Interventions in a Heart Transplant Recipient with a Histrionic Personality Disorder

Abstract

Journal of Transplant Coordination, Vol. 9, Number 2, June 1999 fully oriented, had learned her medications, and was able to provide self-care. At home, the patient remained alert, oriented, and independent in her activities of daily living. Her psychological deterioration was first noted when she began to phone the transplant clinic every day. These conversations would last as long as 30 minutes and end only after the patient was repeatedly assured that she was not in the process of dying or was in need of additional medications. The patient often visited the clinic without a scheduled appointment and demanded to be seen. She self-medicated with over-the-counter and prescription medications, and concluded—without presenting symptoms—that she was allergic to some of her immunosuppressive medications. She also reported taking her medications intermittently. Upon being told that she could cause rejection of her transplanted heart by not complying with her immunosuppressant regimen, the patient accused the transplant team of issuing threats. She also complained of smelling food on the breath of a staff member while undergoing tests that required her to fast, and became agitated and verbally abusive. A psychiatric referral or psychotropic medications were recommended, both of which were refused by the patient. The patient was readmitted to the hospital on day 34 for treatment of mild rejection and evaluation of Interventions in a heart transplant recipient with a histrionic personality disorder