title: [From querulous neurosis to querulous delusion: the psychopathological aspects of persistent dysfunctional complaining].
abstract: BACKGROUND
  The clinical concept of querulous behaviour is used only sporadically in modern psychiatry, although the concept seems to be just as clinical relevant as it was many years ago. The extension of the right to complain has played a role in the acceptance of querulous behaviour. Judicial bodies and other government organisations are being kept busier than ever because people who feel they have been denied justice became entangled in interminable litigation. Gradually, querulous behaviour causes the initial sense of injustice to disappear and querulous patients are damaged economically, socially and personally and experience suffering and function less efficiently.
  
  
  OBJECTIVE
  To describe the history, clinical features, differential diagnosis, possible psychodynamic hypotheses and possible ways of treating querulous behaviour.<br/>
  
  
  METHODS
  We studied the literature using PubMed, PsychInfo, Google and Google Scholar.
  
  
  RESULTS
  There seems to be a spectrum with fluent transitions from normal complaining behaviour, querulous behaviour which is based on a paranoid, narcissistic or obsessive-compulsive personality structure, to severe pathologies like a delusional disorder. There is little evidence that pharmacotherapy or psychotherapy is effective. Nevertheless, there are opportunities for administering psychiatric treatment in order to alleviate the loss and suffering for the patients and their next-of-kin.
  
  
  CONCLUSIONS
  Querulous behaviour is an old clinical concept that still has relevance today for the individual patient, complaints officers and society in general. Our current diagnostic systems provide sufficient opportunities for diagnosing patients correctly. Patients may be best served by judicial mediation at an early stage, combined with psychiatric treatment aimed at controlling emotions and restricting harmful behaviour.
authors.forename: P R M
authors.initials: PR
authors.lastname: Tewarie
authors.forename: R
authors.initials: R
authors.lastname: van der Zwaard
mesh_terms: D015928:Cognitive Behavioral Therapy; D003702:Delusions / Q000628:therapy*; D055317:Evidence-Based Practice; D006801:Humans; D009497:Neurotic Disorders / Q000628:therapy*