Tate2020

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Tate2020
BibType ARTICLE
Key Tate2020
Author(s) Alexandra Tate
Title Matter over mind: How mental health symptom presentations shape diagnostic outcomes
Editor(s)
Tag(s) EMCA, Mental health, Physician-patient partnership, Primary care
Publisher
Year 2020
Language English
City
Month
Journal Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine
Volume 24
Number 6
Pages 755–772
URL Link
DOI 10.1177/1363459319834991
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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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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