Does Medicalization of Life Imperil Health? Expanding Indications for Diagnosis and Treatment of Chronic “Disease”

A 2010 Wall Street Journal (WSJ) report highlighted a novel training method now being used by medical schools to “help budding psychologists and psychiatrists gain experience and confidence” in differential diagnosis—assessment of fictional characters. Popular movies and books have provided rich fare for the trainees. Southern vamp Scarlett O’Hara has narcissistic personality disorder. Harry Potter’s “battle with Voldemort can be seen as an internal conflict between aspects of his own psyche.” HBO gangster Tony Soprano has panic attacks and depression. And Winnie the Pooh, the “bear of little brain” with a seemingly never-ending penchant for “hunney,” has a cognitive impairment disorder coupled with obsession. The WSJ assessment of Pooh was not the first of its kind. In 2000, Pooh had been described in a tongue-in-cheek CMAJ commentary as having attention-deficit hyperactivity disorder (ADHD), inattentive subtype, possibly the result of “being dragged downstairs bump, bump, bump,on the back of his head” according to an early account by Pooh’s creator, A. A. Milne, perhaps leading to “Shaken Bear Syndrome. Although the spoof was witty, health care payers and the enrollees they serve may have less reason to be amused. Research published within the past few years suggests an explosion in the medicalization and treatment of…