Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Many emergency department (ED) psychiatric patients present after traveling. Although such travel, orperegrination, has long been associated with factitious disorder, other diagnoses are more commonamong travelers, including psychotic disorders, personality disorders, and substance abuse. Travelers’intense psychopathology, disrupted social networks, lack of collateral informants, and unawareness of localresources complicate treatment. These patients can consume disproportionate time and resources fromemergency providers. We review the literature on the emergency psychiatric treatment of peregrinatingpatients and use case examples to illustrate common presentations and treatment strategies. Difficultiesin studying this population and suggestions for future research are discussed. [West J Emerg Med.2016;17(5)600-606.]