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Matter over mind: How mental health symptom presentations shape diagnostic outcomes.

Authors
  • Tate, Alexandra1
  • 1 The University of Chicago, Chicago, IL, USA.
Type
Published Article
Journal
Health (London, England : 1997)
Publication Date
Nov 01, 2020
Volume
24
Issue
6
Pages
755–772
Identifiers
DOI: 10.1177/1363459319834991
PMID: 30939931
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Mental health disorders face less stigma today than in the past, yet they continue to be misdiagnosed and at times improperly treated. One account for this problem is that physicians rely exclusively on a verbal interview of patients for diagnosis. Because this diagnostic method is likely to be shaped by the way patients present their symptoms, it is critical that we examine whether and how patients' communication practices shape diagnostic and treatment outcomes. This study examines a sample of 14 encounters involving mental health-related symptoms from a dataset of adult primary care visits. Using conversation analytic methods, I show that when patients present mental health symptoms by simply describing the symptoms, primary care physicians exhibit a preference for providing a physical health diagnosis. Conversely, when patients provide a concrete link between their symptoms and the way the symptoms are disrupting their everyday lives, primary care physicians typically provide a mental health diagnosis.

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