A 24yo lady has been low after the death of her husband and had stopped contacting her family. She was started on SSRI tx and starts feeling better after a few months. On discontinuating the meds she starts feeling that she has developed cancer just like her husband.
What is the most appropriate next step?
a. Continue SSRI
b. Add TCA
c. Neuropsychiatric analysis
d. CBT
e. Antipsychotics
answer: D
She was feeling low
previously, therefore don't treat as if depression,
now she is feeling
something else:
Hypochondrial disorder
- persistent belief in the presence of an underlying serious DISEASE, e.g. cancer
- patient again refuses to accept reassurance or negative test results
- Treatment: CBT, SSRI may play a small role
CBT can help to
identify unhelpful thoughts about a person and their health, which
can make symptoms worse. For example, someone may worry that,
because people in the family have been ill, they are bound to get
ill too. Or they may think that they need to have all
possible tests done in case something is missed. CBT helps
people to recognise and tackle these unhelpful thoughts and to
develop ways to change the way they think and behave, which can
improve their symptoms.
n.b. Neuropsychiatric analysis is done when we suspect a brain pathology e.g. dementia.
No comments:
Post a Comment