How to recognize and control the problem patient.

All surgery has a psychological impact, but nowhere does the patient's psyche come into play more prominently than in the field of elective surgery. Psychological manifestations related to elective surgery must be recognized and controlled preoperatively, lest they control the operative outcome. This article discusses the personality characteristics associated with the potential problem patient; counseling and evaluative techniques; common psychogenic conditions; cause and management of patient dissatisfaction; and psychology of the terminal patient.