“My Patient is Psychotic”

In Chapter 4, the liaison model of consultation illustrates how including a psychiatrist on a medical team can enhance patient care. I use a case history of a patient with a delusion about her eyes and her need for ophthalmologic surgery to illustrate the diagnosis and management of patients who misinterpret or deny signs of disease. This patient’s paranoid delusion complicated her physician’s medical management of her. I outline a collaborative approach using a liaison model for psychiatric consultation. A discussion of mechanisms of defense in paranoid individuals is included.