Introduction :
Mental attitude of the patient is important in diagnosis and treatment planning
1.Cornell Medical index id a health questionnaire used to obtain a large amount of relevant medical and psychiatric information
2.Psychological testing [ Psychometrics] is a field characterised by use of behaviour samples to assess the cognitive and emotional functioning of an individual.
3.Graphology is described as a scientific study and analysis of hand writing ,art of interpreting character and personality from pecularities in Hand writing -GARDNER 1977
4.First serious treatise on Hand writing analysis -1622- By Camillo Baldo -"How to Judge the nature and character of a person from his letter "
Classification :
1.Blum In 1960 - [Sharry 1974]
1.reasonable /unreasonable
2.Realistic/Unrealistic
The psychological changes assosciated with ageing were well described by BURDACH [1819]
2.M.M House classification
a.The Philosophical patient
b.The Exacting
c.Indifferent
D.The Hysterical
3.Heart well classification
a.the realists
b.the resenters
c.the resigned
4.Dr.Suzanne Richard Classification [1957]
a. the Mature group
b.The rocking chair group
c.the armoured
d.the angry men
e.the self haters
4.Winklers Traits of an ideal patient
5.Simon Gamer's Classification
-Modification of House classification
a.Level of involvement
b.Level of trust
+ -disengaged
+++- reasonably engaged [ideal patient ]
engagementt -++++.trust ++ -- Submitter
engagement ++, trust ++ -Reluctant
eng -+ ,trust + - Indifferent
engagement-++++.trust + - Resistant
++++- over involovement
6.Pankey system by Dr.L.D Pankey
Class I -High level Dental I.Q
Class II - Good dental I.Q
Class III- Poor Dental I.Q
Class IV- Very Low Dental I.Q
7.O'Shea Classification
a.Complaint
b.Sophisticated
c.Responsive
8.Koper classification
a.Problem patients
b. Difficult denture wearers
Jamieson stated that fitting the personality of the aged patient is often more difficult than fitting the prostheses to the patient mouth .
Krochack, recognizing the critical need to understand the behaviour of the edentulous patient stated that many patients with favourable anatomy cannot tolerate a well fabricated prosthesis and yet other patient with unfavourable anatomy willing endure prosthesis that may be ill fitting. He asserted that the inconsistencies of patient adaptation in this situation may be related to the patient psychological state .
Kent stated that the ability of a doctor to determine when a patient has unrealistic expectation and the ability to manage that interaction effectively may avert a conflict
A specific classification system has been presented to identify response by individuals who are edentulous. Three types of maladaptive responses are considered as probable consequences of fear, anxiety and depression associated with complete edentulism. In class1, the patient adapts physically but is maladaptive psychologically. In maladaptive class 2, the so called difficult patients is maladaptive physically and psychologically and there by keeps the doctor involved technically and emotionally for a protracted period of time . The maladaptive class 3 patient collapses with complete edentulisim. Physical and emotion maladaptibility is accompanied by much suffering and social withdrawal
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