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Who's read 'Age of Diagnosis' (overdiagnosis in Long Covid, ADHD, Lymes, autism, cancer screening)

437 replies

FrodoBiggins · 27/05/2025 23:42

Inspired by another thread, has anyone read/ listened to Suzanne O’Sullivan's new book Age of Diagnosis? I just finished it and found it so interesting. She's a high profile consultant neurologist.

Touches on Long Covid, Autism, ADHD, Lymes disease (all in terms of diagnostic debates) and also Huntingdons genetic testing and Cancer/ Alzheimers screening (along what benefits there are of knowing of a risk/ certainty of future illness, especially if there is no cure).

I'll quote from a review:

"in her outstanding new book O’Sullivan offers a third possibility; that variance in bodily and mental health is being unnecessarily medicalised and pathologised: “We are not getting sicker – we are attributing more to sickness.”
She describes a trinity of “overs”. Overdiagnosis, where a medical problem is treated when treatment might not be needed; overmedicalisation, where non-medical behaviours are turned into the business of doctors; and underlying both, overdetection: we are ever better at identifying signals of disease, sometimes earlier than necessary, when those indicators may not end up presaging the disease itself. Alongside balanced analysis of the epidemiological data on prostate and breast cancer, O’Sullivan examines the growth in behavioural conditions such as autism and ADHD. The tone is not sneering or dismissive, as debunkings of bad science so often can be. O’Sullivan is instead full of compassion, care and grace."

I believe it was also the Radio 4 Book of the Week. The full review quoted from above is here: https://www.theguardian.com/books/2025/mar/12/the-age-of-diagnosis-by-suzanne-osullivan-review-do-no-harm?CMP=Share_AndroidApp_Other

Has anyone else read it? Thoughts?

The Age of Diagnosis by Suzanne O’Sullivan review – do no harm

A doctor’s brilliant study of the dangers of overdiagnosis, from ADHD to long Covid

https://www.theguardian.com/books/2025/mar/12/the-age-of-diagnosis-by-suzanne-osullivan-review-do-no-harm?CMP=Share_AndroidApp_Other

OP posts:
FrodoBiggins · 28/05/2025 11:23

BlueTitFly · 28/05/2025 11:19

@L00pl00p

Absolutely! But can they get away with doing what they want - despite what the law states? Yes they can.

Also reasonable adjustments are not an absolute requirement. They have to be made if they can be, but can be avoided if the provider can prove it's too onerous/expensive/generally disproportionate.

OP posts:
BlueTitFly · 28/05/2025 11:22

@MyHouseInThePrairie

Yes I was talking more about ND and excluding children. Relating to my experience : which is 2 exclusions and an attempt to exclude my child before the age of 6.

Riaanna · 28/05/2025 11:22

BlueTitFly · 28/05/2025 10:58

@Riaanna

When a person receives a diagnosis it should benefit their quality of life and the diagnosis should be an accurate reflection of a person’s needs so they get the right support.
A diagnosis should not result in an individual being excluded from society, an individual being made to feel there is something wrong with them or detrimental assumptions being made about an individual.

I have no idea why you’re telling me any of this.

L00pl00p · 28/05/2025 11:20

BlueTitFly · 28/05/2025 11:19

@L00pl00p

Absolutely! But can they get away with doing what they want - despite what the law states? Yes they can.

Really! How?

BlueTitFly · 28/05/2025 11:19

@L00pl00p

Absolutely! But can they get away with doing what they want - despite what the law states? Yes they can.

MyHouseInThePrairie · 28/05/2025 11:18

BlueTitFly · 28/05/2025 10:58

@Riaanna

When a person receives a diagnosis it should benefit their quality of life and the diagnosis should be an accurate reflection of a person’s needs so they get the right support.
A diagnosis should not result in an individual being excluded from society, an individual being made to feel there is something wrong with them or detrimental assumptions being made about an individual.

Not all diagnosis lead to an improvement in quality of life or access to support though.
Because there are illnesses that don’t have treatment. And I’m not talking about ND here. I’m talking about LC, ME, ALS etc etc….

