Death, suffering and disease – a different kind of grief

Detalhes bibliográficos
Autor(a) principal: Dias, Tânia
Data de Publicação: 2014
Outros Autores: Sousa, Nunes de
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
DOI: 10.32385/rpmgf.v30i2.11284
Texto Completo: https://doi.org/10.32385/rpmgf.v30i2.11284
Resumo: Introduction: The Family Physician should have the ability to manage health problems in all their dimensions and use health resources efficiently as the patient’s advocate. Case Description: This report describes a 51 year-old man who was married and the father of three living children. His symptoms began in 2008 following the death of his son and an episode of reactive depression. In 2011 he had his first “seizure”. He consulted with a neurologist who diagnosed epilepsy and prescribed anticonvulsants in progressively increasing doses despite inconclusive investigations. In August 2012, he attempted suicide with a drug overdose saying “... I want to be near the boy.” He was then referred, for the first time, to a psychiatrist. In March 2013, he was re-evaluated by his family physician, because of the persistence of the symptoms. He was diagnosed with somatization/conversion and was again referred for psychiatric consultation. He was treated with sertraline and clonazepam, which contributed to the partial resolution of the “seizures”. Comment: This case emphasizes the importance of assessing all of the patient’s health issues in the biopsychosocial context. The loss of a family member is associated with increased vulnerability to develop psychiatric disorders, including suicidal behavior. It emphasizes the role of the family physician, who has the tools to manage health resources and the ability to guide the patient. In an era of sub-specialization, it is important that the family physician has the ability to use a holistic approach, focusing on suffering as well as the disease.
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spelling Death, suffering and disease – a different kind of griefA morte, o sofrimento e a doença – um luto diferenteGriefConversion DisorderHolistic HealthPesarTranstorno ConversivoSaúde HolísticaIntroduction: The Family Physician should have the ability to manage health problems in all their dimensions and use health resources efficiently as the patient’s advocate. Case Description: This report describes a 51 year-old man who was married and the father of three living children. His symptoms began in 2008 following the death of his son and an episode of reactive depression. In 2011 he had his first “seizure”. He consulted with a neurologist who diagnosed epilepsy and prescribed anticonvulsants in progressively increasing doses despite inconclusive investigations. In August 2012, he attempted suicide with a drug overdose saying “... I want to be near the boy.” He was then referred, for the first time, to a psychiatrist. In March 2013, he was re-evaluated by his family physician, because of the persistence of the symptoms. He was diagnosed with somatization/conversion and was again referred for psychiatric consultation. He was treated with sertraline and clonazepam, which contributed to the partial resolution of the “seizures”. Comment: This case emphasizes the importance of assessing all of the patient’s health issues in the biopsychosocial context. The loss of a family member is associated with increased vulnerability to develop psychiatric disorders, including suicidal behavior. It emphasizes the role of the family physician, who has the tools to manage health resources and the ability to guide the patient. In an era of sub-specialization, it is important that the family physician has the ability to use a holistic approach, focusing on suffering as well as the disease.Introdução: São competências do Médico de Família (MF) a gestão dos problemas de saúde em todas as suas dimensões e a utilização eficiente dos recursos de saúde num papel de provedoria do doente. Descrição do Caso: Homem de 51 anos, casado, pai de 3 filhos vivos. Os antecedentes patológicos iniciaram-se em 2008, com uma perturbação depressiva reativa à morte de um filho. Em 2011 inicia «convulsões», atribuindo-se-lhe o diagnóstico, em neurologia, de epilepsia, tendo sido medicado com doses crescentes de anticonvulsivantes apesar de estudo etiológico inconclusivo. Em agosto de 2012, após intoxicação medicamentosa voluntária (referindo «…eu tenho de ir para a beira do menino…»), é referenciado à consulta de psiquiatria que nunca se concretizou. Em março de 2013, na consulta do MF, dada a persistência da sintomatologia, considera-se que poderá existir um quadro de somatização/conversão, sendo o doente referenciado à consulta de psiquiatria. É observado em abril de 2013, medicado com sertralina e clonazepam, com resolução parcial das «crises». Comentário: Este caso salienta a importância da valorização das queixas no contexto biopsicossocial do doente. A perda de um membro da família está associada a uma maior vulnerabilidade a distúrbios psiquiátricos, nomeadamente comportamentos suicidas. Ressalta o papel do MF como gestor dos recursos de saúde e orientador do paciente. Numa era de subespecialização, é função do Médico de Família oferecer ao doente uma abordagem holística, valorizando tanto o seu sofrimento como a sua doença.Associação Portuguesa de Medicina Geral e Familiar2014-04-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.32385/rpmgf.v30i2.11284https://doi.org/10.32385/rpmgf.v30i2.11284Portuguese Journal of Family Medicine and General Practice; Vol. 30 No. 2 (2014): Revista Portuguesa de Medicina Geral e Familiar; 110-6Revista Portuguesa de Medicina Geral e Familiar; Vol. 30 Núm. 2 (2014): Revista Portuguesa de Medicina Geral e Familiar; 110-6Revista Portuguesa de Medicina Geral e Familiar; Vol. 30 N.