The difficult patient: identification and response
Neill, J.R.
Journal of Clinical Psychiatry 40(5): 209-212
1979
ISSN/ISBN: 0160-6689 PMID: 438141 Document Number: 151153
A group of "difficult" psychiatric outpatients in a university hospital system was identified and its distinguishing characteristics compared to a sample of other psychiatric outpatients not so labeled. "Difficult" patients were perceived to be significantly more demanding (p less than or equal to 0.005), dangerous, difficult to empathize with, manipulative and likely to polarize the staff. These patient were perceived differently by physician and nonphysican staff. An analysis revealed that a major source of "difficulty" appeared to be the structure of the treatment system rather than the patient. A corrective strategy was devised to test this hypothesis.