راهنمای بالینی پزشکی روان‌تنی: راهنمایی برای روان‌پزشکی مشاوره‌ای-همکاری

More concise, practical, and clinically oriented than other available texts, Clinical Manual of Psychosomatic Medicine: A Guide to Consultation-Liaison Psychiatry is designed to aid today's busy clinicians with bedside and office consultation. This manual presents the distilled wisdom of two highly experienced consultation-liaison psychiatrists and includes many illustrative figures and tables that offer quick, easy access to critical information about how to diagnose and treat psychiatric disorders in patients who have, or believe they have, other medical disorders. The authors of Clinical Manual of Psychosomatic Medicine begin by summarizing how to do effective psychiatric consultation in a changing health care environment, citing key trends such as managed health care, reallocation of health care resources, medical care, and psychiatric consultation's shift from inpatient to outpatient settings, and to multidisciplinary teams. After discussing the mental status examination, the authors examine Epidemiology, clinical characteristics, differential diagnosis, and treatment and management of various syndromes and disorders—Delirium, dementia, depression, mania, anxiety, somatoform and related disorders, and substance-related disorders (alcohol, sedatives/hypnotics/anxiolytics, opiates/narcotics, amphetamines, and cocaine)—violence/aggression and suicidality. Pharmacological issues—Patients who are medically ill are usually taking one or more medications. Therefore, consultation-liaison psychiatrists must thoroughly understand drug actions, metabolism, and elimination; the cytochrome P450 system; and drug interactions, including the risks for pregnant and breast-feeding women. Other critical issues—Pain management, personality, ethical and legal, and geriatric psychiatry issues. Special consultation-liaison topics—Pregnant/postpartum, pediatric, burn, cancer, neurology and neurosurgery, HIV/AIDS, critically ill, and impotent patients, and organ transplant donors and recipients. The work of consultation-liaison psychiatrists has been proven to reduce mortality, morbidity, length of stay, and hospital costs in general hospital patients and medical-surgical outpatients. To accommodate the shift from inpatient to outpatient settings and to the evolving importance of psychiatric care delivered within specialty and primary care settings, this invaluable reference shows how consultation psychiatrists are the ideal clinicians to provide rapid, focused, and practical diagnostic assessments and treatment recommendations. Essentially an expanded fourth edition of the Concise Guide to Consultation Psychiatry , the eminently practical Clinical Manual of Psychosomatic Medicine: A Guide to Consultation-Liaison Psychiatry will be welcomed by consultation-liaison and general psychiatrists, primary care physicians, consultation-liaison/psychosomatic fellows, psychiatry residents, and medical students. This manual is an outstanding resource for didactics and clinical rotations for those in training or reviewing for board examinations. Contents......Page 6 Preface......Page 12 History......Page 14 Cost-Effectiveness of Psychiatric Consultation......Page 15 Approach to the Consultation......Page 16 Outpatient Psychosomatic Medicine......Page 19 References......Page 21 Additional Readings......Page 22 2 Mental Status Examination and Other Tests of Brain Function......Page 24 Mental Status Examination......Page 26 Screening Mental Status Examinations......Page 30 Other Useful Tests of Cognitive Function......Page 32 Tests of Executive Function......Page 34 The Consultation Psychiatrist as Neuropsychiatrist......Page 35 References......Page 39 Additional Reading......Page 40 Epidemiology and Risk Factors......Page 42 Clinical Characteristics......Page 43 Differential Diagnosis......Page 47 Treatment and Management......Page 53 Course (Prognosis)......Page 57 References......Page 58 Additional Readings......Page 60 Epidemiology......Page 62 Clinical Characteristics......Page 63 Differential Diagnosis and Evaluation......Page 70 Treatment and Management......Page 73 References......Page 76 Additional Readings......Page 77 Interrelations Between Depression and Other Medical Illnesses......Page 80 Clinical Characteristics......Page 81 Differential Diagnosis......Page 84 Treatment and Management......Page 85 References......Page 97 Additional Readings......Page 100 Clinical Characteristics......Page 102 Treatment and Management......Page 104 References......Page 112 Additional Readings......Page 114 Anxiety and Anxiety Disorders......Page 116 Insomnia......Page 129 References......Page 131 Additional Readings......Page 132 8 Somatoform and Related Disorders......Page 134 Somatization......Page 136 Somatization Disorder (Briquet’s Syndrome)......Page 139 Undifferentiated Somatoform Disorder......Page 141 Hypochondriasis......Page 143 Conversion Disorder......Page 145 Body Dysmorphic Disorder......Page 148 Pain Disorder......Page 149 Somatoform Disorder Not Otherwise Specified......Page 151 Factitious Disorders......Page 152 Malingering......Page 155 Differential Diagnosis......Page 156 Additional Treatment and Management Considerations......Page 159 References......Page 161 Additional Readings......Page 165 9 Substance-Related Disorders......Page 166 Alcohol-Related Disorders......Page 167 Sedative-, Hypnotic-, or Anxiolytic-Related Disorders......Page 176 Opioid (Narcotic)–Related Disorders......Page 179 Amphetamine-Related Disorders......Page 181 Cocaine-Related Disorders......Page 183 References......Page 186 Additional Readings......Page 188 10 Important Pharmacological Issues......Page 190 Drug Actions......Page 191 Drug Interactions......Page 199 Neuroleptic Malignant Syndrome......Page 202 Pregnancy......Page 208 References......Page 211 Additional Readings......Page 216 Emergency Consultation......Page 218 Differential Diagnosis of Violence and Aggression......Page 221 Treatment and Prevention of Chronic Aggression......Page 222 Additional Readings......Page 225 12 Pain and Analgesics......Page 226 Pain Terminology......Page 228 Pain Behavior, Suffering, and Psychiatric Diagnoses......Page 233 Measurement