H.G. is a 28-year-old Caucasian female who has been a patient in your primary care clinic for about six months. She has seen several other providers in your group, but you are the only provider she has requested to see more than once. She is generally healthy and spends most of her visits describing vague anxiety symptoms interspersed with complaints about her dramatic romantic relationships. At her last two visits, she has made a point to tell you that you are the only provider in the group who really cares about patients, that your colleagues are all “dismissive” of her concerns, and that you are the only health care provider she has ever trusted.
On a particularly busy day in the clinic, H.G. attempts to secure a last-minute appointment. Given your hectic schedule, you arrange for one of your group partners to see H.G. that day. As you are running in and out of consulting rooms you are stopped by your office manager who informs you that H.G. has called the clinic five times in the last 3 hours, growing increasingly frantic and demanding to see no other provider but you. On one call she stated that she was going to report you to “the Board” for patient abandonment, and on her last call she hinted darkly that the entire practice will be responsible “for whatever happens to me.”
PART 1:
What is your differential diagnosis?
What is the most likely diagnosis? Why is this the most likely diagnosis? [HINT: Include your decision making and diagnostic criteria for reaching this diagnosis]
What is the diagnostic work-up?
Some of the differential diagnosis are
The most likely diagnosis is personality disorder (Histrionic Personality Disorder) in which the patient are most dramatic having romantic relationship which are also dramatic,approaching specific persons and avoiding others by having a disbelief on them,quarrelsome behaviour ,conflicts with other providers .
The diagnostic work up here are psychotherapy ,counselling and medications to treat anxiety
H.G. is a 28-year-old Caucasian female who has been a patient in your primary care clinic...
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