UCC lecture:Depression and other psychological disorders are overdiagnosed in the Republic, resulting in inappropriate treatment, a leading psychiatrist will say in a keynote lecture tomorrow.
Giving the Last Lecture at University College Cork, part of a series of lectures to mark Cork's year as European City of Culture, Prof Patricia Casey will say she is concerned that about twice as many people as require them are being prescribed antidepressants.
The professor of adult psychiatric at University College Dublin also claims that post-traumatic stress disorder (PTSD) and attention deficit hyperactivity disorder (ADHD) are overdiagnosed. "By overdiagnosing and overtreating we are robbing people psychologically of their own resolution to difficulties," Prof Casey told The Irish Times yesterday.
She said she was also concerned that by overutilising therapists, there was a danger of causing further illness. "Critical incident stress debriefing, which is used after trauma, can upset a person's normal responses of resolution, so that PTSD becomes more rather than less likely," she said.
But she said there was "no harm" in interventions such as cognitive behavioural therapy, apart from the resulting "waste of time and money".
Asked what were the implications of overdiagnosing psychological illness, Prof Casey said medications had side-effects. "Serotonin selective reuptake inhibitors [ the first-line treatment for depression] causes dyspepsia and headache. They also cause a discontinuation syndrome [ nausea, pins and needles and anxiety] when a person comes off treatment. And the older tricyclic antidepressants cause cardiac side-effects."
She said there were also service and financial implications: "Decision-makers in government become dubious about the veracity of the claims made for service need if the prevalence of a disorder lacks credibility." She called for more focused research into the aetiology of psychological disease to include neuroimaging and genetic approaches.
In relation to ADHD, Prof Casey said there was a possibility the condition was being overdiagnosed in children.
"While there is no scientific evidence, there has been a huge increase in Ritalin [ a drug used to treat ADHD] prescribing in the UK."