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Malingering
4%
163/4356
Complex regional pain syndrome
2%
88/4356
Anxiety disorder
5%
206/4356
Intimate partner violence
88%
3831/4356
Fibromyalgia
1%
49/4356
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Based on the history and clinical presentation, the most likely diagnosis is intimate partner violence. Domestic violence or intimate partner violence can be in the form of mental or physical abuse, neglect or abandonment. Close to 25% of women will experience domestic violence. Risk factors include young age (19-29 years of age), females, pregnancy and lower socioeconomic status. Affected patients will have repeated visits to the emergency room, find reasons to stay in a treatment facility for an extended period of time and constantly seek approval of their partner. Shields et al. reviewed factors influence outcome in treatment of patients affected by domestic violence. They found that positive outcomes were associated with interdisciplinary approaches to management. This included better history assessment, providing written documentation regarding intervention and better access to information on community resources. Illustration A is a chart documenting the frequency of female domestic violence throughout the world as of 2012. Incorrect Answers Answers 1, 2, 3, 5: These conditions are not consistent with this patient’s history.
2.4
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