Primary polydipsia symptoms, such as delusions involving fluid intake or other unusual behaviours. Primary polydipsia may have physiological causes, such as autoimmune hepatitis. Since primary polydipsia is a diagnosis of exclusion, the diagnosis may be made for patients who have medically unexplained excessive thirst, and this is sometimes incorrectly referred to as "psychogenic" rather than "primary" polydipsia. As a diagnosis of exclusion, a diagnosis of primary polydipsia may be the result of elimination of the possibility of diseases causing similar signs and symptoms, such as diabetes insipidus. Diagnosis may be complicated by the fact that chronic and extreme compulsive drinking may impair
Shared decision-making in medicine instances where the term "shared decision-making" was employed was in a report on ethics in medicine by Robert Veatch in 1972. It was used again in 1982 in the "President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research." This work built on the increasing interest in patient-centredness and an increasing emphasis on recognising patient autonomy in health care interactions since the 1970s. Some would even claim that a general paradigm shift occurred in the 1980s in which patients became more involved in medical decision-making than before. For example, a 2007 review of 115 patient