But getting a diagnosis is still essential. Because it names the issue. It’s not just in people’s head. It’s not them being lazy. Or anxious or whatever.

This author is just one of those arrogant doctors who dint listen to patients and think they know best. Not sure why. It’s like they feel they have a god given power to decide how people feel for them.

L00pl00p · 28/05/2025 11:18

TheAgileGoldPoet · 28/05/2025 11:15

What are you on about? They are actual statistics. So why do you think someone wouldn't meet the criteria 'just for ADHD?'.

The statistics are for people whose MAIN disability is adult ADHD, and they are awarded PIP as ADHD being the main disabling condition. Other conditions can and are mentioned but I don't know why you think someone would put a claim in for PIP with ADHD as their main disability if that wasn't the case?

Of course it also means some people will be receiving it for 'just' ADHD. I personally know people who are.

So considering you know so much and the very lengthy form so well, show me how just an ADHD diagnosis would rack up enough points and where you’d get the evidence from to back your claim?

PawsAndTails · 28/05/2025 11:15

Namechangedformyanswer · 28/05/2025 10:10

Wipe their own bottoms, dress themselves, massive life changing ocd behaviour meaning they cannot hold down any job, aggressive, non verbal, needing 3 to 1 support, very complex and life changing is different from many late diagnosed adults!

Yes, it's different. It doesn't mean the struggles of the other autistic adults should be negated or aren't difficult.

Barnets5pSlots · 28/05/2025 11:15

TheAgileGoldPoet · 28/05/2025 10:11

I think they were talking about adult ADHD, which is 100% being diagnosed in an hour by numerous private clinics.

Here's just one from a quick Google search, there are many others.

https://www.berkeleypsychiatrists.co.uk/lp/adhd-assessment#book

Adult ADHD assessment - 60-90 minutes.
Virtual - £745, in-person £1,045.

"The assessment typically takes 60 minutes"

So, really not hard and really not that expensive despite what other posters may claim.

It’s not an hour diagnosis though. The assessment may last an hour, but there will have been forms filled in beforehand that give the assessor context about the individual’s life and history; there will have been forms filled in by family members/other professionals. There may be medical/educational reports given. These all inform the assessment, it’s never just an isolated hour with no preparatory work

TheAgileGoldPoet · 28/05/2025 11:15

L00pl00p · 28/05/2025 10:46

Wouldn’t meat the PIP criteria for just ADhD. Hell I have both and don’t meat the criteria. Doesn’t mean they haven’t significantly impacted my life though.

And again you can’t get an autism diagnosis in an hour with a tick box form.

What are you on about? They are actual statistics. So why do you think someone wouldn't meet the criteria 'just for ADHD?'.

The statistics are for people whose MAIN disability is adult ADHD, and they are awarded PIP as ADHD being the main disabling condition. Other conditions can and are mentioned but I don't know why you think someone would put a claim in for PIP with ADHD as their main disability if that wasn't the case?

Of course it also means some people will be receiving it for 'just' ADHD. I personally know people who are.

FrodoBiggins · 28/05/2025 11:14

"the idea that autism is a sickness is offensive"

I'm not sure about the word 'sickness', to me that's being in bed with a flu or something, and eg I wouldn't say my cousin with Down Syndrome has a sickness but for sure he has a disability.

Would you consider it offensive to say that autism is a disability, at least for some? eg those who are non-verbal?

OP posts:
BadDinner · 28/05/2025 11:12

Onlyharmony · 28/05/2025 10:30

ADHD is actually underdiagnosed. See here: https://www.facebook.com/story.php?storyfbid=pfbid02zcdhEHgmLaykk4HjYpz5WGHXozPnv5YshncD1UZZnSF8QYrummwH2Hn9duj9psKBl&id=100068086362854

The waiting lists are huge and in west Yorkshire alone, the service has been stopped due to 10 years waiting list. People are fighting to be assessed so not really a sign of over diagnosing when you can't even get an assessment!

