Diagnostic Overshadowing

Diagnostic overshadowing is the attribution of a person's physical or behavioral symptoms to an existing psychiatric diagnosis or intellectual disability, rather than a proper evaluation of what might actually be causing them, so that a genuine additional condition goes unrecognized. Once a patient carries a confirmed diagnosis, clinicians can develop a tendency to attribute any new symptom or behavior to that same diagnosis rather than investigating further, a documented example being a patient who was diagnosed with a psychiatric problem and medicated for head-banging behavior when the actual cause was an undiagnosed dental abscess the patient could not otherwise communicate. The World Health Organization has identified diagnostic overshadowing as one contributor to the substantially lower life expectancy of people with intellectual or mental health disabilities, whose life expectancy is roughly sixteen years shorter than that of the general population, in part because of higher rates of undertreated diabetes, hypertension and obesity alongside barriers to quality healthcare.