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In a November 1, 2026, MedPage Today opinion essay, psychiatrist Devina Wadhwa argues that clinicians should not treat screening scores or symptoms alone as a diagnosis. She says grief and other distress can overlap with psychiatric illness, so assessment must consider life circumstances, duration, functioning and safety without dismissing serious illness.
Psychiatrist Devina Wadhwa argues that clinicians should assess a patient’s circumstances before interpreting sadness, anxiety, sleep problems or appetite changes as evidence of a psychiatric disorder. In an opinion essay published by MedPage Today on November 1, 2026, she says screening questionnaires can identify symptoms but should not replace clinical judgment—an issue that matters because grief and other life crises can resemble mental illness, while also occurring alongside it.
Wadhwa describes patients who struggle after a relationship ends, a death in the family or job loss. Symptoms such as poor sleep, reduced appetite, difficulty concentrating and persistent sadness can appear in psychiatric disorders, but can also arise during painful life events. She asks clinicians to distinguish between illness and suffering without assuming the two are mutually exclusive.
Her concern is that brief assessments or questionnaires, including the PHQ-9 and GAD-7, may capture symptoms without enough information about what happened to the patient. A score may help guide an assessment, she writes, but should not serve as the entire assessment. The source essay provides no new study or prevalence data; its argument is a clinician’s perspective on diagnostic practice.
Wadhwa also stresses that a clear life event does not rule out a psychiatric disorder. Bereavement can coexist with major depression, and severe symptoms after a loss or other upheaval still require careful attention. She urges clinicians to ask about duration, changes in daily functioning, the patient’s earlier baseline and safety, including whether symptoms are evolving or the person is at risk.
Balancing Diagnosis With Life Context
The distinction can shape how patients understand their experiences and what care they receive. Wadhwa says a diagnosis may give someone language for troubling symptoms and help direct treatment; she also notes that psychiatric care, including therapy, medication and hospitalization, can change or save lives. Her argument is not against diagnosis, but against making it without enough attention to the person’s circumstances.
That balance matters for patients facing grief or sudden instability. Treating every painful response as illness may risk medicalizing ordinary distress, while dismissing serious symptoms as an understandable reaction could miss a disorder or a safety concern. Wadhwa’s position is that context informs assessment but does not settle it. Clinicians still need to evaluate the symptoms and the person’s level of risk.
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Symptoms Can Overlap With Grief
Psychiatric assessment often involves symptoms that also occur in everyday life: sadness, worry, insomnia and changes in appetite or concentration. Wadhwa points out that this overlap makes diagnosis different from simply matching a symptom to a label. A person grieving a spouse, for example, may report experiences that also feature in major depression, but the overlap alone does not determine the diagnosis.
Wadhwa frames this as a matter of clinical judgment rather than a simple rule separating grief from disorder. The source essay does not propose new diagnostic criteria or offer evidence that overdiagnosis is increasing. Instead, it calls for clinicians to combine symptom assessment with questions about what happened, how long the response has lasted and how much functioning has changed.
No New Data on Diagnostic Rates
The essay is an opinion piece by a psychiatrist, not a research report measuring how often normal distress is diagnosed as a disorder. It does not establish whether overdiagnosis is increasing, how commonly screening tools are used without fuller assessment, or what proportion of patients are affected. It also offers no single test for distinguishing grief from depression; Wadhwa says the distinction requires clinical judgment.
How any individual’s symptoms should be understood depends on details not captured in the essay’s examples, including their duration, severity, impact on daily life and safety. The article does not argue that symptoms after a loss should be left untreated or that a screening result is useless. Its stated concern is that neither context nor a questionnaire should replace a complete assessment.
Clinical Judgment Remains Central
Wadhwa’s essay calls on psychiatrists to keep asking about the events surrounding symptoms and how a patient has changed over time, rather than moving directly from a symptom score to a label. Her proposed approach is a careful assessment that considers history, functioning, symptom progression and risk before deciding what diagnosis or care is appropriate.
The source material does not announce a policy change, new screening standard or follow-up study. For now, its practical message is directed at clinical practice: use screening tools as part of an assessment, remain alert to serious illness even when distress has an understandable cause, and avoid treating the diagnosis as a substitute for understanding the patient.
Key Questions
Is the article reporting new research on overdiagnosis?
No. It is an opinion essay by psychiatrist Devina Wadhwa published by MedPage Today on November 1, 2026. It presents her view on clinical assessment and does not report a new study or measure diagnostic rates.
Does Wadhwa say grief should not be diagnosed or treated?
No. She says grief can overlap with, or occur alongside, a psychiatric disorder. Her argument is that clinicians should assess symptoms and circumstances carefully rather than assume either that grief is an illness or that a loss rules illness out.
What questions does she say clinicians should ask?
Wadhwa points to what happened, how long symptoms have lasted, changes in functioning, how the response is developing, the patient’s earlier baseline and whether the person is at risk. She says such questions add context that a screening score alone may not provide.
Are screening questionnaires useful?
Wadhwa does not say they are useless. She cautions that tools such as the PHQ-9 or GAD-7 can show symptoms but should not replace a fuller clinical assessment.
Source: medpagetoday.com