º 2 (2014): Revista Portuguesa de Medicina Geral e Familiar; 110-62182-51812182-517310.32385/rpmgf.v30i2reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://rpmgf.pt/ojs/index.php/rpmgf/article/view/11284https://rpmgf.pt/ojs/index.php/rpmgf/article/view/11284/11007Dias, TâniaSousa, Nunes deinfo:eu-repo/semantics/openAccess2024-09-17T11:59:46Zoai:ojs.rpmgf.pt:article/11284Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-09-17T11:59:46Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Death, suffering and disease – a different kind of grief
A morte, o sofrimento e a doença – um luto diferente
title Death, suffering and disease – a different kind of grief
spellingShingle Death, suffering and disease – a different kind of grief
Death, suffering and disease – a different kind of grief
Dias, Tânia
Grief
Conversion Disorder
Holistic Health
Pesar
Transtorno Conversivo
Saúde Holística
Dias, Tânia
Grief
Conversion Disorder
Holistic Health
Pesar
Transtorno Conversivo
Saúde Holística
title_short Death, suffering and disease – a different kind of grief
title_full Death, suffering and disease – a different kind of grief
title_fullStr Death, suffering and disease – a different kind of grief
Death, suffering and disease – a different kind of grief
title_full_unstemmed Death, suffering and disease – a different kind of grief
Death, suffering and disease – a different kind of grief
title_sort Death, suffering and disease – a different kind of grief
author Dias, Tânia
author_facet Dias, Tânia
Dias, Tânia
Sousa, Nunes de
Sousa, Nunes de
author_role author
author2 Sousa, Nunes de
author2_role author
dc.contributor.author.fl_str_mv Dias, Tânia
Sousa, Nunes de
dc.subject.por.fl_str_mv Grief
Conversion Disorder
Holistic Health
Pesar
Transtorno Conversivo
Saúde Holística
topic Grief
Conversion Disorder
Holistic Health
Pesar
Transtorno Conversivo
Saúde Holística
description Introduction: The Family Physician should have the ability to manage health problems in all their dimensions and use health resources efficiently as the patient’s advocate. Case Description: This report describes a 51 year-old man who was married and the father of three living children. His symptoms began in 2008 following the death of his son and an episode of reactive depression. In 2011 he had his first “seizure”. He consulted with a neurologist who diagnosed epilepsy and prescribed anticonvulsants in progressively increasing doses despite inconclusive investigations. In August 2012, he attempted suicide with a drug overdose saying “... I want to be near the boy.” He was then referred, for the first time, to a psychiatrist. In March 2013, he was re-evaluated by his family physician, because of the persistence of the symptoms. He was diagnosed with somatization/conversion and was again referred for psychiatric consultation. He was treated with sertraline and clonazepam, which contributed to the partial resolution of the “seizures”. Comment: This case emphasizes the importance of assessing all of the patient’s health issues in the biopsychosocial context. The loss of a family member is associated with increased vulnerability to develop psychiatric disorders, including suicidal behavior. It emphasizes the role of the family physician, who has the tools to manage health resources and the ability to guide the patient. In an era of sub-specialization, it is important that the family physician has the ability to use a holistic approach, focusing on suffering as well as the disease.
publishDate 2014
dc.date.none.fl_str_mv 2014-04-01
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https://doi.org/10.32385/rpmgf.v30i2.11284
url https://doi.org/10.32385/rpmgf.v30i2.11284
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dc.publisher.none.fl_str_mv Associação Portuguesa de Medicina Geral e Familiar
publisher.none.fl_str_mv Associação Portuguesa de Medicina Geral e Familiar
dc.source.none.fl_str_mv Portuguese Journal of Family Medicine and General Practice; Vol. 30 No. 2 (2014): Revista Portuguesa de Medicina Geral e Familiar; 110-6
Revista Portuguesa de Medicina Geral e Familiar; Vol. 30 Núm. 2 (2014): Revista Portuguesa de Medicina Geral e Familiar; 110-6
Revista Portuguesa de Medicina Geral e Familiar; Vol. 30 N.º 2 (2014): Revista Portuguesa de Medicina Geral e Familiar; 110-6
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10.32385/rpmgf.v30i2
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