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Guest khuram

Unexpected PMP

11 posts in this topic

I was wndering if we could list the unsusual PMP which is definitely going to be there.

They say that expect one out of the three which will surprise you.

I know that basics of answering will remain the same but just for the sake of self confidence.

I could think of:

Pathological gambling.

Any more ideas?

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testamentary capacity/ enduring power of attorney..................dementa/paranoia picture

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Pathological gambling:

is it pathological?-- inability to stop restlessness and irritbility when notgambling, 'chasing losses' requirement to raise stakes to achieve a thrill

take bio psycho social history

manage by

bio: if illness found

psyco: gamblers anon,? CBT

soc: marital discord..refer, citizens advice bureau

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Also SSRIs.

testamentary capacity/ enduring power of attorney..................dementa/paranoia picture

This is about capacity,isn`t it?

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what about a pt with histrionic personality complaining about her doctor making sexual advances towards her/ being sexually disinhibited?

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ok

again review her diagnosis

see her with a nurse

(cos iam male and i dont want her flaunting herself over my desk..and making accusations..

assess previous accusations etc

monitior mental state

dd. affective, hypomania, mania?

under infuence drugs alcohol

is she middle aged?

disinhibited

frontal lobe sgns?>

possible early picks?

question her about the allegations? could be true.

MMSE early dementia?

advise coleague

allow her the info to make a complaint

report etc

hopefully she'll go away

document it clearly

any addition?

i hate these ones

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pathological gambling:

Pathological Gambling is persistent and recurrent maladaptive gambling behavior that disrupts personal, family, or vocational pursuits. The individual may be preoccupied with gambling (e.g., reliving past gambling experiences, planning the next gambling venture, or thinking of ways to get money with which to gamble). Most individuals with Pathological Gambling say that they are seeking an aroused, euphoric state that the gambling gives them which appears more exhilarating than the money. Increasingly larger bets, or greater risks, may be needed to continue to produce the desired level of excitement.

Persistent, maladaptive gambling is expressed by 5 or more of the following. The patient

Needs to put increasing amounts of money into play to get the desired excitement.

Has repeatedly tried (and failed) to control or stop gambling.

Feels restless or irritable when trying to control gambling.

Uses gambling to escape from problems.

Often tries to recoup loses.

Lies to cover up the extent of gambling.

Has stolen to finance gambling.

Has jeopardized a job or important relationship.

Has had to rely on others for money to relieve the consequences of gambling.

Is preoccupied with gambling.

A Manic Episode doesn't better explain this behavior

Treatment for the person with compulsive gambling begins with the recognition of the problem. It is often associated with denial, allowing the person to believe there is no need for treatment. Most people affected by compulsive gambling enter treatment under pressure from others, rather than a voluntary acceptance of the need for treatment. Addicts to gambling need professional help and they should get behavioral therapy. Often this happens too late and the patient has already accumulated large debts.

Counseling and Psychotherapy

Treatment options include individual and group psychotherapy, and self-help support groups such as Gamblers Anonymous. Abstinence principles that apply to other types of addiction, such as substance abuse and alcohol dependence, are also relevant in the treatment of compulsive gambling behavior.

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Dutchie-Brilliant answer (patho gambling)!

You are definitely in a flow state. I wish you well! :)

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i copied this from the web..

not from my brain alas

iam in a no flow state and anxious!

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We all have done hard work.

Thats all we are expected to do.

Bring it on!

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i copied this from the web..

not from my brain alas

iam in a no flow state and anxious!

Look at it this way- you have been contributing in some way...

Like Khuram rightly said, we have all done some hard work. Lets bring it on.

Good luck everyone!

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