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2 thoughts on “Improving Diagnostic Accuracy: Medical Mimicry, Part 1

  • June 17, 2020 at 11:10 am
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    When I do an initial assessment and a client informs me of any type of concern, I always ask them when they last had a complete physical examination by a medical professional to rule out any underlying medical condition which might mimic a mental health disorder. I’m surprised to read this is not a common protocol.

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    • June 17, 2020 at 4:17 pm
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      Hi Tom, and thanks for reading! Sounds like you’re certainly covering the base, a sign of good training and practice. Given the blog’s focus is on newer practitioners, I chose to write on it because many students and supervisees, in my experience, forget about this given the psychogenic/non-physical lens we’re used to, as noted in the post. The exception seems to be people doing internships or working in emergency rooms, geriatric psych or other med-psych or neuropsychiatric facilities where they’re going to be more exposed to a medical etiology and it easily becomes ingrained in the interview. There is an interesting book, though written in 1996, called Preventing Misdiagnosis in Women by Klonoff and Landrine. The book illustrates some more complicated cases of psych misdiagnosis and suggests that it is a good idea to even ask about childhood medical history in detail in opening interviews, which may seem overboard for an adult patient, but can have its merits.

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