Biomedical subjects
Publications and source records attributed to S D Nicholson.
Anorexia nervosa is an illness typically associated with youth. However, older patients too can suffer from this condition which sometimes arises de novo in old age. The aetiology, features, management and outcome in the older patient are reviewed in this article.
A 29-year-old man admitted to a psychiatric unit was successfully treated for a paranoid psychosis with trifluoperazine. Following reduction of neuroleptic dosage and addition of paroxetine he developed severe extra-pyramidal side effects. These remitted after withdrawal of medication and did not recur following recommencement of trifluoperazine. This is the first report of such a side effect associated with paroxetine use in man.
There are no objective means of verifying a psychiatric diagnosis. Some patients appear to exploit this inherent uncertainty by claiming to be mentally ill when they are not. Occasional exaggeration or feigning of illness may be normal, but persistent, severe or recurrent simulation is rare, is associated with major character disorder and has a poor prognosis.