Sabella Kathryn, Lane Ian A
University of Massachusetts Chan Medical School, Worcester, MA, United States.
Providence College, Providence, RI, United States.
Int J Behav Med. 2025 Sep 12. doi: 10.1007/s12529-025-10390-x.
Diagnostic shifts commonly occur in young adulthood and are often associated with medication changes. Such changes can have a profound influence on how an individual experiences and perceives mental health services. Prior research on how young adults experience and make meaning of diagnostic shifts and medication changes is limited. This exploratory study seeks to describe how young adults with serious mental health conditions (SMHC) in the United States experience diagnostic adjustments of their SMHC and associated medication changes.
Qualitative interviews were conducted among young adults (ages 25-30) with SMHCs in community-based settings in the Northeast region of the United States. Participatory research methods and qualitative descriptive analysis techniques were used to explore themes around SMHC diagnoses, symptoms, and treatment.
Most young adults identified as women, non-Hispanic, White, self-identified as having major depression or anxiety disorders, and had received multiple diagnoses from providers. Many young adults described being given alternate or "corrected" diagnoses to replace original diagnoses. Pharmacological treatment was common, and many reported periods of "medication trial and error." Shifting diagnoses and changing medications were associated with confusion, ambivalence, and doubt. Medication changes were disruptive to young adults' ability to function in their daily lives.
Diagnostic and medication changes can create "secondary doubt and disruptions" in the perceptions and lives of young adults. More research is needed to understand how secondary doubts and disruptions influence young adults' long-term mental health trajectories. Findings indicate the importance of clear communication and shared decision-making between provider and patient.
诊断转变常见于青年期，且往往与药物治疗的改变有关。此类变化会对个体体验和认知心理健康服务的方式产生深远影响。先前关于青年如何体验诊断转变和药物治疗变化并赋予其意义的研究较为有限。这项探索性研究旨在描述美国患有严重精神健康状况（SMHC）的青年如何体验其SMHC的诊断调整及相关药物治疗变化。
对美国东北部社区环境中患有SMHC的青年（25 - 30岁）进行了定性访谈。采用参与式研究方法和定性描述分析技术来探索围绕SMHC诊断、症状和治疗的主题。
大多数青年为女性、非西班牙裔白人，自我认定患有重度抑郁症或焦虑症，且从医疗服务提供者处获得过多种诊断。许多青年描述自己被给予替代或“修正”诊断以取代原诊断。药物治疗很常见，许多人报告经历过“药物试验与试错”阶段。诊断转变和药物治疗变化与困惑、矛盾心理和怀疑有关。药物治疗变化干扰了青年在日常生活中的功能发挥能力。
诊断和药物治疗变化会在青年的认知和生活中造成“继发性怀疑和干扰”。需要更多研究来了解继发性怀疑和干扰如何影响青年的长期心理健康轨迹。研究结果表明了医疗服务提供者与患者之间清晰沟通和共同决策的重要性。
