>"Then, when they finally go to the doctor, their list of self-reported symptoms is no longer a list of what they independently noticed but a laundry list of whatever they read on webmd."
Sure, it happens all the time, in all areas of medicine. Not just psychiatry. The key here is that when someone says "I'm depressed," or "I have 5 of 9 criteria of a Major Depressive Episode," or "I have gout," that does not mean that the diagnostic evaluation is over. It's important to get clear examples of what people have noticed. Despite their conclusion, is this better explained by cancer, or anxiety, or a thyroid problem, or substance abuse? Like migraine, psychiatric illness is evaluated clinically rather than by imaging or lab tests, but there can be important overlaps that sometimes make these tests helpful to rule out other causes.
A patient's own conclusion is an important piece of the puzzle, but it's still just one piece.
Sure, it happens all the time, in all areas of medicine. Not just psychiatry. The key here is that when someone says "I'm depressed," or "I have 5 of 9 criteria of a Major Depressive Episode," or "I have gout," that does not mean that the diagnostic evaluation is over. It's important to get clear examples of what people have noticed. Despite their conclusion, is this better explained by cancer, or anxiety, or a thyroid problem, or substance abuse? Like migraine, psychiatric illness is evaluated clinically rather than by imaging or lab tests, but there can be important overlaps that sometimes make these tests helpful to rule out other causes.
A patient's own conclusion is an important piece of the puzzle, but it's still just one piece.