Cancer, autism, and long covid: The "over-diagnosis" crisis
Mar 20, 2025
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Dr. Suzanne O'Sullivan, a seasoned neurologist from London's National Hospital and author of "It's All in Your Head," dives into the pressing issues of over-diagnosis in health. She highlights that 1 in 10 in England believe they have long COVID and questions the potential dangers of over-medicalization in mental health. O'Sullivan also discusses the complexities surrounding autism diagnoses and the need for nuanced understandings of health conditions to avoid mislabeling and unnecessary stigma. Her insights encourage a more holistic approach to health care.
Overdiagnosis is increasingly identifying healthy individuals as patients, leading to unnecessary treatments and heightened health anxieties throughout society.
The rise of Long COVID demonstrates how societal narratives can shape illness definitions, with many symptoms arising from psychosomatic sources rather than physiological ones.
Mental health support should prioritize addressing emotional and social well-being over medical labels, ensuring resources reach those in genuine need without additional stigmatization.
Deep dives
Understanding Overdiagnosis
Overdiagnosis is defined as when a diagnosis does not benefit the person receiving it, regardless of whether the diagnosis itself is correct. This issue applies to both mental and physical health, with an increasing number of healthy individuals being labeled as patients due to misinterpreted health criteria. For example, the medical community has adjusted benchmarks for conditions like high blood pressure and diabetes, systematically turning more individuals into patients to prevent strokes and other complications. While some patients benefit from early interventions, a larger population faces unnecessary treatments and health anxieties from being labeled as sick.
The Impact of Screening Practices
Current screening practices often catch mild cases of diseases, leading to treatments for conditions that might never have developed into serious health issues. Advances in detection technology allow for the identification of abnormal cells that do not necessarily lead to cancer, yet all detected cases are treated as such. For instance, in breast cancer screening, only a fraction of those treated may have experienced significant progression of the disease. This practice results in many healthy individuals receiving unnecessary treatments, raising concerns about the overall cost to the healthcare system and the mental health of those involved.
Consequences of Mislabeling Health Conditions
Labeling individuals with medical conditions can have profound psychological effects, often altering their relationship with their own health. When healthy individuals are informed that they have a disease, it can create anxiety and lead to a distorted perception of their wellbeing. This shift in focus can lead to a cycle of health anxiety where normal bodily sensations are interpreted as symptoms of more serious conditions. The repercussions extend beyond psychological impacts, as individuals may face unnecessary treatments that can exacerbate their health and well-being.
The Case of Long COVID
The emergence of Long COVID underscores the complexities surrounding illness definitions and diagnoses following the pandemic. Initially termed in response to social media narratives, this condition quickly gained political and medical recognition without extensive scientific validation. As more research emerges, it appears that a significant number of individuals applying the Long COVID label have psychosomatic symptoms rather than direct physiological consequences of the virus. This trend highlights the importance of critically examining how societal anxieties and media engagement can shape our understanding of health conditions.
Reevaluating Mental Health Diagnoses
The current mental health landscape often requires medical diagnoses to access support, complicating the treatment of those in need. Initiatives to provide assistance should focus on recognizing individual struggles without necessitating medical labels, facilitating support systems that address emotional and social wellbeing. This approach advocates for better resource allocation towards high-risk individuals, especially those from disadvantaged backgrounds, rather than medicalizing normal challenges. Striking a balance between recognizing genuine medical issues and addressing societal factors will strengthen mental health support systems for all.
Award-winning author Dr. Suzanne O’Sullivan discusses her new book The Age of Diagnosis, and some curious cases of “over-diagnosis”.
1 in 10 in England now believe they have long Covid. The UK’s new Health Secretary, Wes Streeting, now says mental health is being “over-diagnosed”. Is Trump and RFK Jr’s aggressively sceptical approach to public health the way forward? Are trends in neurodivergent and autism identification becoming a problem? Are we living in The Age of Diagnosis?
