Diaguessnosis and Agnosis

Diaguessnosis is a condition that often afflicts psychiatrists, whilst agnosis is commonly found amongst psychological therapists, but sometimes they coexist. They have in common that the person doesn’t know who or what they are dealing with. It is debateable whether they are in fact different conditions, and a transdiagnostic approach might suggest the common feature is a deficit in understanding the contribution of a standardised reliable diagnosis.

I first heard the term diagussnosis used a few weeks ago by Stephen Fry on Radio 4 when he was interviewing a comedienne and fellow mental health sufferer. She said that she had been given so many labels for her ?bipolar disorder that  she thought that professionals engaged in diaguessnosis rather than diagnosis.

Shortly afterwards I saw a lady, Ms A who was injured and scarred at work, she had a telephone IAPT interview and was told she needed CBT. But when a face to face appointment came to pass it was decided she needed counselling. Ms A had 4 counselling sessions, missed a session and could not be bothered to ring to make the missed appointment, she was frustrated that the focus had been on different family members reactions to her scarring.  Further she was offered no diagnosis. This illustrated to me that generally the psychological practitioners maintain a rigid agnosticism about diagnosis with occasional forays into diaguessnosis.

I concluded that she met DSM-5 criteria for a chronic adjustment disorder, this led to a profitable discussion of the better and worse ways of playing her difficulties.

Dr Mike Scott

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