{"id":186,"date":"2010-12-08T16:48:00","date_gmt":"2010-12-08T16:48:00","guid":{"rendered":"https:\/\/blogs.bmj.com\/case-reports\/?p=186"},"modified":"2010-12-08T16:51:59","modified_gmt":"2010-12-08T16:51:59","slug":"ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/","title":{"rendered":"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness"},"content":{"rendered":"

The authors of this case report, “Ineffective chronic illness behaviour,” illustrate how difficulties in treatment interactions need analysis beyond the patient\u2019s presumed diagnosis or disorder
\n– especially when patients\u2019 behaviour during treatment is unusual or unexpected related to the primary symptoms.<\/p>\n

The authors describe their patient\u2019s behaviour as “a form of ineffective chronic illness behaviour that has been jointly but inadvertently created by patient and professional. Analyzing the\u00a0situation from this perspective, another strategy \u2013 apart from referral or \u201cpampering and\u00a0dithering\u201d \u2013 is within reach: making a fresh start in the treatment process of the so-called
\n\u201cdifficult\u201d patient.”<\/p>\n

“Such an endeavour includes, but is not necessarily limited to: a disentanglement of symptoms and (learned) illness behaviour, an analysis of the dynamics of the treatment alliance, a reconsideration of the given diagnosis and available treatment options, and \u2013 preferably \u2013 a discussion with the patient about aforementioned issues. In this case, the authors choose to discuss the issues openly with the patient, starting from the concept of the \u201cdifficult\u201d patient, who runs the risk to be expelled from every health care system available.”<\/p>\n

They then jointly establish a “explanatory theory of patient\u2019s claim on care: an enduring lack of recognition of qualities and vulnerabilities by important others.”<\/p>\n

Particularly interesting in this case was the role of a community nurse (and researcher) who assumed “a case-manager role, coordinating efforts to ameliorate social problems (including work and meaningful contacts), to structure access to additional psychiatric care (e.g. crisis intervention, hospitalization), and to be a trusted person in the background.”<\/p>\n

The case report describes in lucid detail how these joint efforts between multiple stakeholders have decreased the patient\u2019s symptoms, improved his social functioning, and limited his health care use.<\/p>\n

