Psychological disorders going undiagnosed, study says
Published Friday, February 10, 2012 7:24AM EST
Serious mood and anxiety disorders, including depression and bipolar disorder, are being missed in troublingly high numbers, Canadian research suggests, leaving patients to go without treatment and suffer with symptoms for years.
For their study, the researchers interviewed 800 patients who were sitting in the waiting rooms at seven different family doctors' offices in Ontario, Nova Scotia and British Columbia.
The patients were given a survey known as the Mini International Neuropsychiatric Interview (MINI), a 15-minute test designed to help doctors diagnose various psychiatric disorders.
Of the patients who met the criteria for a psychiatric illness, many had never been diagnosed, including:
- 65.9 per cent with a major depressive disorder
- 92.7 per cent with bipolar disorder
- 85.8 per cent with panic disorder
- 71.0 per cent with generalized anxiety disorder
- 97.8 per cent with social anxiety disorder
The researchers classified patients as having been "misdiagnosed" if they met the criteria for a psychological disorder but there was no evidence of a diagnosis in their medical charts.
"With high prevalence rates and poor detection, there is an obvious need to enhance diagnostic screening in the primary care setting," the authors conclude in an abstract that accompanies their findings.
Sari Alter knows the pain of having a mental disorder go undiagnosed and the suffering that goes without proper treatment.
She spent seven years enduring the emotional highs of her manic phases in the summer months followed by depression in the winter, before finally being told she had bipolar disorder.
She was misdiagnosed several times.
"I was very confused before because I did not know what was wrong with me," Alter told CTV News.
Alter said it was a "relief" when she was finally diagnosed and began to treat her illness. She is well enough that she now volunteers at the Mood Disorders Association offices in Toronto.
Researcher Dr. Martin Katzman of Toronto's Clinic for Mood and Anxiety Disorders said society would not accept patients being misdiagnosed and untreated for health problems such as diabetes or heart disease.
Lead study author Dr. Monica Vermani said patients are not being left undiagnosed because doctors are not adequately trained to spot the diseases. Rather, it may be a question of being pressed for time.
As well, Vermani said patients often present with physical symptoms and are referred for diagnostic tests that don't reveal the true nature of their problem.
"Often times the family physician tries to treat the illness, not to explore the psychological cause of the physical illness," Vermani told CTV.
The consequences, Vermani says, include patients self-medicating with drugs and alcohol because their symptoms become too much to bear. This type of behaviour can lead people to stop socializing with friends and family, and make it difficult to work.
The researchers are now trying to develop a new, simple diagnostic test that makes it easier for doctors and nurses to spot mental health issues in their patients.
With a report from CTV's medical specialist Avis Favaro and producer Elizabeth St. Philip