Journal of Medical Case Reports Volume 2

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Psychiatric evaluation would have been interesting

Maneesh Gupta   (01 July 2008)  Mater Hospital, Belfast

It is an interesting case report. Factitious disorder is a difficult diagnosis to make and it would have been intersting to read about the psychiatric evaluation and the conclusions thereof about factitious diorder. Could the authors shed some light on the psychiatric assessment and treatment??

Competing interests

None declared

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Response

Nnamdi Nwaejike   (02 July 2008)  Barts and the London NHS Trust

Dear Dr Gupta,

Thank you for your question..

The patient required specialist care (psychiatry in this case) for optimised treatment, which we realised after our interventions (analgesia including bier blocks)did not provide definitive relief from his symptoms..

Once refered, the patient had no further problems with pain control or other symptoms and signs for reflex sympathetic dystrophy and so we (trauma and orthopaedics) did not continue follow-up..

He was adequately managed by psychiatry, but we do not have details of his subsequent treatment..

The learning point is the recognition of the factitous disorder by non-psychiatrists and early referal to appropriate specialists..

Sincerely

Nnamdi Nwaejike

Competing interests

None declared

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