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Original poster

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:
elliejjtiny · 28/05/2025 00:28

I've not read it but as a mum of 4 dc with autism and one with another ND condition I find the subject interesting.

I have noticed on social media an increase in people with more significant needs having children, which just wouldn't have happened 20 or 30 years ago. I'm sure that is part of the reason there are more people being diagnosed with ND conditions. Also there is considerably less shame in being disabled or having a disabled child. Dh was diagnosed as an adult because PIL thought that if he wasn't diagnosed then his disability would go away Confused.

Pleaseshutthefuckup · 28/05/2025 00:24

PawsAndTails · 28/05/2025 00:17

Yes, I've read it, and I would once have agreed things like ADHD.autism are overdiagnosed, until I got involved with the realities of that community. I now think they are actually under-diagnosed, especially among women.

My own view is that it's the nature of society, rather than the traits themselves, that cause difficulties for ND people. In another society, they may blend in perfectly as it would accommodate differences better and everyone would find their niche. However, this is the society we are forced to be in so, from that POV, recognising the difference may be helpful and necessary. But society is the problem, not the person or traits.

Some things may be over treated perhaps, when different management would do?

Edited

Yes, agree entirely. 👏

Pleaseshutthefuckup · 28/05/2025 00:22

I don't think I want to read this if she's an advocate for this nonsensical FND stuff.

it might seem wrong to have all these ND conditions diagnosed; because it's a huge proportion of people who are ND, therefore not so ' abnormal '.if we accept the true prevalence and increase. With the true population significant in numbers, medicalisation by way of diagnosis may feel wrong and instead it might be best asking ' wtf is normal '.

But, we have very rigid systems such as school and work in this culture which truly makes life a nightmare for our huge, genuine, ND population. This is where the need for a diagnosis proliferates for me.

I have a number of horrible autoimmune conditions, including one neuro disease. Every dealing with a neurologist has resulted in me educating them. There's something about that profession wherein I have little faith in intellect, capacity for critical thinking and much more.

In the bin with this one for me.

PawsAndTails · 28/05/2025 00:17

Yes, I've read it, and I would once have agreed things like ADHD.autism are overdiagnosed, until I got involved with the realities of that community. I now think they are actually under-diagnosed, especially among women.

My own view is that it's the nature of society, rather than the traits themselves, that cause difficulties for ND people. In another society, they may blend in perfectly as it would accommodate differences better and everyone would find their niche. However, this is the society we are forced to be in so, from that POV, recognising the difference may be helpful and necessary. But society is the problem, not the person or traits.

Some things may be over treated perhaps, when different management would do?

Original poster
FrodoBiggins · 28/05/2025 00:07

@steamlover ah thanks for recommendation, have just downloaded it.

OP posts:
SteamLover · 28/05/2025 00:01

In Search of Normal by Sami Timini also came out this year and covers some of the same issues in more depth. He is a child psychologist and very interesting on autism and adhd. I’d recommend any parent thinking of seeking a diagnosis for their child to read this book first.

Original poster
FrodoBiggins · 27/05/2025 23:58

ArtTheClownIsNotAMime · 27/05/2025 23:57

I haven't read it but will look for a copy, thanks OP. It's a topic that interests me, especially the overdiagnosis of autism and ADHD.

In the interests of addressing PPs accusation that this was an ad (fair point I posted in totally the wrong place!) I think lots of it is serialised on BBC Radio 4 so you might be able to listen to much of it for free. I got it for a credit on audible. Or the library! 😂

OP posts:
Original poster
FrodoBiggins · 27/05/2025 23:57

KabukiNoh · 27/05/2025 23:49

I’ve read her other 2 books, and although she tries to expand into other area, she does retreat to her comfort zone of functional neurological disorders. Some chapters very familiar, others more interesting to me eg the Huntingdon’s one.

My main take home was her description of the difference between misdiagnosis and overdiagnosis. Diagnosis should give meaning and benefit. Overdiagnosis suggests that technically it may not be misdiagnosis, but it is not beneficial and dilutes the meaning. I found this a very helpful concept.

I also found the Huntingdons chapter particularly interesting (although very sad). Agree that the question of what benefit diagnosis brings is a huge one. I think I had always assumed I would get genetic testing if I thought something ran in family (and was confused by my step siblings not wanting the same when they appear to have an inherited condition in the family) but it really opened my eyes to how that would actually feel and the benefit/detriment weighting exercise.

I found it interesting that most of the people in the ND chapters she did case studies on did report that they benefited from their diagnosis. She seemed somewhat dismissive of it but I don't think that can be dismissed.

OP posts:
ArtTheClownIsNotAMime · 27/05/2025 23:57

I haven't read it but will look for a copy, thanks OP. It's a topic that interests me, especially the overdiagnosis of autism and ADHD.

Original poster
FrodoBiggins · 27/05/2025 23:52

pinkdelight · 27/05/2025 23:49

Is this an aibu or an advert?

Argh yes sorry I should have posted it in the books section! I think the post which led me to make it was in AIBU so I was in the wrong bit. Will try to move it 🙈

OP posts:
KabukiNoh · 27/05/2025 23:49

I’ve read her other 2 books, and although she tries to expand into other area, she does retreat to her comfort zone of functional neurological disorders. Some chapters very familiar, others more interesting to me eg the Huntingdon’s one.

My main take home was her description of the difference between misdiagnosis and overdiagnosis. Diagnosis should give meaning and benefit. Overdiagnosis suggests that technically it may not be misdiagnosis, but it is not beneficial and dilutes the meaning. I found this a very helpful concept.

pinkdelight · 27/05/2025 23:49

Is this an aibu or an advert?