According to an article published in the March 2021 issue of the journal Society and Mental Health, diagnostic standards are consequential, as diagnoses can label and stigmatize, while conferring or denying access to social resources. Diagnostic criteria also are fluid and malleable, with the boundaries between health and illness subject to redefinition and reorganization. Technology may be an engine driving such redefinition of diagnoses. Viewed from that perspective, science and technology can create, reveal, or redefine disorders, making some diagnoses possible while hindering others. In this article, the author engages with the intersection of science and diagnosis by demonstrating how the prodrome, an emerging phase of illness characterized by neuroscientific research, creates problems for patients, their families, and health care institutions. In biomedical research, the prodrome is a period wherein someone experiences some symptoms of an illness before meeting formal diagnostic criteria. The prodrome ends once a patient meets formal criteria and is diagnosed with a disorder. It is of biomedical interest because these symptoms might provide advanced notice of impending illness.
The focus of this particular article is on Huntington Disease (HD), while acknowledging that neuroscientific research suggests the presence of prodromal phases for a growing list of conditions, including schizophrenia and autism. In this instance, the prodrome is examined from the standpoint of its social, experiential, and institutional consequences. Based on interviews with individuals and their informal caregivers, an explanation is provided regarding how the prodrome is a site of healthcare disadvantage. Although participants suffer from psychiatric and cognitive prodromal symptoms (e.g., hallucinations, mood changes) and associated challenges (e.g., job loss), they do not receive necessary support because they do not meet formal diagnostic criteria. The prodrome is viewed as being connected to: (1) the inability to access health care, (2) the inability to access health resources, (3) the depletion of personal resources, and (4) extensive caregiver burden and burnout. The HD prodrome also provides a contrast to research on the negative repercussions of diagnostic expansion, as prodromal individuals report struggling with symptoms that are well-characterized in neuroscientific research, but remain unacknowledged and under supported by health care institutions. An argument is advanced that prodromal individuals are shut out of health services as a result of such institutional ambiguities.
More February 2021 TRENDS Articles
PALIMSEST
Discusses how this term can be viewed metaphorically in considering how topics are updated and revised in successive issues of the newsletter TRENDS. Read More
AMERICAN RESCUE PLAN AND COVID-19
Lists how separate components of various congressional bills are combined into overall reconciliation legislation. Read More
HEALTH REFORM DEVELOPMENTS
Looks at how an incoming new Administration goes about reversing policies established by the previous set of office holders. Read More
DEVELOPMENTS IN HIGHER EDUCATION
Points out some ramifications associated with making it free to attend public institutions, reduce student debt, and control the spread of coronavirus on campus. Read More
QUICK STAT (SHORT, TIMELY, AND TOPICAL)
Sexual Orientation Disparities In Risk Factors For Adverse COVID-19-Related Outcomes
Instant Death More Common In Absence Of Physical Exercise
Identifying Candidates For Drug Repurposing For SARS-CoV-2
Affordable CRISPR App Reveals Unintended Mutations At Site Of CRISPR Gene Repair Read More
OBTAINABLE RESOURCES
Voluntary Support Of Education
National Healthcare Quality And Disparities Report
50-State Survey Of Telehealth Commercial Insurance Laws Read More
THE PRODOME: DIAGNOSIS, DISADVANTAGE, AND BIOMEDICAL AMBIGUITY
Examines how the prodome as an emerging phase of illness can create problems for patients, their families, and health care institutions. Read More
IMPLICATIONS OF GENETIC TESTING FOR SUICIDE RISK
Pertains to a discussion regarding the possibility that polygenic risk scores eventually may be used regarding suicide death and some concerns once any product is commercialized and marketed directly to consumers. Read More