Table 1.

Overview of the Three Types of Excessive Expansion of Diagnoses: Too Much, Too Mild, and Too Early

	Too Much	Too Mild	Too Early
Type of expansion	Including New Phenomena	Expansion by Degrees	Temporal Expansion
Description	Including (labelling) new phenomena a) ordinary life experiences b) social phenomena c) biomedical phenomena	Lowering the detection threshold including milder cases in the definition of the disease that do not bother the person (here and now)	Diagnosing abnormalities not going to cause harm by disease (pain, dysfunction, suffering) in the future
Ley explanation	Ordinary life conditions (potentially better dealt with by others or left alone) or irrelevant biological or mental phenomena are labelled as diagnoses	Conditions you live with without being bothered by them	Conditions that would not come to bother you, ie, conditions that you die with and not from.
Class of expansion	Ontological	Normative-Conceptual	Epistemic-Temporal
Main problem	Wrong treatment, potential harm from unnecessary or wrong treatment; divert from more efficient measures; digress responsibility; anxiety, stigma, discrimination	Unnecessary treatment, potential harm from diagnostics and unnecessary treatment	Overtreatment, potential harm from overdiagnosis and overtreatment
Example	a) Loneliness, grief b) School behavior (ADHD) c) Obesity, various risk factors, such as high blood glucose	Gestational diabetes, chronic kidney disease	Precursors of disease that do not develop into disease
Terminology	Medicalization Maldetection, Overdetection	Misclassification, Overdefinition	Overdiagnosis
Concept creep	Horisontal expansion	Vertical expansion	NA