Around half of people who are diagnosed with schizophrenia may just have anxiety, research suggests.
Only 26 of 54 patients who had been diagnosed with the mental disorder actually had it when they were checked over by a specialist.
And the remaining patients were simply battling anxiety, according to the scientists who delved into schizophrenia.
The researchers have now warned doctors are too quick to diagnose patients with the disorder when they complain of ‘hearing voices’.
They said this is often a ‘fleeting phenomenon with little significance’ and does not automatically mean the person has the severe mental-health condition.
Around half of people who are diagnosed with schizophrenia just have anxiety (stock)
The research was carried out by Johns Hopkins University and led by Dr Russell Margolis, clinical director of the Johns Hopkins Schizophrenia Center.
Study author Krista Baker, manager of the adult outpatient schizophrenia services at Johns Hopkins Medicine, said: ‘Because we’ve shined a spotlight in recent years on emerging and early signs of psychosis, diagnosis of schizophrenia is like a new fad.
‘And it’s a problem especially for those who are not schizophrenia specialists because symptoms can be complex and misleading.
‘Diagnostic errors can be devastating for people, particularly the wrong diagnosis of a mental disorder.’
WHAT IS SCHIZOPHRENIA?
Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves.
People with schizophrenia may seem like they have lost touch with reality.
The cause of schizophrenia is not understood and it is believed to be a mix of genetics (hereditary), abnormalities in brain chemistry and/or possible viral infections and immune disorders.
Symptoms of schizophrenia usually begin between ages 16 and 30. In rare cases, children have schizophrenia too.
The symptoms of schizophrenia fall into three categories: positive, negative, and cognitive.
Positive symptoms are disturbances that are ‘added’ to the person’s personality and include:
- Thought disorders (unusual or dysfunctional ways of thinking)
Negative symptoms are capabilities that are ‘lost’ from the person’s personality and include:
- ‘Flat affect’ (reduced expression of emotions via facial expression or voice tone)
- Reduced feelings of pleasure in everyday life
- Difficultly beginning and sustaining activities
Cognitive symptoms are changes in their memory or other aspects of thinking and include:
- Trouble focusing or paying attention
- Problems with ‘working memory’
- Poor ability to understand information and use it to make decisions
Figures suggest around one percent of the world population suffers from schizophrenia with around two million in the US.
Source: National Institute of Mental Health
Schizophrenia is thought to affect up to 0.25-to-0.64 per cent of people in the US, according to the National Institute of Mental Health.
And in the UK, around 220,000 people are being treated for the mental-health condition on the NHS at any one time, Living with Schizophrenia statistics reveal.
Common symptoms include hallucinations, delusions and muddled thoughts.
Diagnosing psychotic disorders early is ‘vital in reducing dysfunction, morbidity and mortality’, the authors wrote in the Journal of Psychiatric Practice.
However, this can be tricky to get right, with an incorrect diagnosis potentially having ‘significant consequences’.
To uncover the extent of schizophrenia misdiagnoses, the researchers analysed 78 patients who were referred to the Johns Hopkins Early Psychosis Intervention Clinic between February 2011 and July 2017.
The patients, who had an average age of 19, were referred to the clinic by psychiatrists, primary care physicians, nurses, outpatient psychiatric centres, neurologists or psychologists.
The participants, and their families, underwent in-depth interviews and tests, including physical examinations, by the researchers.
Although 54 of the patients had previously been diagnosed with a form of schizophrenia spectrum disorder, the scientists concluded just 26 actually had the condition.
And the remaining patients had anxiety or a mood disorder.
The researchers worry doctors are too quick to diagnose schizophrenia when a patient reports hearing voices in their head.
‘Hearing voices is a symptom of many different conditions, and sometimes it is just a fleeting phenomenon with little significance,’ Dr Margolis said.
‘At other times when someone reports “hearing voices” it may be a general statement of distress rather than the literal experience of hearing a voice.
‘The key point is hearing voices on its own doesn’t mean a diagnosis of schizophrenia.’
Dr Margolis blames the mistakes on doctors using computer programmes to reach certain diagnoses via pull-down menus, which he called ‘checklist psychiatry’.
‘The big take-home message from our study is that careful consultative services by experts are important and likely underutilised in psychiatry,’ he said.
‘Just as a primary care clinician would refer a patient with possible cancer to an oncologist, it’s important for general mental health practitioners to get a second opinion from a psychiatry specialty clinic.
‘This may minimise the possibility that a symptom will be missed or overinterpreted.’
The researchers stress, however, they only analysed patients from one clinic.
But, they add, if further studies confirm their finding, it could ‘support the belief that overdiagnosis may be a national problem’.