Abstract
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.
Highlights
Patients who travel long distances and present for psychiatric care are familiar to emergency providers
The ready accessibility of emergency department (ED) care compared to outpatient or inpatient mental health services is attractive to traveling patients who are unfamiliar with local healthcare providers or have few local social supports and no healthcare providers.[1]
We reviewed the scientific literature for articles describing the prevalence, pathology, or treatment of patients who present to the ED after traveling
Summary
Many emergency department (ED) psychiatric patients present after traveling 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. Difficulties in studying this population and suggestions for future research are discussed. [West J Emerg Med. 2016;17(5)600-606.]
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