Heart-sink patients are those where diagnosis is not possible, who do not get better despire every effort on the part of the doctor and especially those who do not comply with treatment.
Also included in this group are patients who attend frequently for every minor ailment for the ulterior motive o emotional support such as a marital problem, loneliness or social incompetence. Sometimes a contract with the patient agreeing on a monthly consultation to listen to, but not often treat, the problems is the best compromise.
Sometimes the patient appears unable to acknowledge emotion, stress or depression as a cause of seemingly physical symptoms. This somatization may be particularly difficult to manage. Depression should be added to the list of the great mimicking diseases.
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