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Tijdschrift voor Psychiatrie 56 (2014) 1, 50 - 53

Case report

Hidden diseases: tuberculosis in a woman with a severe mental illness

F.M. van Hasselt, Y. Coehorst, L. Verheijen-Breemhaar, B. Feenstra, A.J.M. Loonen

Patients with severe mental illness often have only limited access to health care for physical symptoms. They have difficulty in organising their thoughts and articulating their requests for medical help; in addition, they often have a reduced perception of stimuli like physical pain. There may also be a lan­guage barrier and sometimes a cultural barrier. The case that we present demonstrates that these are not separate causes but they are interrelated in a complex manner. Screening for a latent disease such as tuberculosis reduces the risk of a delayed diagnosis stemming from the patient’s inability to arti­culate a request for medical help. The physical symptoms of patients with severe mental illness can only be reliably interpreted when there is close cooperation between physicians and psychiatrists.

keywords mental disorders, patient care management, somatic health status