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Epistemic injustice in a case of cyclic vomiting syndrome. A case report

Published online by Cambridge University Press:  13 August 2021

A. Cerame Del Campo*
Affiliation:
Centro De Salud Mental, Instituto Psiquiátrico José Germain, Leganes, Spain
P. Coucheiro Limeres
Affiliation:
Centro De Salud Mental, Instituto Psiquiátrico José Germain, Leganes, Spain
A. Franco Soler
Affiliation:
Centro De Salud Mental, Instituto Psiquiátrico José Germain, Leganes, Spain
*
*Corresponding author.

Abstract

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Introduction

We present the case of a 19-year-old female patient treated in our hospital due to an outburst of persistent vomiting. The patient had a diagnosis of Cyclic Vomiting Syndrome (CVS), a year before the diagnosis the patient had been labeled as a somatizer and admitted into the department of psychiatry. Given her psychiatric record and the fact that CVS is a rare diagnosis we were consulted on arrival.

Objectives

CVS is an infrequent disorder of unknown etiology which shares similarities with migraine headaches. It is characterized by episodes of vomiting followed by periods of remission without active symptomatology with no organic pathology to account for the symptoms. Epistemic injustice (EI) is defined by Miranda Fricker as “a damage done to someone in their capacity as a knower”. She defined two forms of EI: testimonial and hermeneutical injustice.

Methods

A case report is presented alongside a review of the relevant literature regarding CVS and epistemic injustice.

Results

On arrival at the emergency department she tried explaining her condition, but her testimony was disregarded on the basis of her psychiatric record. It was only after the on-call psychiatrist explained the condition when she received the appropriate abortive treatment, after which she was admitted to the internal medicine department where she was followed by the liaison psychiatrist.

Conclusions

CVS is a disabling disease still unknown to most clinicians in spite of the increasing quality evidence about its identification and treatment. The case highlight how cases of newly identified disease can suffer from testimonial and hermeneutical injustice.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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