Difficult Patients in the Emergency Department: Personality Disorders and Beyond

Nidal Moukaddam; Araceli Flores; Anu Matorin; Nicholas Hayden; Veronica Theresa Tucci

doi:10.1016/j.psc.2017.05.005

Difficult Patients in the Emergency Department: Personality Disorders and Beyond

Psychiatr Clin North Am. 2017 Sep;40(3):379-395. doi: 10.1016/j.psc.2017.05.005.

Authors

Nidal Moukaddam¹, Araceli Flores¹, Anu Matorin¹, Nicholas Hayden¹, Veronica Theresa Tucci²

Affiliations

¹ Department of Emergency Medicine, Baylor College of Medicine, 1504 Taub Loop, Houston, TX 77030, USA.
² Department of Emergency Medicine, Baylor College of Medicine, 1504 Taub Loop, Houston, TX 77030, USA. Electronic address: vtuccimd@gmail.com.

PMID: 28800796
DOI: 10.1016/j.psc.2017.05.005

Abstract

Physician-patient encounters in clinical settings, especially in the emergency department, can be of varying degrees of difficulty. Medically complicated, challenging cases can be paradoxically rewarding, whereas psychologically driven difficulty is frustrating and counterproductive for patient care. This article presents 3 different complementary perspectives on difficult patients: clinical presentations, manifestations of personality traits and disorders in clinical settings, and how physician feelings may affect care. Management strategies are discussed.

Keywords: Borderline; Countertransference; Difficult patient; Frequent flyers; High utilizers; Personality traits/disorders; Super utilizers.

Publication types

Review

MeSH terms

Countertransference*
Emergency Service, Hospital*
Humans
Personality Disorders / psychology*
Physician-Patient Relations*