The Indications for Abdominal Surgery in Psychiatric Patients

Publisher Website
Google Scholar
Abstract
The paper discusses the problem of patients demanding surgery on little or no indication. A survey of the literature suggests that this is a not infrequent problem, especially in patients of an hysterical make-up. Two cases have been presented in which surgery was deferred because the patients were known in the past to have demanded surgery for symptoms which were, in the one case, self-imposed and, in the other case, psycho-neurotic of nature. In both cases the delay lead to the death of the patient from an initially benign source. It is suggested that in cases of this nature, where it is doubtful whether they are surgical, psychiatric consultation should be requested. It is also suggested that cases of self-inflicted or fictitious disease should receive psychiatric attention before they reach a “chronic state” and a notice with a description of the patient and his behaviour should appear in the local medical journal. Yet in spite of the past history, the physician faced with such a patient should always be prepared to rule out the ever-present possibility of serious physical illness. It is suggested that closer teamwork between surgeon and psychiatrist might result in greater service to the patient, at the same time as it will safeguard the physician. The psychiatric diagnosis must be made on positive criteria, not as is so often done, on the basis of negative physical findings.

This publication has 7 references indexed in Scilit: