Severe personality disorders

Patients with severe personality disorders typically pose a significant challenge to surgical teams. These patients may have unrealistic expectations about their surgical care and the outcome of the surgery and may either be unreasonably demanding and/or may create divisions amongst the treatment team. The psychiatric consultant may need to serve as an advocate for these individuals, who may be viewed negatively by staff who regard their behaviour simply as wilful or manipulative rather than as arising from an underlying disorder. A team conference prior to admission or immediately postoperatively may facilitate a consistent and coordinated treatment approach.(!6)

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