Version June 2024
| Attendance or referral | Symptoms and precipitants | Tests and investigations | Outcome and plan | Key events | |
| 1986 (age 12 years) | Hospital A admission | Right flank pain | Normal laparoscopy | Non-specific abdominal pain | Death of father |
| 1987 (age 13 years) | Hospital A admission | Overdose of analgesics | -- | Referred to social worker; patient stealing money from mother | Arguments with mother |
| 1990 (age 16 years) | Hospital B admission | Inhalation of smoke from fire after fire setting | Normal blood tests | Self-discharged | Set fire to house; pregnant |
| 1991 (age 17 years) | Neurology outpatient services (B) | Episodes of loss of consciousness and muscle twitching | Normal EEG and CT scan; normal blood tests | Reassured no organic cause | -- |
| 1991 (age 17 years) | Emergency admission to general surgery (A) | Right-sided abdominal pain | Normal radiograph | Admitted for observation; self-discharged against medical advice | -- |
| June, 1992 (age 18 years) | Gynecology outpatient clinic | Claims to be pregnant | Normal pregnancy test | "She lied to the registrar, saying that she had a positive pregnancy test when she had been told by the GP [general practitioner (family doctor)] that she was not pregnant" | -- |
| October, 1992 (age 18 years) | Emergency admission (A) | Overdose of paracetamol in context of excess alcohol | Noted abscess on right breast | Worried about scarring on right breast; dermatologist considered possibility of artifactual skin disorder | Grandfather ill |
| 1993 (age 19 years) | Ear, nose, and throat outpatient clinic (C) | Episodes of hemoptysis | Normal direct laryngoscopy | Followed up in psychiatric outpatients clinic; possibility of personality disorder considered | -- |
| 1993 (age 19 years) | General medicine outpatient clinic (B), with subsequent admission | Unexplained septicemia | Isolated blood culture of saprophytic organisms not usually associated with the cause of sepsis in the immunocompetent patient | "Given these findings we feel that there has been deliberate introduction into the body of material from an environmental source" | Boyfriend of 2 years has left her |
| 1994 (age 20 years) | Gynecology outpatient clinic (B) | "Told me she had been sterilized" | Fallopian tubes patent | "When I obtained her notes and showed her this she decided to self-discharge" | -- |
| 1995 (age 21 years) | Neurology outpatient clinic on second opinion (C) | Recurrent blackouts and odd movements since age 17 years | All investigations normal (video telemetry) | Diagnosis of psychogenic non-epileptic seizures | -- |
| 1995 (age 21 years) | Psychiatric outpatient clinic | Patient denies that non-epileptic seizures are related to emotional problems; attends clinic with crutches | Cognitive behavioral therapy not helping | Demands to be kept on carbamazepine despite advice to taper drug | Drinking a bottle of vodka every day |
| 1996 (age 22 years) | Emergency admission orthopaedics | Pain in right forearm after repeatedly punching wall | Substantial soft tissue injury with swelling but no fracture | Currently an inpatient on local psychiatric ward; follow-up by mental health team | Child born |
| 1996 (age 22 years) | Admission orthopaedics (D) | Infection right wrist; demanding oramorph | No positive cultures; "birefringent particles found consistent with foreign material in a distribution incompatible with wound-care procedures" | Planned supportive confrontation; patient self-discharged; family doctor and psychiatric team informed | -- |
| 1996 (age 22 years) | Pediatric outpatient clinic (B) | Worried about 1-year-old son with 3 month history of "shaking episodes" | Investigations unable to detect any relevant organic cause | Patient requesting disability living allowance for son; asking how to hire a wheelchair for herself | Case conference convened by social services at surgery of family doctor |
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