Self-Diagnosis and its Implications in Child and Adolescent Psychiatry: Addressing Epistemic Injustice and Childism

The conventional diagnostic process in psychiatry is often shaped by epistemic asymmetries and power dynamics that can tend to prioritize professional interpretations over patient experiences. In child and adolescent psychiatry, these dynamics may intersect with epistemic injustice and childism, potentially reinforcing the marginalization of young patients’ voices. This paper explores how self-diagnosis could challenge traditional diagnostic hierarchies by allowing adolescents to reclaim epistemic authority and question adult-centric biases. While self-diagnosis questions diagnostic accuracy and the influence of non-expert sources, it may also offer an opportunity for epistemic justice and patient empowerment. By analyzing the clinician-patient relationship through the lens of epistemic agency, we suggest that self-diagnosis could serve as a resource for collaborative decision-making, possibly enhancing both diagnostic equity and therapeutic engagement. This perspective calls for greater epistemic humility and relational approaches to care, supporting an environment where children and adolescents may become more active contributors in the diagnostic process.