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Related Experiment Videos

Personality disorders among difficult patients

S Schafer1, D P Nowlis

  • 1Department of Family Practice, University of California at San Francisco/Fresno Medical Education Program, USA.

Archives of Family Medicine
|March 31, 1998
PubMed
Summary

Difficult patients are more likely to have unrecognized personality disorders, particularly dependent personality disorder. Increased physician awareness can improve patient care and relationships.

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Area of Science:

  • Psychiatry
  • Family Medicine
  • Psychology

Background:

  • Challenging patient interactions are common in family medicine.
  • The underlying causes of difficult patient-provider relationships are not fully understood.

Purpose of the Study:

  • To investigate the association between patients perceived as "difficult" by family physicians and the presence of personality disorders.

Main Methods:

  • A case-control study was conducted using the Diagnostic Interview for Personality Disorders.
  • Twenty-one patients identified as "difficult" by their family physicians were compared with 22 systematically selected control subjects.

Main Results:

  • Personality disorders were significantly more prevalent in the "difficult" patient group (7/21) compared to controls (1/22; P = .02).
  • Dependent personality disorder was the most common diagnosis among difficult patients.
  • Physicians were unaware of the personality disorders in these patients.

Conclusions:

  • Unrecognized personality disorders contribute to difficult patient-provider relationships.
  • Dependent personality disorder may be a key factor in patient difficulty.
  • Enhanced physician training on recognizing personality disorders could improve patient management and outcomes.

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