Physical sxs in mental disease. was: cruel people

[Shannon Nelson]

Hi Andrew,
This does make sense to me.
But, I'm remembering one of my frustrating cases has had no physical
complaints, but very rich assortment of M/E sxs. In enquiring about past
physical sxs (I've tried!), she reports none, except some sorta-maybe
things: "never got sick", "warmblooded", thirsty for water. Really, that's
all I was able to come up with. Maybe family members could give more...

Or maybe hers is an example of where we need to "follow the case" -- if
there are no physical sxs to speak of but the VF is still reasonably strong,
there should be clear, *distinctive* M/E symptoms (and in her case there
are, and they've led to a variety of "close" choices). If there are no
distinctive physicals *and* no distinctive mentals, then we have a case
which is either unperceived (e.g. closed pt that the casetaker isn't able to
reach?), or nearly incurable (VF is too weak to express clearly)...

I definitely agree with your thought that one needs to fill out the picture
by checking out past history, and also that physical expressions are an
important part of the case. I have only a small caseload to draw from, but
this one above makes me wonder whether there will "always" be useful
physical sxs available.

Can anyone offer cases they've treated successfully where deep mental
disturbance was or was not accompanied by useful physicals, or whether
examining the pt's history did or didn't yield useful physical sxs to round
out the picture? I guess experience will be the key...

I'm thinking that if mental disease was strong even in childhood, that could
have eclipsed the other? (Family history should be helpful then.)

Shannon
on 1/24/03 9:10 PM, Phosphor at phosphor@hotkey.net.au wrote: