Unusually persistent complainants.

BACKGROUND Querulous paranoia may have disappeared from the psychiatric literature, but is it flourishing in modern complaints organisations and the courts? AIMS To investigate the unusually persistent complainants who lay waste to their own lives and place inordinate demands and stress on complaints organisations. METHOD Complaints officers completed questionnaires on both unusually persistent complainants and matched controls. RESULTS Persistent complainants (distinguished by their pursuit of vindication and retribution) consumed time and resources and resorted to both direct and veiled threats. Attempts to distinguish these people from a control group on the basis of the manner in which their claims were initially managed failed. CONCLUSIONS Persistent complainants' pursuit of vindication and retribution fits badly with complaints systems established to deliver reparation and compensation. These complainants damaged the financial and social fabric of their own lives and frightened those dealing with their claims. The study suggests methods of early detection and alternative management strategies.