- Complaints seem out of proportion to organic pathology.
- Treatment does not yield expected results despite an improved organic status.
- New symptoms arise as old symptoms resolve.
- The patient repeatedly raises issues/questions already addressed.
- The patient seems to require more time and attention than usual.
- The patient does not adhere to prescribed treatment.
- The patient takes anxiolytic, sleep or analgesic medication for a longer period of time than appropriate.
- The patient resists the idea of attempting to wean from anxiolytic, sleep, or analgesic medication.
- The patient exhibits a great deal of emotional distress.
- The patient reports significant family problems in dealing with illness.
- The patient overuses alcohol or other psychoactive substances.
- Psychophysiological components could exacerbate the medical condition [10].
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