In the face of a clinical syndrome reflecting lack of forensic and impulse disinhibition, clinicians often incline to investigate a patient with CT scan and neuropsychological tests relative to frontal functions. Meanwhile, when the patient refuses tests and when the CT scan is perfectly normal, the clinician evaluation can make clinicians more sensitive to a different way for interpreting the syndrome.
CASE REPORT
P D is a 46 year old woman. At the age of 22, she became pregnant and secretly gave birth to a boy in Montreal without her parents ever knowing she was expecting a baby. PD entrusted the child to her eldest sister, who already had nine children of her own. After two years, this sister decided to adopt the boy. Naturally, this family secret was thought to he a critical element in the psychopathological history of the patient. The patient then met her husband, whom she married at the age of 24 after again becoming pregnant. The couple separated in July 1984 shortly after PD refused to have a hysterectomy. In November 1984, she quit her job as a secretary-receptionist in a store. In March 1985, one month after the death of her mother, she agreed to a hysterectomy and, on her return home from the hospital, her behaviour began to change until her personality stood in stark contrast with the pleasant, orderly person she used to be. At this time, she also began to embezzle funds, which eventually led to a criminal conviction. In all, she was accused of siphoning $40,000 from the social club where she worked as a secretary. In