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The case demonstrates that the exclusion of organic causes is just one side of the coin.
IE may also present as a classical affective or psychotic syndrome without the hallmarks of organic causes.
Careful exclusion of organic causes is critical, and this should be followed by a judicious approach to coping with symptoms.
Irritable bowel syndrome (IBS), a well-known functional gastrointestinal disorder, is characterized by abdominal pain, bloating or abdominal discomfort occurring in association with disturbed bowel patterns in the absence of organic causes detectable by routine investigations [ 1].
When the questionnaire is used in epidemiologic research, however, such investigations are often deemed unnecessary because of the presumed low prevalence of organic causes in people with gastrointestinal symptoms [ 8- 10].
A 2001 Consensus Report written by prominent urologists and psychiatrists, for example, proposes a nomenclature that would cover both 'psychogenic and organically based disorders' (unlike the DSM, which it describes as narrowly psychiatric, 'not intended to be used for classification of organic causes of female sexual dysfunctions'; Basson et al., 2001: 92001
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Other findings were highly suggestive of different social role expectations for boys and girls with girls being more likely to be relieved of responsibility regardless of the presence or absence of organic cause.
However, males were more likely to distinguish between pain types regardless of organic cause, only discussing "real" pain (that with a legitimate social cause, as opposed to a legitimate organic cause) and remaining quiet about pain resulting from mishap or clumsiness.
It is possible that they had already ruled out organic causes of their disease before coming to a psychiatrist.
ADHD children are likely under closer surveillance than control children and may additionally be screened for organic causes of their symptoms.
In our clinical practice, a colonoscopy is usually requested after a negative screen for organic causes of diarrhoea such as parasitic infestation, thyroid disease, etc.
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