I'm so tired of this goady crap. I'm a late 30s woman, diagnosed late in life. Due to gender bias, women are massively under diagnosed as we present differently. The biggest diagnosis age group is my age group. Do you think women my age follow a trend? I wish this was a trend. I'm sick of myself, my life because of this shit. People who think it's over diagnosed politely don't know what they are talking about. If someone wants my life they can have it. I'm not medicated either.

Edited

I agree in principle and doctors like this make me sick. The entire profession of medical training needs a reevaluation. God complex needs to be removed from the system. It's making sick women's lives harder.

That said, I have struggled all my life with what I think is ADHD (which is essentially meaningless and my opinion) and my life is severely negatively affected. When I went to school it simply didn't exist in girls. That said I have not gone for a formal diagnosis (well I tried, but my borough does not do NHS adult assessments and I didn't push myself to try and obtain a private one) and the reason why is partly because I do think that ADHD in women is possibly not defined tightly enough and so you see so many influencers online doing 'trope' ADHD symptom presentation reels that read as essentially normal everyday things.

Of course women talk about things affecting them more than men do, it's why breast cancer has more public awareness than prostate cancer does, so it's not suprising that women discuss ADHD more as diagnosis in women has become more prevalent

But by the metric displayed (often on SM) it's not surprising that many people dismiss ADHD as being mental health cosplay (not my opinion). I find it frustrating and you do not get this sort of flippant attitude given regarding other neurological diagnosis and perhaps there needs to be a more serious tone about the entire thing.

L00pl00p · 28/05/2025 11:12

BlueTitFly · 28/05/2025 10:35

@Riaanna

But this nearly happened to my son.

With a SEN system in crisis, exclusions at an all time high, a school trying to exclude my child before they had even met him because they thought he had ASD, and two further exclusions in DS’s class already before the age of 6 - very, very open discussions need to be had around this and discussions shouldn’t be shut down.

We should NOT be excluding children. I also don’t think we should be labelling children. We should be meeting their individual needs and NOT giving them the impression that there is something ‘wrong’ with a child by our adult-defined labels and standards of ‘normality’.

It is illegal to deny a child a school place solely because they have autism. The Equality Act 2010 prohibits discrimination against disabled pupils, and autism is considered a disability under this act. Schools must make reasonable adjustments to ensure all pupils, including those with autism, can access education.

WhereIsMyJumper · 28/05/2025 11:06

I’m all for diagnosing if it helps the individual child cope better… and more importantly isn’t to the detriment of NT kids.
Surely we cannot change the entire education system to accommodate the few and exclude the many.
It’s the same argument someone made upthread about how you cannot accommodate ALL types of ND as they’re different and present differently.

I have seen threads on here when someone was told to remove her NT child from school after she was being touched inappropriately by an ND child. That blows my mind.
If the majority of children are able to thrive with the education system as it is, why would we want to change that? There needs to be far more support for ND kids I agree, but we cannot make the world fit around the few to the detriment of the many

BlueTitFly · 28/05/2025 10:58

@Riaanna

When a person receives a diagnosis it should benefit their quality of life and the diagnosis should be an accurate reflection of a person’s needs so they get the right support.
A diagnosis should not result in an individual being excluded from society, an individual being made to feel there is something wrong with them or detrimental assumptions being made about an individual.

Namechangedformyanswer · 28/05/2025 10:53

TheAgileGoldPoet · 28/05/2025 10:42

Exactly.

They say the Panorama expose was poor journalism when the programme was made because so many people working in the field, were saying it is a problem. And the programme proved that it is.

As do all of these companies doing these poor assessments, prove there is a problem and that misdiagnosis is happening which of course leads to over-diagnosis.

Yet all these myths still persist: "it's hard to get a diagnosis, it's expensive, nobody would want one, ADHD meds don't work if you don't have ADHD, you can't get disability benefits for ADHD, there are no financial or employment advantages to the diagnosis"

All false.

When I worked in the sector and was part of diagnosing someone with adult ADHD, the person would sometimes say 'so can I claim PIP?' and i'd say, you can try but PIP is based on really specific functional disability so it would be rare for someone with adult ADHD to get it unless there were other conditions.

