Neurologic symptoms in a depressed woman : A medical-psychiatric case conference

A 48-year-old woman with head and neck pain and upper extremity weakness demonstrated equivocal neurologic findings and otherwise essentially negative laboratory and x-ray evaluations. An interview at a case conference revealed significant depression, severe marital discord, and a poor self-image. The correlation of the onset of her physical symptoms with certain life events suggested that psychologic factors were important contributors to her disorder. Discussed here are an approach to understanding such problem patients and methods of ongoing management.