinion from a psychiatry specialty clinic. This would “minimize the possibility that a symptom will be missed or overinterpreted,” he said.

Experts believe that further confirmation from additional studies could show that overdiagnosis of schizophrenia and other mental illnesses is a national problem.

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