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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1288

Reframing diagnostic overshadowing through participatory action research and epistemic justice

REFRAMING DIAGNOSTIC OVERSHADOWING THROUGH PARTICIPATORY ACTION RESEARCH AND EPISTEMIC JUSTICE

Diagnostic overshadowing is not merely an attribution error or cognitive bias, but a form of epistemic injustice that discredits the person's voice.

The study aimed to define the characteristics of diagnostic overshadowing and understand how individuals with psychiatric diagnoses and healthcare professionals experience it. Participatory action research was conducted in Quebec, Canada, in partnership with a citizen collective (Health without prejudice) comprising individuals with lived experience of the issue and community stakeholders. The methodology combined a scoping review of 50 articles with qualitative interviews involving 36 participants (patients, members of their support networks, and physicians), using iterative reflexive thematic analysis; findings were integrated in joint workshops involving the collective and the research team. The findings indicate that diagnostic overshadowing is a form of injustice that extends beyond the misattribution of physical symptoms to mental illness and profoundly affects the experience of care; individuals describe painful emotions associated with not being heard, inadequately substantiated clinical decisions, unresolved health problems, and a loss of credibility and respect. The process was modeled as a multifactorial chain consisting of the invalidation of experiential knowledge, failure to address the presenting concern, and attribution of symptoms to a psychiatric label; professionals' stigmatizing attitudes, resource-constrained and siloed organizations, and vulnerability factors such as complex disorders, communication difficulties, and intersectionality were identified as key determinants. Consequences include deteriorating health, diagnostic limbo, increased dependence on psychiatric care, disrupted follow-up, and, in some cases, death, with substantial costs to the healthcare system. The authors emphasize that research conducted collaboratively with those most directly affected made it possible to map the phenomenon's components, mechanisms, and consequences at both individual and organizational levels, and that participatory research not only examines injustice but also responds to it.

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