The Peregrinating Psychiatric Patient in the Emergency Department.
Many emergency department (ED) psychiatric patients present after traveling. Although such travel, or peregrination, has long been associated with factitious disorder, other diagnoses are more common among travelers, including psychotic disorders, personality disorders, and substance abuse. Travelers' intense psychopathology, disrupted social networks, lack of collateral informants, and unawareness of local resources complicate treatment. These patients can consume disproportionate time and resources from emergency providers. We review the literature on the emergency psychiatric treatment of peregrinating patients and use case examples to illustrate common presentations and treatment strategies. Difficulties in studying this population and suggestions for future research are discussed.
University of Colorado, Denver, School of Medicine, Department of Psychiatry, Aurora, Colorado; Denver Health Medical Center, Department of Psychiatry, Denver, Colorado.
Scott A
SA
Simpson
University of Washington School of Medicine, Department of Psychiatry, Seattle, Washington.
Jagoda
J
Pasic
D004637:Emergency Services, Psychiatric; D006801:Humans; D008487:Medical History Taking; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis*; D009110:Munchausen Syndrome / Q000175:diagnosis*; D011567:Psychiatric Department, Hospital; D019966:Substance-Related Disorders / Q000175:diagnosis*; D014195:Travel