Chaya B. Gopin

"Psychiatry has some of the richest yet most poorly understood diagnostic labels in medicine."

This point, in my mind, is what makes labeling particularly dangerous; very often, we are not even completely sure what we are labeling patients with! I do think that it is extremely important to give a title to a disease, as that is what enables doctors to converse with one another about a particular case and provide the most suitable treatment. But, as Raj argues, in the area of mental health, labels come along with a great deal of stigma. Why would a patient, with a currently untreatable condition, want to walk around with a label attached to them?

I think that the other problem with labeling is that people are often over-labeled. With the current DSM system, patients are often overloaded with labels that each account for a part of their presenting symptoms. I actually just saw an 8 year old patient who was previously diagnosed by her psychiatrist with psychotic disorder, NOS, in remission, ADHD, combined type, and a learning disorder, and mood disorder was recorded as a rule-out. When I saw this child's records I was extremely frustrated by the ease with which these highly charged labels were assigned. While it definitely gave me a sense of the type of patient who was about to walk into the office, I would hope that a psychiatrist would be more hesitant to label such a young child with all of those diagnoses. Instead of diagnosing a patient with the most troublesome of the diagnoses, attempting to treat that problem, and then seeing if the remaining symptoms lift, people want to make sure that they aren't the ones to leave off one of the possible labels. As a result, the patient is given some labels that are probably not actually present, and he/she is the one who has to live with the list of labels and their stigmas.