Quantifying the psychological and behavioural consequences of a diagnostic label for non-cancer conditions: systematic review

Rebecca Sims; Zoe A. Michaleff; Paul Glasziou; Mark Jones; Rae Thomas

doi:10.1192/bjo.2023.49

Quantifying the psychological and behavioural consequences of a diagnostic label for non-cancer conditions: systematic review

Rebecca Sims^*, Zoe A. Michaleff, Paul Glasziou, Mark Jones, Rae Thomas

^*Corresponding author for this work

Institute for Evidence-Based Healthcare

Research output: Contribution to journal › Review article › Research › peer-review

5 Citations (Scopus)

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Abstract

BACKGROUND: Screening for asymptomatic health conditions is perceived as mostly beneficial, with possible harms receiving little attention.

AIMS: To quantify proximal and longer-term consequences for individuals receiving a diagnostic label following screening for an asymptomatic, non-cancer health condition.

METHOD: Five electronic databases were searched (inception to November 2022) for studies that recruited asymptomatic screened individuals who received or did not receive a diagnostic label. Eligible studies reported psychological, psychosocial and/or behavioural outcomes before and after screening results. Independent reviewers screened titles and abstracts, extracted data from included studies, and assessed risk of bias (Risk of Bias in Non-Randomised Studies of Interventions). Results were meta-analysed or descriptively reported.

RESULTS: Sixteen studies were included. Twelve studies addressed psychological outcomes, four studies examined behavioural outcomes and none reported psychosocial outcomes. Risk of bias was judged as low ( n = 8), moderate ( n = 5) or serious ( n = 3). Immediately after receiving results, anxiety was significantly higher for individuals receiving versus not receiving a diagnostic label (mean difference -7.28, 95% CI -12.85 to -1.71). On average, anxiety increased from the non-clinical to clinical range, but returned to the non-clinical range in the longer term. No significant immediate or longer-term differences were found for depression or general mental health. Absenteeism did not significantly differ from the year before to the year after screening.

CONCLUSIONS: The impacts of screening asymptomatic, non-cancer health conditions are not universally positive. Limited research exists regarding longer-term impacts. Well-designed, high-quality studies further investigating these impacts are required to assist development of protocols that minimise psychological distress following diagnosis.

Original language	English
Article number	e73
Pages (from-to)	1-11
Number of pages	11
Journal	BJPsych Open
Volume	9
Issue number	3
DOIs	https://doi.org/10.1192/bjo.2023.49
Publication status	Published - 19 May 2023

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@article{dfc71bae1a0b4e2ba6eac5884b865d32,

title = "Quantifying the psychological and behavioural consequences of a diagnostic label for non-cancer conditions: systematic review",

abstract = "BACKGROUND: Screening for asymptomatic health conditions is perceived as mostly beneficial, with possible harms receiving little attention.AIMS: To quantify proximal and longer-term consequences for individuals receiving a diagnostic label following screening for an asymptomatic, non-cancer health condition.METHOD: Five electronic databases were searched (inception to November 2022) for studies that recruited asymptomatic screened individuals who received or did not receive a diagnostic label. Eligible studies reported psychological, psychosocial and/or behavioural outcomes before and after screening results. Independent reviewers screened titles and abstracts, extracted data from included studies, and assessed risk of bias (Risk of Bias in Non-Randomised Studies of Interventions). Results were meta-analysed or descriptively reported.RESULTS: Sixteen studies were included. Twelve studies addressed psychological outcomes, four studies examined behavioural outcomes and none reported psychosocial outcomes. Risk of bias was judged as low ( n = 8), moderate ( n = 5) or serious ( n = 3). Immediately after receiving results, anxiety was significantly higher for individuals receiving versus not receiving a diagnostic label (mean difference -7.28, 95% CI -12.85 to -1.71). On average, anxiety increased from the non-clinical to clinical range, but returned to the non-clinical range in the longer term. No significant immediate or longer-term differences were found for depression or general mental health. Absenteeism did not significantly differ from the year before to the year after screening. CONCLUSIONS: The impacts of screening asymptomatic, non-cancer health conditions are not universally positive. Limited research exists regarding longer-term impacts. Well-designed, high-quality studies further investigating these impacts are required to assist development of protocols that minimise psychological distress following diagnosis.",

author = "Rebecca Sims and Michaleff, {Zoe A.} and Paul Glasziou and Mark Jones and Rae Thomas",

note = "Funding Information: R.S. is supported by an Australian Government research training program scholarship. R.T. is supported by a National Health and Medical Research Council (NHMRC) programme grant (#1106452). Z.A.M. is supported by an NHMRC programme grant (#1106452) and the Northern New South Wales Local Health District. P.G. is supported by an NHMRC investigator grant (#1175487). M.J. is supported by an NHMRC investigator grant (#1175487) and an NHMRC Partnership Centre for Health System Sustainability grant (#9100002). The funding sources have no role in study design, data collection, data analysis, data interpretation or writing of the report. Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.",

year = "2023",

month = may,

day = "19",

doi = "10.1192/bjo.2023.49",

language = "English",

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TY - JOUR

T1 - Quantifying the psychological and behavioural consequences of a diagnostic label for non-cancer conditions: systematic review

AU - Sims, Rebecca

AU - Michaleff, Zoe A.

