Which scenario illustrates diagnostic overshadowing?

• A. When a clinician attributes new physical symptoms to a mental illness diagnosis without properly investigating.
• B. When a clinician ignores mental illness and treats symptoms completely separately.
• C. When a clinician updates the diagnosis with new information.
• D. When a clinician uses a holistic approach.

Answer: (A)

Diagnostic overshadowing happens when a clinician explains away or ignores physical symptoms by assuming they’re all due to a known mental health condition, instead of thoroughly checking for other medical or physiological causes. This bias can lead to missed or delayed diagnoses and potentially harmful care.

In the scenario presented, new physical symptoms are attributed to a mental illness diagnosis without proper investigation. That is the essence of diagnostic overshadowing: letting a psychiatric label shape the evaluation of new somatic complaints rather than pursuing objective assessment and appropriate medical workup.

This contrasts with approaches that either treat symptoms in isolation, update diagnoses with careful new information, or take a holistic view that considers both physical and psychosocial factors. The key is maintaining thorough, unbiased assessment of physical symptoms regardless of mental health history.