Psychiatric Interview Explained

Revised and updated, this practical handbook is a succinct how-to guide to the psychiatric interview. In a conversational style with many clinical vignettes, Dr. Carlat outlines effective techniques for approaching threatening topics, improving patient recall, dealing with challenging patients, obtaining the psychiatric history, and interviewing for diagnosis and treatment. This edition features updated chapters on the major psychiatric disorders, new chapters on the malingering patient and attention-deficit hyperactivity disorder, and new clinical vignettes. Easy-to-photocopy appendices include data forms, patient education handouts, and other frequently referenced information. Pocket cards that accompany the book provide a portable quick-reference to often needed facts.

This book offers an alternative to operational diagnostic manuals and manuals for structured interviewing as the only sources of theoretical and clinical knowledge. It provides an exposition of psychiatric interviewing that is theoretically and clinically well founded and supplies the reader with a coherent framework for performance of a thorough psychiatric examination. The goal is not to come up with yet another interview scheme but to facilitate an understanding of the basic (but, today, completely neglected) tenets of psychopathology and phenomenology. This exposition targets the disorders of subjectivity (consciousness), the second-person processes involved in converting subjective, first-person and observable data into a third person, diagnostically useful, format. In addition, the most pertinent clinical descriptions concerning the major diagnostic groups are presented and discussed.

Much has changed in the critical interval since the last edition of The Psychiatric Interview in Clinical Practice was published. This new, third edition provides an up-to-date examination of the psychiatric interview that reflects changes introduced in DSM-5, while continuing to recognize that describing symptoms and establishing a diagnosis should command only a portion of the clinician's attention, and that a patient's personal history must be elicited and character structure addressed in the clinical engagement. Significant advances have been made in biological psychiatry, and research in genetics, cognitive neuroscience, psychopharmacology, brain imaging, and the neurosciences in general continues apace, informing the culture of psychiatry and providing growing insight into the etiology of mental illnesses. However, the book reflects the authors' belief that virtually all major psychiatric disorders are complex amalgams of genetic disposition and environmental influences. In this context, the psychiatric interview is a vitally important dialogue, and effective strategies are modeled through the use of clinical vignettes taken from the authors' experience. Topics and features of this new edition include: * An updating of diagnostic considerations to reflect the publication of DSM-5.* A chapter on interviewing the patient with dissociative identity disorder (DID), which is now recognized as an entity distinct from other psychopathological conditions and rooted in childhood trauma. The frequency of DID in the ambulatory setting has been repeatedly demonstrated and speaks to the need to accurately diagnose and treat this often-debilitating disorder.* An entirely updated chapter on interviewing the traumatized patient.* A section on interviewing the patient of different background. The book emphasizes that the subjective experience of being "different" is universal and that psychiatry is enriched by recognizing and exploring that experience, validating its existence, and attempting to understand how it influences the patient's life.* Continued emphasis on and inclusion of relevant case vignettes drawn from the authors' clinical experiences.* Structural consistency across chapters, with sections on psychopathology and psychodynamics, differential diagnosis, management of the interview, transference and countertransference, and so forth, which reinforces skills acquisition and makes the text easy to use. By creating a text that is aligned with DSM-5 while continuing to stress the importance of eliciting the patient's subjective experience and achieving a therapeutic dialogue, the authors of The Psychiatric Interview in Clinical Practice have done a great service to the profession and provided much-needed guidance to mental health clinicians and trainees.

While the ABPN has now supplied such standards for psychiatry,psychiatric interviewing instruction has not been standardized inthe US or in other countries. Similarly, the few psychiatricinterviewing books available are written in textbook form, oftenlong and often from the subpecialty perspective (e.g. psychodynamicinterviewing). Critically, no interviewing guides to datetake a true biopsychosocial perspective. That is, they limitthemselves to “interviewing” as an isolated techniquedivorced from full patient assessment, which for quality patientcare must include the interface of psychological and socialcomponents with biological components. Similarly, fewinterviewing texts are fully integrated with DSM/ICD categoricaldiagnostic schemata, even though these descriptive diagnosticsystems represent the very core of our clinical language—thelingua franca of the mental health professions. Without good descriptive diagnoses there cannot be adequatecommunication of clinical data among providers. The proposed book will meet this need for training inbiopsychosocial assessment and diagnosis. The patient interview is at the heart of psychiatricpractice. Listening and interviewing skills are the primarytools the psychiatrist uses to obtain the information needed tomake an accurate diagnosis and then to plan appropriatetreatment. The American Board of Psychiatry and Neurology andthe Accrediting Council on Graduate Medical Educationidentify interviewing skills as a core competency forpsychiatric residents. The Psychiatric Interview: evaluation and diagnosis is anew and modern approach to this topic that fulfills the need fortraining in biopsychosocial assessment and diagnosis. Itmakes use of both classical and new knowledge of psychiatricdiagnosis, assessment, treatment planning and doctor-patientcollaboration. Written by world leaders in education, the book isbased on the acclaimed Psychiatry Third Edition byTasman, Kay et al, with new chapters to address assessment inspecial populations and formulation. The psychiatricinterview is conceptualized as integrating the patient's experiencewith psychological, biological, and environmental components of theillness. This is an excellent new text for psychiatry residents at allstages of their training. It is also useful for medicalstudents interested in psychiatry and for practicingpsychiatrists who may wish to refresh their interviewingskills.