I believed that to be true at the time but have since discovered that out of 500 plus conditions that can form a PIP claim, ADHD is the 14th most awarded as the main condition, with 41% of ADHD claimants getting the enhanced rate of both daily living and mobility awards.

As you can only claim PIP over 16 years old, we're essentially dealing with adults with ADHD and as adult ADHD has only been formally recognised as a condition in the UK since 2000 and by NICE since 2008, it's astonishing that it's risen to such a position in PIP benefit claims in such a short space of time.

Exactly. I've also worked in this area for many years. People won't believe what you or I say though, despite working in the area, just their own beliefs and despite evidence to the contrary.

TheAgileGoldPoet · 28/05/2025 10:52

Toootss · 28/05/2025 10:23

I am disappointed that checking for a diagnosis of adhd or autism with prisoners doesn’t seem to get mentioned.

If you fail at school I’m not sure how people are supposed to make a living these days.

If you have a low dopamine level due to ADHD you are more likely to drink, smoke, take risks, gamble, take drugs -to think that medication for a few hundred £ a year could fix some of the problems which have prisoners in jail and costing £40,000 a year. But no one seems to be following this up.

I don't know why you'd be disappointed with people not mentioning it on a chat forum about a book.

But to reassure you, when I worked in the Adult ADHD field I was part of leading trying to make that happen in the areas covered by my NHS trust and I made business plans to seek funding from NHS England for a specific service.

That didn't happen so I was using my own time quite often going into prisons to perform assessments and train staff to look for signs/symptoms.

That was a few years ago and I have since left that service as I got a more senior role and since I then, there are now specific specific neurodevelopmental teams covering the prisons in the areas covered by my NHS trust.

I believe it's happening in other areas too and if successful, i'd imagine they'll be rolled out nationwide.

https://www.gov.uk/government/news/greater-support-for-neurodivergent-offenders-in-bid-to-cut-crime is a good start and I believe more dedicated health teams are in the pipeline.

L00pl00p · 28/05/2025 10:47

Riaanna · 28/05/2025 10:22

The term over diagnosis is absurd. What are we suggesting people are being diagnosed who don’t have the condition they’re diagnosed with? Or that people should live with it and not be diagnosed? I wish this debate would stop.

This! It’s ridiculous .

L00pl00p · 28/05/2025 10:46

TheAgileGoldPoet · 28/05/2025 10:42

Exactly.

They say the Panorama expose was poor journalism when the programme was made because so many people working in the field, were saying it is a problem. And the programme proved that it is.

As do all of these companies doing these poor assessments, prove there is a problem and that misdiagnosis is happening which of course leads to over-diagnosis.

Yet all these myths still persist: "it's hard to get a diagnosis, it's expensive, nobody would want one, ADHD meds don't work if you don't have ADHD, you can't get disability benefits for ADHD, there are no financial or employment advantages to the diagnosis"

All false.

When I worked in the sector and was part of diagnosing someone with adult ADHD, the person would sometimes say 'so can I claim PIP?' and i'd say, you can try but PIP is based on really specific functional disability so it would be rare for someone with adult ADHD to get it unless there were other conditions.

I believed that to be true at the time but have since discovered that out of 500 plus conditions that can form a PIP claim, ADHD is the 14th most awarded as the main condition, with 41% of ADHD claimants getting the enhanced rate of both daily living and mobility awards.

As you can only claim PIP over 16 years old, we're essentially dealing with adults with ADHD and as adult ADHD has only been formally recognised as a condition in the UK since 2000 and by NICE since 2008, it's astonishing that it's risen to such a position in PIP benefit claims in such a short space of time.

Wouldn’t meat the PIP criteria for just ADhD. Hell I have both and don’t meat the criteria. Doesn’t mean they haven’t significantly impacted my life though.

And again you can’t get an autism diagnosis in an hour with a tick box form.

TheAgileGoldPoet · 28/05/2025 10:42

Namechangedformyanswer · 28/05/2025 10:14

When people deny what is provable.

Just because they didn't get an hour diagnosis doesn't mean it's made up.

Exactly.

