Here are few tips to recognize “PSYCHO” patients.
1.)Their response to pain is completely act of proportion. For e.g. while doing RCT they will feel even the routine biomech as pain , This can occurs even of the pulp tissue is completely extirpated. So in a nutshell they not only feel “pressure” as pain but react abnormally to it.
Please differentiate these patients from low pain threshold and anxious patients. Low pain threshold patients are in fact very good patients. They may feel pain but do not react abnormally to it.
Psycho patients may use the pain as an opportunity to strike a conversation with the clinician.
2.) It is inevitable that over the years some patients become good friends and such patients share details of their family life with you as is expected within friends.
But if a patients keeps on discussing & telling about his/her family life to the dentist without any reciprocation from the dentist than be careful. Such patients are in search of some outlet for catharsis of their genuine or imagined problems. Since most successful dentists are usually very patient individuals these patients find an outlet to talk to someone . So these patients will keep on coming to the clinic for some genuine or imagined problems.
3.) If consistently the signs & symptoms do not co-relate with clinical examination than there is a possibility that patient could be having psychological issues.
4.) Patients keeps on coming to the clinic for some reason or the other. Patients talks & shares his/her family details with auxiliary staff.
A dentist needs to differentiate between routine & casual conversation & excessive conversation with auxiliary staff.
A demanding patient is the one who demands the best. A fussy patients is the one who is never satisfied but his problems remain constant.
A psycho patients is the one who comes up with a new problem once you solve his previous problem. Most of the times the clinical examination does not co- relate with the patients complaints.
There patients must also be differentiated from anxious& depressed patients. A psycho patientmay praise you highly one day & criticize you severely the next day. There is no consistency in their behaviour.
5.) Also , at times such patients may tell the dentist something else and their family something else. This at times creates a terrible miscommunication between the dentist and the patients family.
Before you actually brand the patient as psycho you need to delve a little deeper and find out the cause of patient having to search for an outlet for catharsis.
Most of the times it is just plain loneliness at home & the patient has no one to talk to. At times there are martial & familial issues which are unsolved. And sometimes you will find a history of a major surgery/accident etc. which was life changing.
Finally be careful before you label the patient as psycho.
Blame is a powerful weapon & it must be used sparingly .
Management of such patients will be dealt in a separate blog.
