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

Eduardo Duran

Social Science & Medicine, 2021, vol. 280, issue C

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.

Keywords: Rare disorders; Self-diagnosis; Clinical uncertainty; Engaged patienthood; Derealization/depersonalization (search for similar items in EconPapers)
Date: 2021
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DOI: 10.1016/j.socscimed.2021.114054

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