of Pain......Page 236 Additional Aids to Diagnosis......Page 237 Pharmacotherapy and Adjunctive Treatments for Pain......Page 239 Treatment and Management of Chronic Pain......Page 247 References......Page 248 Additional Readings......Page 251 Personality and Response to Illness......Page 252 Personality Disorder......Page 255 Medical Psychotherapy......Page 261 References......Page 263 Additional Readings......Page 264 14 Medicolegal Issues in Consultation......Page 266 Confidentiality......Page 267 Competency Versus Capacity......Page 269 Informed Consent and the Right to Refuse Medical Treatment......Page 272 Guardianship......Page 275 Involuntary Hospitalization......Page 276 Restraints......Page 277 Prescribing “Unapproved” Medications......Page 278 References......Page 279 Additional Readings......Page 280 Epidemiology......Page 282 Clinical Features and Risk Factors......Page 286 Treatment and Management......Page 288 References......Page 291 Additional Readings......Page 292 Psychiatric Disorders......Page 294 Diagnostic Evaluation......Page 298 Treatment and Management......Page 299 Elder Abuse......Page 304 References......Page 305 Additional Readings......Page 307 Pregnancy and the Postpartum Period......Page 308 Pediatric Psychosomatic Medicine......Page 311 Burns......Page 314 Cancer......Page 317 Death and Dying......Page 320 Neurology and Neurosurgery......Page 321 HIV Disease and AIDS......Page 324 Organ Transplantation......Page 327 Critically Ill Patients and the ICU......Page 329 Male Erectile Disorder (Impotence)......Page 332 References......Page 334 Additional Readings......Page 337 A......Page 338 B......Page 339 C......Page 340 D......Page 341 F......Page 343 L......Page 344 M......Page 345 N......Page 346 P......Page 347 R......Page 348 S......Page 349 T......Page 350 Z......Page 351 Contents 6 Preface 12 1 Effective Psychiatric Consultation in a Changing Health Care Environment 14 History 14 Cost-Effectiveness of Psychiatric Consultation 15 Approach to the Consultation 16 Consultation or Liaison Psychiatry? 19 Outpatient Psychosomatic Medicine 19 References 21 Additional Readings 22 2 Mental Status Examination and Other Tests of Brain Function 24 Mental Status Examination 26 Screening Mental Status Examinations 30 Other Useful Tests of Cognitive Function 32 Tests of Executive Function 34 Neurological Examination 35 The Consultation Psychiatrist as Neuropsychiatrist 35 References 39 Additional Reading 40 3 Delirium 42 Epidemiology and Risk Factors 42 Clinical Characteristics 43 Differential Diagnosis 47 Treatment and Management 53 Course (Prognosis) 57 References 58 Additional Readings 60 4 Dementia 62 Epidemiology 62 Clinical Characteristics 63 Differential Diagnosis and Evaluation 70 Treatment and Management 73 References 76 Additional Readings 77 5 Depression 80 Epidemiology 80 Interrelations Between Depression and Other Medical Illnesses 80 Clinical Characteristics 81 Differential Diagnosis 84 Treatment and Management 85 References 97 Additional Readings 100 6 Mania 102 Clinical Characteristics 102 Treatment and Management 104 References 112 Additional Readings 114 7 Anxiety and Insomnia 116 Anxiety and Anxiety Disorders 116 Insomnia 129 References 131 Additional Readings 132 8 Somatoform and Related Disorders 134 Somatization 136 Somatization Disorder (Briquet’s Syndrome) 139 Undifferentiated Somatoform Disorder 141 Hypochondriasis 143 Conversion Disorder 145 Body Dysmorphic Disorder 148 Pain Disorder 149 Somatoform Disorder Not Otherwise Specified 151 Psychological Factors Affecting Medical Condition 152 Factitious Disorders 152 Malingering 155 Differential Diagnosis 156 Additional Treatment and Management Considerations 159 References 161 Additional Readings 165 9 Substance-Related Disorders 166 DSM-IV-TR Substance-Related Disorders 167 Alcohol-Related Disorders 167 Sedative-, Hypnotic-, or Anxiolytic-Related Disorders 176 Opioid (Narcotic)–Related Disorders 179 Amphetamine-Related Disorders 181 Cocaine-Related Disorders 183 References 186 Additional Readings 188 10 Important Pharmacological Issues 190 Adherence to Pharmacological Treatment 191 Drug Actions 191 Drug Interactions 199 Neuroleptic Malignant Syndrome 202 Pregnancy 208 References 211 Additional Readings 216 11 Violence and Aggression 218 Emergency Consultation 218 Physiological Basis for Violence and Aggression 221 Differential Diagnosis of Violence and Aggression 221 Treatment and Prevention of Chronic Aggression 222 References 225 Additional Readings 225 12 Pain and Analgesics 226 Pain Terminology 228 Pain Behavior, Suffering, and Psychiatric Diagnoses 233 Measurement of Pain 236 Additional Aids to Diagnosis 237 Pharmacotherapy and Adjunctive Treatments for Pain 239 Treatment and Management of Chronic Pain 247 References 248 Additional Readings 251 13 Personality, Response to Illness, and Medical Psychotherapy 252 Personality and Response to Illness 252 Personality and General Medical Conditions 255 Personality Disorder 255 Medical Psychotherapy 261 References 263 Additional Readings 264 14 Medicolegal Issues in Consultation 266 Confidentiality 267 Competency Versus Capacity 269 Informed Consent and the Right to Refuse Medical Treatment 272 Guardianship 275 Involuntary Hospitalization 276 Restraints 277 Prescribing “Unapproved” Medications 278 References 279 Additional Readings 280 15 Suicidality 282 Epidemiology 282 Clinical Features and Risk Factors 286 Approach to the Patient 288 Treatment and Management 288 References 291 Additional Readings 292 16 Geriatric Psychiatry 294 Epidemiology 294 Psychiatric Disorders 294 Diagnostic Evaluation 298 Treatment and Management 299 Elder Abuse 304 Conclusion 305 References 305 Additional Readings 307 17 Special Psychosomatic Medicine Settings and Situations 308 Pregnancy and the Postpartum Period 308 Pediatric Psychosomatic Medicine 311 Burns 314 Cancer 317 Death and Dying 320 Neurology and Neurosurgery 321 HIV Disease and AIDS 324 Organ Transplantation 327 Critically Ill Patients and the ICU 329 Male Erectile Disorder (Impotence) 332 References 334 Additional Readings 337 Index 338 A 338 B 339 C 340 D 341 E 343 F 343 G 344 H 344 I 344 L 344 M 345 N 346 O 347 P 347 Q 348 R 348 S 349 T 350 U 351 V 351 W 351 Z 351

