Complex and Emotionally Demanding Patients Flashcards

1
Q

List 7 types of patients.

A

1 - Histrionic patients.

2 - Dependent patients.

3 - Demanding patients.

4 - Narcissistic patients.

5 - Suspicious patients.

6 - Help-rejecting complainers.

7 - Manipulative patients.

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2
Q

What are histrionic patients?

A
  • Dramatic, emotional and overwhelming patients.

- Often come across as emotional and flirtatious.

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3
Q

What are dependent patients?

A
  • Patients that need an inordinate amount of attention.

- Likely to make repeated urgent calls between appointments and to demand special consideration.

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4
Q

What are demanding patients?

A

Patients that have difficulty delaying gratification and demand that their problems be eliminated immediately.

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5
Q

What are narcissistic patients?

A
  • Patients that initially may idealise the doctor, but soon feel contempt for the doctor’s inadequacies.
  • Feel that they are superior to the doctor.
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6
Q

What are suspicious patients?

A
  • Patients that ave a deeply ingrained suspicion that other people are unreliable / untrustworthy.
  • Likely to misinterpret neutral events as evidence of a conspiracy.
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7
Q

List 5 diagnoses that are in disputed territory.

A

1 - Somatisation disorder.

2 - Hypochonriacal disorder.

3 - Conversion disorder.

4 - Body dysmorphic disorder.

5 - Factitious disorder & factitious disorder by proxy.

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8
Q

What is somatisation?

A

The manifestation of psychological distress by the presentation of physical symptoms.

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9
Q

List 7 factors predisposing to the development of somatisation.

A

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).

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10
Q

What are the criteria for somatisation disorder?

A
  • History of physical complaint beginning before 30 years of age.
  • Investigation shows that symptoms cannot be explained by a medical condition.
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11
Q

What is hypochondriacal disorder?

A
  • A preoccupation with fears of having a serious disease based on a misinterpretation of bodily symptoms.
  • The preoccupation persists despite negative medical evaluation.
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12
Q

What is conversion disorder?

A
  • 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.
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13
Q

What are the types of conversion disorder?

A

1 - Motor symptoms.

2 - Sensory symptoms.

3 - Seizures.

4 - Mixed presentation.

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14
Q

What is the psychodynamic theory of conversion disorder?

A

A theory that holds that symptoms are caused by the repression of unconscious psychological conflict.

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15
Q

What is ‘la belle indifference’?

A

Where a patient seems surprisingly unconcerned about their physical symptoms.

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16
Q

What is body dysmorphic disorder?

A
  • A preoccupation with an imagined defect in appearance, or with a slight physical anomaly.
  • The person’s concern is excessive.
  • The preoccupation causes clinically significant distress.
17
Q

What is factitious disorder?

A
  • The intentional production of physical or psychological signs or symptoms.
  • Motivation is to assume the sick role.
18
Q

What is factitious disorder by proxy?

A
  • Physical or psychological symptoms or signs intentionally produced or invented by a parent or carer.
  • The symptoms or signs diminish when the child is separated from the perpetrator.
19
Q

What is the difference between factitious disorder and malingering?

A
  • With malingering, the reason for the deception is tangible and rationally understandable, such as avoiding military duty, avoiding work, etc.
  • With factitious disorder, the motive is to assume the sick role.