Rakesh Biswas<\/em>
\n Deputy Editor<\/em><\/p>\n

Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

The authors of this case report, “Ineffective chronic illness behaviour,” illustrate how difficulties in treatment interactions need analysis beyond the patient\u2019s presumed diagnosis or disorder – especially when patients\u2019 behaviour during treatment is unusual or unexpected related to the primary symptoms. The authors describe their patient\u2019s behaviour as “a form of ineffective chronic illness behaviour […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":142,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[203],"tags":[],"class_list":["post-186","post","type-post","status-publish","format-standard","hentry","category-editors-choice"],"yoast_head":"\nIneffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness - BMJ Case Reports blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness - BMJ Case Reports blog\" \/>\n<meta property=\"og:description\" content=\"The authors of this case report, “Ineffective chronic illness behaviour,” illustrate how difficulties in treatment interactions need analysis beyond the patient\u2019s presumed diagnosis or disorder – especially when patients\u2019 behaviour during treatment is unusual or unexpected related to the primary symptoms. The authors describe their patient\u2019s behaviour as “a form of ineffective chronic illness behaviour [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/\" \/>\n<meta property=\"og:site_name\" content=\"BMJ Case Reports blog\" \/>\n<meta property=\"article:published_time\" content=\"2010-12-08T16:48:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2010-12-08T16:51:59+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/2010\\\/12\\\/08\\\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/2010\\\/12\\\/08\\\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\\\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness\",\"datePublished\":\"2010-12-08T16:48:00+00:00\",\"dateModified\":\"2010-12-08T16:51:59+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/2010\\\/12\\\/08\\\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\\\/\"},\"wordCount\":315,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/#organization\"},\"articleSection\":[\"Editors choice\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/2010\\\/12\\\/08\\\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/2010\\\/12\\\/08\\\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/2010\\\/12\\\/08\\\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\\\/\",\"name\":\"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness - BMJ Case Reports blog\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/#website\"},\"datePublished\":\"2010-12-08T16:48:00+00:00\",\"dateModified\":\"2010-12-08T16:51:59+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/2010\\\/12\\\/08\\\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/2010\\\/12\\\/08\\\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/2010\\\/12\\\/08\\\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/\",\"name\":\"BMJ Case Reports blog\",\"description\":\"The official BMJ Case Reports blog, a place to discuss wider medical progress and implications.\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/#organization\",\"name\":\"BMJ Case Reports blog\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/files\\\/2017\\\/10\\\/blog-logo-case-reports.png\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/files\\\/2017\\\/10\\\/blog-logo-case-reports.png\",\"width\":224,\"height\":34,\"caption\":\"BMJ Case Reports blog\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/case-reports\\\/author\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness - BMJ Case Reports blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/","og_locale":"en_US","og_type":"article","og_title":"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness - BMJ Case Reports blog","og_description":"The authors of this case report, “Ineffective chronic illness behaviour,” illustrate how difficulties in treatment interactions need analysis beyond the patient\u2019s presumed diagnosis or disorder – especially when patients\u2019 behaviour during treatment is unusual or unexpected related to the primary symptoms. The authors describe their patient\u2019s behaviour as “a form of ineffective chronic illness behaviour [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/","og_site_name":"BMJ Case Reports blog","article_published_time":"2010-12-08T16:48:00+00:00","article_modified_time":"2010-12-08T16:51:59+00:00","twitter_card":"summary_large_image","twitter_misc":{"Written by":"","Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/"},"author":{"name":"","@id":""},"headline":"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness","datePublished":"2010-12-08T16:48:00+00:00","dateModified":"2010-12-08T16:51:59+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/"},"wordCount":315,"commentCount":0,"publisher":{"@id":"https:\/\/blogs.bmj.com\/case-reports\/#organization"},"articleSection":["Editors choice"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/","url":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/","name":"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness - BMJ Case Reports blog","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/case-reports\/#website"},"datePublished":"2010-12-08T16:48:00+00:00","dateModified":"2010-12-08T16:51:59+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/case-reports\/2010\/12\/08\/ineffective-chronic-illness-behaviour-in-a-patient-with-long-term-non-psychotic-psychiatric-illness\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/case-reports\/"},{"@type":"ListItem","position":2,"name":"Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/case-reports\/#website","url":"https:\/\/blogs.bmj.com\/case-reports\/","name":"BMJ Case Reports blog","description":"The official BMJ Case Reports blog, a place to discuss wider medical progress and implications.","publisher":{"@id":"https:\/\/blogs.bmj.com\/case-reports\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/case-reports\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/case-reports\/#organization","name":"BMJ Case Reports blog","url":"https:\/\/blogs.bmj.com\/case-reports\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/case-reports\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/case-reports\/files\/2017\/10\/blog-logo-case-reports.png","contentUrl":"https:\/\/blogs.bmj.com\/case-reports\/files\/2017\/10\/blog-logo-case-reports.png","width":224,"height":34,"caption":"BMJ Case Reports blog"},"image":{"@id":"https:\/\/blogs.bmj.com\/case-reports\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"","url":"https:\/\/blogs.bmj.com\/case-reports\/author\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/case-reports\/wp-json\/wp\/v2\/posts\/186","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/case-reports\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/case-reports\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/case-reports\/wp-json\/wp\/v2\/users\/142"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/case-reports\/wp-json\/wp\/v2\/comments?post=186"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/case-reports\/wp-json\/wp\/v2\/posts\/186\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/case-reports\/wp-json\/wp\/v2\/media?parent=186"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/case-reports\/wp-json\/wp\/v2\/categories?post=186"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/case-reports\/wp-json\/wp\/v2\/tags?post=186"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}