AU - Glasziou, Paul

AU - Jones, Mark

AU - Thomas, Rae

N1 - Funding Information: R.S. is supported by an Australian Government research training program scholarship. R.T. is supported by a National Health and Medical Research Council (NHMRC) programme grant (#1106452). Z.A.M. is supported by an NHMRC programme grant (#1106452) and the Northern New South Wales Local Health District. P.G. is supported by an NHMRC investigator grant (#1175487). M.J. is supported by an NHMRC investigator grant (#1175487) and an NHMRC Partnership Centre for Health System Sustainability grant (#9100002). The funding sources have no role in study design, data collection, data analysis, data interpretation or writing of the report. Publisher Copyright: © 2023 The Author(s). Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.

PY - 2023/5/19

Y1 - 2023/5/19

N2 - BACKGROUND: Screening for asymptomatic health conditions is perceived as mostly beneficial, with possible harms receiving little attention.AIMS: To quantify proximal and longer-term consequences for individuals receiving a diagnostic label following screening for an asymptomatic, non-cancer health condition.METHOD: Five electronic databases were searched (inception to November 2022) for studies that recruited asymptomatic screened individuals who received or did not receive a diagnostic label. Eligible studies reported psychological, psychosocial and/or behavioural outcomes before and after screening results. Independent reviewers screened titles and abstracts, extracted data from included studies, and assessed risk of bias (Risk of Bias in Non-Randomised Studies of Interventions). Results were meta-analysed or descriptively reported.RESULTS: Sixteen studies were included. Twelve studies addressed psychological outcomes, four studies examined behavioural outcomes and none reported psychosocial outcomes. Risk of bias was judged as low ( n = 8), moderate ( n = 5) or serious ( n = 3). Immediately after receiving results, anxiety was significantly higher for individuals receiving versus not receiving a diagnostic label (mean difference -7.28, 95% CI -12.85 to -1.71). On average, anxiety increased from the non-clinical to clinical range, but returned to the non-clinical range in the longer term. No significant immediate or longer-term differences were found for depression or general mental health. Absenteeism did not significantly differ from the year before to the year after screening. CONCLUSIONS: The impacts of screening asymptomatic, non-cancer health conditions are not universally positive. Limited research exists regarding longer-term impacts. Well-designed, high-quality studies further investigating these impacts are required to assist development of protocols that minimise psychological distress following diagnosis.

AB - BACKGROUND: Screening for asymptomatic health conditions is perceived as mostly beneficial, with possible harms receiving little attention.AIMS: To quantify proximal and longer-term consequences for individuals receiving a diagnostic label following screening for an asymptomatic, non-cancer health condition.METHOD: Five electronic databases were searched (inception to November 2022) for studies that recruited asymptomatic screened individuals who received or did not receive a diagnostic label. Eligible studies reported psychological, psychosocial and/or behavioural outcomes before and after screening results. Independent reviewers screened titles and abstracts, extracted data from included studies, and assessed risk of bias (Risk of Bias in Non-Randomised Studies of Interventions). Results were meta-analysed or descriptively reported.RESULTS: Sixteen studies were included. Twelve studies addressed psychological outcomes, four studies examined behavioural outcomes and none reported psychosocial outcomes. Risk of bias was judged as low ( n = 8), moderate ( n = 5) or serious ( n = 3). Immediately after receiving results, anxiety was significantly higher for individuals receiving versus not receiving a diagnostic label (mean difference -7.28, 95% CI -12.85 to -1.71). On average, anxiety increased from the non-clinical to clinical range, but returned to the non-clinical range in the longer term. No significant immediate or longer-term differences were found for depression or general mental health. Absenteeism did not significantly differ from the year before to the year after screening. CONCLUSIONS: The impacts of screening asymptomatic, non-cancer health conditions are not universally positive. Limited research exists regarding longer-term impacts. Well-designed, high-quality studies further investigating these impacts are required to assist development of protocols that minimise psychological distress following diagnosis.

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DO - 10.1192/bjo.2023.49

M3 - Review article

C2 - 37073644

SN - 2056-4724

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JO - BJPsych Open

JF - BJPsych Open

IS - 3

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ER -

Quantifying the psychological and behavioural consequences of a diagnostic label for non-cancer conditions: systematic review

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