In a new study, a psychiatric diagnosis was found to be incorrect for more than two-thirds of those who experienced antidepressant withdrawal. Their withdrawal symptoms were misdiagnosed as DSM-5 psychiatric disorders like panic disorder and major depressive disorder.
The researchers write, “In 58 (78.4%) of the 74 cases, the DSM-5 diagnosis of current mental disorder was not confirmed when the DID-W1 was completed since patients’ symptoms corresponded to a diagnosis of current withdrawal syndrome.”
The study was led by Fiammetta Coscia at the University of Florence and Maastricht University, as well as Virginie-Anne Chouinard at McLean Hospital, and Guy Chouinard at the University of Montreal and McGill University. It was published in
Psychotherapy and Psychosomatics.
The fact that the DSM does not include criteria for withdrawal symptoms is a barrier to accurate diagnosis and treatment, the authors write. While the DSM asks clinicians to differentiate “mental disorders” from drug-induced symptoms, it does not include drug
withdrawal symptoms—from either recreational or prescribed drugs. Thus, they suggest supplementing diagnosis with their measure for identifying and categorizing withdrawal symptoms, the DID-W1.
“We propose that the clinical picture modified by SSRI and SNRI withdrawal be detected through the use of the DID-W1 and not DSM, because the DSM-5 does not include SSRI/SNRI in the list of drugs responsible for drug-induced disorders and the DSM-5 diagnostic algorithm does not include withdrawal syndromes due to decrease, discontinuation, or switch of SSRI/SNRI,” the researchers write.
