The medical management of the paranoid patient

Patients who are medically ill and distrustful of their care-providers are unfortunately a fact of life for most physicians. Medical management of such patients can be a frustrating experience because their suspiciousness is usually heightened by the stress of medical illness. Most often the patient's mistrust covers profound feelings of personal inadequacy and is a defense against feared passivity. Understanding of basic paranoid thought processes combined with knowledge of practical management techniques will lead to increased confidence and effectiveness when interacting with these difficult patients.