In the past few years, there have been an increasing number of commentaries on the issues of medical gaslighting [1-5] and diagnostic overshadowing [6-8] in patient-clinician encounters. The two phenomena are closely related; medical gaslighting (MG) occurs when a patient’s expressed or observed symptoms pertaining to a physical health condition are incorrectly (or believed by the patient to be incorrectly) dismissed or denied by a clinician. Originating as a term from the controlled manipulation of a person’s actual reality via the means of a gaslight in the 1944 Ingrid Bergman film of the same name [9], MG is not altogether positively received in the medical community [10]. Diagnostic overshadowing (DO) is a similarly contentious term that can provoke strong reactions. It arises when a patient receives a diagnosis that is attributed to a pre-existing or new mental illness for their reported symptoms of a physical health condition.
MG/DO arise disproportionately in certain patient populations and for particular types of physical conditions. The former include adults and children with autism, mobility disabilities, learning disabilities, low health literacy, obesity, history of substance abuse and psychiatric or mental health disorders [8]. The latter includes conditions where clinical standards and diagnostic capabilities are either lacking or developing (e.g., long covid, chronic primary pain), and/or where patient reports of their symptoms rely heavily on their subjective expression and their (sometimes diminished) capacities to express them.
In this research, we wish to reveal, understand and find ways to address the prevalence and forms of MG/DO that are experienced by people with generalised anxiety disorder or GAD in the UK.