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Consultation/Liaison Management in the General Hospital

  • Stephanie H. Cho
Chapter

Abstract

This case demonstrates the basic principles of working with BPD as employed by the psychiatric consultant in the general hospital setting. Diagnostic disclosure establishes appropriate expectations for treatment and may improve patient and clinician interaction. Effective consultants are flexible and practical, reassuring to the patient while at the same time containing reactivity and encouraging introspection. Finally, this case highlights the vital role psychiatric consultants play in improving quality of care for borderline patients through crisis intervention and liaison efforts.

Keywords

Consultation liaison psychiatry Borderline personality disorder Managing borderline personality Difficult patient Psychosomatic medicine General hospital psychiatry 

References and Recommended Reading

  1. 1.
    Frankenburg FR, Zanarini MC. The association between borderline personality disorder and chronic medical illnesses, poor health-related lifestyle choices, and costly forms of health care utilization. J Clin Psychiatry. 2004;65(12):1660–5. http://www.ncbi.nlm.nih.gov/pubmed/15641871.CrossRefGoogle Scholar
  2. 2.
    Tomko RL, Trull TJ, Wood PK, Sher KJ. Characteristics of borderline personality disorder in a community sample: comorbidity, treatment utilization, and general functioning. J Personal Disord. 2014;28(5):734–50.  https://doi.org/10.1521/pedi_2012_26_093.CrossRefGoogle Scholar
  3. 3.
    Gross R, Olfson M, Gameroff M. Borderline personality disorder in primary care. Arch Intern Med. 2002;162(1):53–60.  https://doi.org/10.1001/archinte.162.1.53.CrossRefPubMedGoogle Scholar
  4. 4.
    Laugharne R, Flynn A. Personality disorders in consultation-liaison psychiatry. Curr Opin Psychiatry. 2013;26(1):84–9.  https://doi.org/10.1097/YCO.0b013e328359977f.CrossRefPubMedGoogle Scholar
  5. 5.
    Tyrer P, Reed GM, Crawford MJ. Classification, assessment, prevalence, and effect of personality disorder. Lancet (London, England). 2015;385(9969):717–26.  https://doi.org/10.1016/S0140-6736(14)61995-4.CrossRefGoogle Scholar
  6. 6.
    Groves JE. Taking care of the hateful patient. N Engl J Med. 1978;298(16):883–7.  https://doi.org/10.1056/NEJM197804202981605.CrossRefPubMedGoogle Scholar
  7. 7.
    Ricke AK, Lee M-J, Chambers JE. The difficult patient. Obstet Gynecol Surv. 2012;67(8):495–502.  https://doi.org/10.1097/OGX.0b013e318267f1db.CrossRefPubMedGoogle Scholar
  8. 8.
    Dubovsky AN, Kiefer MM. Borderline personality disorder in the primary care setting. Med Clin North Am. 2014;98(5):1049–64.  https://doi.org/10.1016/j.mcna.2014.06.005.CrossRefPubMedGoogle Scholar
  9. 9.
    Riddle M, Meeks T, Alvarez C, Dubovsky A. When personality is the problem: managing patients with difficult personalities on the acute care unit. J Hosp Med. 2016;11(12):873–8.  https://doi.org/10.1002/jhm.2643.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Stephanie H. Cho
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesKeck School of Medicine of the University of Southern CaliforniaLos AngelesUSA

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