A 14-year-old boy was brought to the psychiatric clinic for complaints of abdominal pain and abnormal neck and mouth movement taking place from last 2 months. He was operated for appendix 2 years back and another abdominal surgery for complaints of abdominal pain and vomiting happened 1 year back. A detailed assessment was performed, wherein it was found out that patient’s academic performance has always been below average. The reason for below average performance came out to be Borderline IQ as measured by the IQ test. When asked about disturbing events lately, the boy revealed that a few months back when he was sent to the hostel for improvement in academics, other children used to bully him there and he was beaten by his maths teacher few times for being a failure in solving math problems. The incidents resulted in refusal for school. The patient was of overemotional and anxious temperament. The pressure to perform well despite being of low IQ, peer bullying and difficult temperament resulted in somatic complaints.
— Dr. Aarti Midha (Psychiatrist and Depression Specialist, Jaipur)
52 year old male with complaints of abdominal pain, burning sensation and shivering in limbs, and ghabrahat was referred to psychiatric clinic .Patient took various treatments including ayurvedic treatment, general physician and gastroenterology treatment with no relief in his complaints. At the department, detailed psychiatric assessment was done wherein it was found that patient was of anxious temperament and was found to be significant on rash decision making. Patient was undergoing stress regarding conflict with elder brother over property matter .Things worsened after their father expired . Relations were strained with mother as well who lived with elder brother. Other than the interpersonal conflict, patient disclosed about his sexual difficulty (complaints of delayed erection and premature ejaculation) affecting his sexual life with wife from last 1.5 years. The stressors resulted in somatic complaints. His treatment was planned accordingly. Medicines, psycho education regarding relationship between mind and body and psychotherapy to resolve conflict were planned.
Dr. Aarti Midha
Master N of age 8 years living in Jaipur studying in 3rd class presented with complaints of stomach ache, vomiting, weakness, anxiety and reduced concentration for about 20-25 days and was experiencing increased problem from last 3-4 days. Though he was on gastro treatment with some relief, the complaints still persisted and there were no significant findings in the lab investigations. Patient was therefore referred to the psychiatrist for understanding the cause of presented symptoms.
Detailed history was taken and assessment was done where in the results concluded that Master N was having stubborn, short tempered temperament and not very good academic performance due to which he used to get frequently scolded by his dominating mother and beaten at times which led to dislike for mother. Patient was having ADHD with conduct problems which were impairing his school performance and scoldings by parents were further aggravating his problem. Also when patient was made to write a sentence to rule out any learning disability, it was observed that patient did spelling mistakes and so learning disability test was performed wherein there was strong evidence of him being at risk. Hence, patient and parents psychotherapy was done and pharmacotherapy was advised.
Dr. Aarti Midha