Psychiatric Care Of The Medical Patient

This is the third edition of a classic resource of medical psychiatry. It is intended to be read as well as referred to. Its scope is broad, including such topics as herbal and nutritional treatments, management of conflicting second opinions, and adapting the physical examination to the medical psychiatric context.

The third edition of Psychiatric Care of the Medical Patient brings a classic reference text into the twenty-first century. It combines critical scholarship with the voice of expert clinicians who work at the interface of psychiatry with medical specialties. It is meant to be read for pleasure as well as consulted as a reference. The editors have worked with the authors to bring a consistent perspective to the book - one that sees the medical psychiatrist as an agent for bringing a more comprehensive perspective to medical care. Even seasoned and knowledgeable practitioners will find much that is new to them in this book. The volume covers topics in depth that other books in the field may not cover at all, such as the use of herbal and nutritional therapies for medical-psychiatric symptoms and syndromes, and the choice of questionnaires to supplement history-taking. It looks at old topics in a new way: The chapter on the physical examination applies psychometric considerations to the Babinski sign, describes the method and application of quantitative bedside olfactory testing, and discusses smartphone apps to improve the sensitivity of the examination. Psychiatric Care of the Medical Patient, 3rd Edition provides concepts and information to facilitate the dialogue between psychiatrists and general medical specialists - minimizing psychiatric jargon and speaking in the common language of caring and curious physicians.

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

Manual of Psychiatric Care for the Medically Ill delivers a practical approach to accurate psychiatric diagnosis and treatment in the medical-surgical setting. The editors have updated the literature reviews of their widely used 1996 American Psychiatric Publishing publication A Case Approach to Medical-Psychiatric Practice and have added easy-to-use summaries, Web resources, checklists, flowcharts, and worksheets-all designed to facilitate and teach the process of psychiatric consultation. The appended study guide makes this book even more valuable as an educational tool. Intended as a companion guide to comprehensive textbooks in psychosomatic medicine, this concise volume combines medication updates with "how-to" strategies for the psychiatric treatment of patients with cardiovascular, hepatic, renal, and pulmonary disease; gastrointestinal symptoms; delirium; HIV; hepatitis C; steroid-induced psychiatric syndromes; and organ transplantation. A special feature is the comprehensive chapter on the treatment of psychiatric illness in pregnancy. Each chapter summarizes the literature, emphasizing diagnostic and treatment considerations for patients with psychiatric symptoms and medical illnesses. Representing the work of 24 contributors, this useful, highly informative volume features Checklists, flowcharts, and worksheets that can be photocopied and brought to the patient's bedside for use during the clinical consultation. These templates help focus the information-gathering process, organize the data, and generate important documentation. Standardized assessment instruments and questionnaires, such as the Michigan Alcohol Screening Test, Delirium Rating Scale-Revised-98, and HIV Dementia Scale, which assist in consultation and evaluation. Summaries and charts of differential diagnoses to assist psychiatric consultation to medical patients, including Web addresses to access the latest information on a particular condition or treatment. A study guide in case-question-answer format for selected chapters. This volume also includes a "how-to" chapter on assessing decisional capacity, complete with a worksheet for gathering information and documenting informed consent. It also features practical reviews of psychotherapeutic issues, such as a primer for what to do when patients ask about spiritual issues. Concluding chapters present short, practical guides on addressing general psychological issues occurring in medical patients. This proven manual -- already being used to teach residents the core curriculum in Consultation-Liaison Psychiatry and On-Call Preparedness at Bellevue Hospital in New York City -- will be welcomed by general psychiatrists, consultation-liaison and psychosomatic medicine fellows, residents, and medical students everywhere.

Why do some psychiatric patients fail to get better, even when in the care of competent clinicians? Treatment-refractory conditions are all too common in everyday clinical practice. Treatment resistance occurs across the full spectrum of psychiatric disorders, incurring enormous emotional, economic, and social costs. In the United States, treatment of depression alone costs more than $40 billion annually, and as many as 40% of patients with depression have a treatment-refractory form of the illness. This groundbreaking clinical guide starts where standard textbooks end, focusing on clinical strategies to be used after all basic treatment options, such as medication and psychotherapy, have failed. In this book expert contributors address the sequential clinical steps in treating difficult-to-treat psychiatric patients by offering a blend of evidence-based clinical recommendations, detailed case vignettes, treatment algorithms, and -- when necessary to go beyond the reach of evidence -- the clinical wisdom of leaders in the field. The chapters in this user-friendly, practical guide are organized by major disorder. Each chapter offers concrete recommendations on what to do when the usual first steps in therapy are ineffective, including evidence for biopsychosocial treatments alone versus in combination, generic versus specific therapies, and literature reviews and the latest expert wisdom. A sampling includes The management of the complex and often refractory bipolar disorder, which involves replacing or combining lithium treatment with anticonvulsants or atypical antipsychotic agents with adjuncts such as benzodiazepines, thyroid hormone, and electroconvulsive therapy, but also -- above all -- with careful attention to the therapeutic alliance. The importance of combined therapeutic modalities for patients with schizophrenia -- especially given managed care's cost-cutting strategies, which deprive many schizophrenic patients of effective treatment modalities such as family therapy or early use of an atypical antipsychotic. Combination treatments for anxiety, with medications adjusted over time as symptoms wax and wane, and early and appropriate interventions to mitigate internal and external environmental stressors. The emphasis on common sense, optimism, a sense of humor, and an iron constitution as the most important tools for clinicians wishing to work with the most severely ill patients with borderline personality disorder. The importance of individual differences in biological vulnerability, emotionality and expressiveness, cognitive schemas and beliefs, prior traumatic experience, resilience, and coping strategies for successful treatment of posttraumatic stress disorder. Packed with up-to-date information of immediate relevance, this volume will prove invaluable in both classroom and clinical practice, for everyone from beginning interns and residents to experienced psychiatric and medical practitioners and social workers.

Integrated Care in Psychiatry: Redefining the Role of Mental Health Professionals in the Medical Setting is a landmark title in the field, offering a clear, detailed, and cohesive call by leading experts for coordinated care for patients with concurrent psychiatric and medical conditions. The renowned editors and authors argue that what is slowly occurring, and greatly needed at a faster pace, is nothing less than a sea change in the way that psychiatric care will be delivered. The current, mostly segregated, medical and psychiatric model of care has led to the development of competing medical and psychiatric subcultures that have resulted in a lack of dialog among health providers, administrators, and payers – and thus in less than optimal patient outcomes. To remedy this problem, the book offers a practical, insightful road map to achieving the central tenet of health reform – truly coordinated, patient-centered care where the care experience for the patient, the medical care itself, and the cost outcomes improve as the system changes from fee-for-service to population-based health. An invaluable reference for all clinicians, policy makers, payers, administrators, and others interested in the debate surrounding healthcare systems, Integrated Care in Psychiatry: Redefining the Role of Mental Health Professionals in the Medical Setting is a major contribution to the literature and a gold standard resource.