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Child and Adolescent Psychiatry and Mental Health
Published in: Child and Adolescent Psychiatry and Mental Health 1/2017

Open Access 01-12-2017 | Review

Overdiagnosis of mental disorders in children and adolescents (in developed countries)

Authors: Eva Charlotte Merten, Jan Christopher Cwik, Jürgen Margraf, Silvia Schneider

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2017

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Abstract

During the past 50 years, health insurance providers and national registers of mental health regularly report significant increases in the number of mental disorder diagnoses in children and adolescents. However, epidemiological studies show mixed effects of time trends of prevalence of mental disorders. Overdiagnosis in clinical practice rather than an actual increase is assumed to be the cause for this situation. We conducted a systematic literature search on the topic of overdiagnosis of mental disorders in children and adolescents. Most reviewed studies suggest that misdiagnosis does occur; however, only one study was able to examine overdiagnosis in child and adolescent mental disorders from a methodological point-of-view. This study found significant evidence of overdiagnosis of attention-deficit/hyperactivity disorder. In the second part of this paper, we summarize findings concerning diagnostician, informant and child/adolescent characteristics, as well as factors concerning diagnostic criteria and the health care system that can lead to mistakes in the routine diagnostic process resulting in misdiagnoses. These include the use of heuristics instead of data-based decisions by diagnosticians, misleading information by caregivers, ambiguity in symptom description relating to classification systems, as well as constraints in most health systems to assign a diagnosis in order to approve and reimburse treatment. To avoid misdiagnosis, standardized procedures as well as continued education of diagnosticians working with children and adolescents suffering from a mental disorder are needed.
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Metadata
Title
Overdiagnosis of mental disorders in children and adolescents (in developed countries)
Authors
Eva Charlotte Merten
Jan Christopher Cwik
Jürgen Margraf
Silvia Schneider
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2017
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-016-0140-5

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