They say the Panorama expose was poor journalism when the programme was made because so many people working in the field, were saying it is a problem. And the programme proved that it is.

As do all of these companies doing these poor assessments, prove there is a problem and that misdiagnosis is happening which of course leads to over-diagnosis.

Yet all these myths still persist: "it's hard to get a diagnosis, it's expensive, nobody would want one, ADHD meds don't work if you don't have ADHD, you can't get disability benefits for ADHD, there are no financial or employment advantages to the diagnosis"

All false.

When I worked in the sector and was part of diagnosing someone with adult ADHD, the person would sometimes say 'so can I claim PIP?' and i'd say, you can try but PIP is based on really specific functional disability so it would be rare for someone with adult ADHD to get it unless there were other conditions.

I believed that to be true at the time but have since discovered that out of 500 plus conditions that can form a PIP claim, ADHD is the 14th most awarded as the main condition, with 41% of ADHD claimants getting the enhanced rate of both daily living and mobility awards.

As you can only claim PIP over 16 years old, we're essentially dealing with adults with ADHD and as adult ADHD has only been formally recognised as a condition in the UK since 2000 and by NICE since 2008, it's astonishing that it's risen to such a position in PIP benefit claims in such a short space of time.

Riaanna · 28/05/2025 10:39

BlueTitFly · 28/05/2025 10:35

@Riaanna

But this nearly happened to my son.

With a SEN system in crisis, exclusions at an all time high, a school trying to exclude my child before they had even met him because they thought he had ASD, and two further exclusions in DS’s class already before the age of 6 - very, very open discussions need to be had around this and discussions shouldn’t be shut down.

We should NOT be excluding children. I also don’t think we should be labelling children. We should be meeting their individual needs and NOT giving them the impression that there is something ‘wrong’ with a child by our adult-defined labels and standards of ‘normality’.

So you don’t think an autistic person should have the diagnosis of autism?

faerietales · 28/05/2025 10:36

Toootss · 28/05/2025 10:27

If you are adult being diagnosed surely you will have decades of problems which you can recount to the psychiatrist.

I did - however they also interviewed my dad and wanted a lot of information from him as well.

NormaMajors1992coat · 28/05/2025 10:35

Namechangedformyanswer · 28/05/2025 10:10

Wipe their own bottoms, dress themselves, massive life changing ocd behaviour meaning they cannot hold down any job, aggressive, non verbal, needing 3 to 1 support, very complex and life changing is different from many late diagnosed adults!

Not in terms of their autism though - they are either autistic or not, same as anyone who you might decide is ‘not as bad’. As a PP suggested, much of that may well be comorbid learning difficulties anyway.

BlueTitFly · 28/05/2025 10:35

@Riaanna

But this nearly happened to my son.

With a SEN system in crisis, exclusions at an all time high, a school trying to exclude my child before they had even met him because they thought he had ASD, and two further exclusions in DS’s class already before the age of 6 - very, very open discussions need to be had around this and discussions shouldn’t be shut down.

We should NOT be excluding children. I also don’t think we should be labelling children. We should be meeting their individual needs and NOT giving them the impression that there is something ‘wrong’ with a child by our adult-defined labels and standards of ‘normality’.

Onlyharmony · 28/05/2025 10:30

ADHD is actually underdiagnosed. See here: https://www.facebook.com/story.php?storyfbid=pfbid02zcdhEHgmLaykk4HjYpz5WGHXozPnv5YshncD1UZZnSF8QYrummwH2Hn9duj9psKBl&id=100068086362854

The waiting lists are huge and in west Yorkshire alone, the service has been stopped due to 10 years waiting list. People are fighting to be assessed so not really a sign of over diagnosing when you can't even get an assessment!

I'm so tired of this goady crap. I'm a late 30s woman, diagnosed late in life. Due to gender bias, women are massively under diagnosed as we present differently. The biggest diagnosis age group is my age group. Do you think women my age follow a trend? I wish this was a trend. I'm sick of myself, my life because of this shit. People who think it's over diagnosed politely don't know what they are talking about. If someone wants my life they can have it. I'm not medicated either.