A Qualitative Exploration of Diagnostic Shifts and Medication Changes Among Young Adults with Mental Health Conditions.

Background: 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.

Method: 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.

Results: 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.

Conclusion: 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.