Complex and Emotionally Demanding Patients Flashcards
List 7 types of patients.
1 - Histrionic patients.
2 - Dependent patients.
3 - Demanding patients.
4 - Narcissistic patients.
5 - Suspicious patients.
6 - Help-rejecting complainers.
7 - Manipulative patients.
What are histrionic patients?
- Dramatic, emotional and overwhelming patients.
- Often come across as emotional and flirtatious.
What are dependent patients?
- Patients that need an inordinate amount of attention.
- Likely to make repeated urgent calls between appointments and to demand special consideration.
What are demanding patients?
Patients that have difficulty delaying gratification and demand that their problems be eliminated immediately.
What are narcissistic patients?
- Patients that initially may idealise the doctor, but soon feel contempt for the doctor’s inadequacies.
- Feel that they are superior to the doctor.
What are suspicious patients?
- Patients that ave a deeply ingrained suspicion that other people are unreliable / untrustworthy.
- Likely to misinterpret neutral events as evidence of a conspiracy.
List 5 diagnoses that are in disputed territory.
1 - Somatisation disorder.
2 - Hypochonriacal disorder.
3 - Conversion disorder.
4 - Body dysmorphic disorder.
5 - Factitious disorder & factitious disorder by proxy.
What is somatisation?
The manifestation of psychological distress by the presentation of physical symptoms.
List 7 factors predisposing to the development of somatisation.
1 - Childhood illnesses.
2 - Family illness and consultation in childhood.
3 - Physical illness in adulthood.
4 - Experiences / satisfaction with medical consultations.
5 - Illness in friends.
6 - Publicity in television and newspapers.
7 - Knowledge of illness and treatment (internet).
What are the criteria for somatisation disorder?
- History of physical complaint beginning before 30 years of age.
- Investigation shows that symptoms cannot be explained by a medical condition.
What is hypochondriacal disorder?
- A preoccupation with fears of having a serious disease based on a misinterpretation of bodily symptoms.
- The preoccupation persists despite negative medical evaluation.
What is conversion disorder?
- A condition that presents as an alteration or loss of physical function suggestive of a physical disorder.
- Psychological stressors precede the initiation of symptoms.
- Symptoms are the result of unconscious motives.
- Investigation shows that symptoms cannot be explained by a medical condition.
What are the types of conversion disorder?
1 - Motor symptoms.
2 - Sensory symptoms.
3 - Seizures.
4 - Mixed presentation.
What is the psychodynamic theory of conversion disorder?
A theory that holds that symptoms are caused by the repression of unconscious psychological conflict.
What is ‘la belle indifference’?
Where a patient seems surprisingly unconcerned about their physical symptoms.
