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Review
. 2017 Sep;40(3):379-395.
doi: 10.1016/j.psc.2017.05.005.

Difficult Patients in the Emergency Department: Personality Disorders and Beyond

Nidal Moukaddam  1 , Araceli Flores  1 , Anu Matorin  1 , Nicholas Hayden  1 , Veronica Theresa Tucci  2
Affiliations
Review

Difficult Patients in the Emergency Department: Personality Disorders and Beyond

Nidal Moukaddam et al. Psychiatr Clin North Am. 2017 Sep.

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.

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