The maintenance of clear professional boundaries is an essential part of general practice. Boundary violations are usually considered to be the result of the exploitation of a patient by their doctor, but they can also occur as a result of the behaviour of a patient. This article discusses harassment and stalking of doctors by patients, and outlines some strategies on how to manage this situation. (+info)
Bipolar disorder presenting as stalking--a case report.
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BACKGROUND: Stalking behaviour may find its roots in an individual's psychological development and culture-related factors that facilitate it. Psychiatric disorders may underlie some stalking cases, but no reports exist of the relationship of actual psychiatric status with the expression of stalking behaviour. CASE REPORT: A 22-year-old adoptive woman perpetrated stalking towards her gynaecologist, who took legal action to protect herself. She was admitted to a general hospital psychiatric department and diagnosed with bipolar disorder-I, manic phase, and personality disorder, not otherwise specified. She was prescribed lithium and valproate combination and followed-up as an outpatient. She underwent cognitive-behavioural therapy incorporating Bowlby's concepts. Stalking behaviour did not reemerge. CONCLUSION: Exacerbations of psychiatric episodes may trigger stalking behaviour. Drug treatment may prevent its clinical expression, but underlying ideation and affect may need long-term psychotherapy focusing on attachment. (+info)