Author: Brodie McGhie-Fraser.
Diagnoses are an important part of healthcare, used to categorise people as having or not having a particular health condition. While a diagnosis has potential to provide explanation for symptoms, open treatment pathways or access statutory rights, it can also become a stigmatising label. A diagnosis may affect the identity for a patient, their relationship with healthcare professionals, or how they interact with the people around them.
For functional disorders, diagnostic terms are often used according to treatment specialities. Criteria and diagnosis rates vary between countries and are influenced by the expertise of healthcare professionals. This means that some patients who meet the diagnostic criteria for functional disorders may not receive a formal diagnosis. This raises questions about the factors influencing diagnosis and the implications of this for patients.
A recent study in Denmark (Tattan et al., 2024) aimed to examined factors associated with having received three types of functional disorder diagnoses (fibromyalgia, chronic fatigue syndrome, or irritable bowel syndrome). The study used data from the Danish Study of Functional Disorders (DanFunD), exploring associations of people who had previously received a diagnosis of functional disorder by a healthcare professional. This was done both through self-reported symptom questionnaires and diagnostic interviews.
Their results showed strong associations with female sex, negative illness perceptions, and with poorer health-related quality of life. The study found weaker and less consistent associations with lower socioeconomic status, higher anxiety and exposure to adverse life events, and no associations with health anxiety, depression, kinesiophobia and physical activity.
This study provided evidence that associations with receiving a functional disorder diagnosis go beyond the symptoms that are being presented. There are several potential explanations for this, which could include fewer diagnostic interventions for female patients with similar symptoms, leading to a higher likelihood of functional disorder diagnosis, or diagnoses being based on stereotypes of patients. This also means that other patients might be disadvantaged by not receiving a diagnosis and appropriate treatment for their functional disorder.
While further research could analyse these associations in other large population based cohorts, particularly the use of diagnostic labels as symptoms develop over time, this study represents an important step in understanding what factors influence the receiving of a diagnosis. With greater knowledge about diagnosis, we can ensure that people with functional disorders can receive appropriate and timely treatment.
Brodie McGhie-Fraser is a PhD-student working at the Department of Primary and Community Care, Radboudumc, as part of the ETUDE program.
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This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 956673. The article reflects only the author’s view, the Agency is not responsible for any use that may be made of the information it contains.