- Joined
- Feb 8, 2004
- Messages
- 8,026
- Reaction score
- 4,146
http://www.nutritionj.com/content/pdf/1475-2891-11-9.pdf
http://www.ncbi.nlm.nih.gov/pubmed/20515497
OK vegetarian diets improving mood are half the reason why I'm bringing this up.
I've found this a very effective method to wiggle out malingerers. If I suspect malingering, I offer a vegetarian diet, mention the alleged benefits, mention that there's data showing it can improve mood, and guess what? So far every single person I've offered it to demanded to get out of to the hospital and sign out AMA.
Here's what typically happens. We get a patient, patient alleges to be suicidal, may even show vegetative sx, tell me that they've been on every antidepressant and nothing works. I tell them something to the effect of, "Sir maybe a new approach is needed. We can try a vegetarian diet. Please allow me to show you some articles showing why it can help." Then the patient becomes irate, all of a sudden loses all of their vegetative sx, then demands to leave the hospital, even a lot of them saying they faked all of this when I tell them that if they are suicidal I got to keep them in the hospital against their will. While waiting to sign out AMA, they are told to wait a few hours just so we can check collateral data about their safety and during this entire time we see no signs of depression. Some of them even say they're going to a neighboring hospital because the food is better.
I don't see anything unethical with this. First off, I'm offering them the data showing why it can help. This is evidenced-based data. There is a theory to why it works considering the arachadonic acid/omega 3 ratios in the brain, I've already done a malingering assessment and I have significant reasons to believe they are malingering that meet reasonable medical certainty.
I've not yet had a patient with vegetative signs that when offered this diet maintain their presentation, in which case I would've believed they were depressed. It could also be that because I'm not trying with this those I don't believe to be malingering, I'm not getting non-malingerers to try this approach. I've spent years doing M-FASTs and SIRSs so it's to the degree where I can almost do it in my head based on an interview.
Thoughts?
http://www.ncbi.nlm.nih.gov/pubmed/20515497
OK vegetarian diets improving mood are half the reason why I'm bringing this up.
I've found this a very effective method to wiggle out malingerers. If I suspect malingering, I offer a vegetarian diet, mention the alleged benefits, mention that there's data showing it can improve mood, and guess what? So far every single person I've offered it to demanded to get out of to the hospital and sign out AMA.
Here's what typically happens. We get a patient, patient alleges to be suicidal, may even show vegetative sx, tell me that they've been on every antidepressant and nothing works. I tell them something to the effect of, "Sir maybe a new approach is needed. We can try a vegetarian diet. Please allow me to show you some articles showing why it can help." Then the patient becomes irate, all of a sudden loses all of their vegetative sx, then demands to leave the hospital, even a lot of them saying they faked all of this when I tell them that if they are suicidal I got to keep them in the hospital against their will. While waiting to sign out AMA, they are told to wait a few hours just so we can check collateral data about their safety and during this entire time we see no signs of depression. Some of them even say they're going to a neighboring hospital because the food is better.
I don't see anything unethical with this. First off, I'm offering them the data showing why it can help. This is evidenced-based data. There is a theory to why it works considering the arachadonic acid/omega 3 ratios in the brain, I've already done a malingering assessment and I have significant reasons to believe they are malingering that meet reasonable medical certainty.
I've not yet had a patient with vegetative signs that when offered this diet maintain their presentation, in which case I would've believed they were depressed. It could also be that because I'm not trying with this those I don't believe to be malingering, I'm not getting non-malingerers to try this approach. I've spent years doing M-FASTs and SIRSs so it's to the degree where I can almost do it in my head based on an interview.
Thoughts?