Psychiatry scholars Wise (U. of California-Davis) and Rundell (Uniformed Services U. of the Health Sciences, Maryland) offer a primary resource for psychiatrists who perform consultation, liaison, and psychosomatic work; who see patients with concurrent psychiatric and medical-surgical conditions; or who use a medical model in their psychiatric practice. The arrangement is mostly by condition, such as delirium, anxiety and insomnia, and violence and aggression. This supersedes their Concise Guide to Consultation Psychiatry, published between 1987 and 2000. Annotation ©2004 Book News, Inc., Portland, OR

Doody Review Services

Reviewer:Benjamin Ling, DO(Rush University Medical Center)
Description:This is a concise but systematic look at many pertinent topics relevant to the careful and effective practice of consultation-liaison psychiatry.
Purpose:This book functions as a guide for psychiatrists working in the field of psychosomatic medicine and needing to appreciate the frequent impact of medical issues on psychiatric issues and vice versa. Its ultimate goal is to train psychiatrists how to become a valued member of the healthcare team. With a broad survey of many relevant topics such as delirium, the book is most pertinent to those working in consultation-liaison psychiatry.
Audience:Its utility will be mainly for psychiatric residents, but it will serve as a useful guide for experienced consultation clinicians looking for recent evidence-based recommendations. The authors' depth of knowledge is reflected in the deliberate delineation of pertinent clinical information.
Features:Topics ranging from the common ones, like pain and substance abuse, to the increasing relevance of issues unique to the geriatric and HIV/AlDS populations, are covered. Various tables are laid out in clear format for assisting in generating a quick differential (e.g., medical causes of personality change) or to provide a comparative look at the different pharmacological properties of psychotropics. The chapters on violence/aggression and personality disorders in the medical/surgical setting are especially well written, providing helpful hints and valuable insight.
Assessment:This book may prove useful to clinicians looking to access current practice guidelines, thereby gaining a broad sense of standard of care in many areas of consultation psychiatry. It will help inform and enrich the consultation experience and will help the clinician to remain a sought-after member of the healthcare delivery team.

"Clinical Manual of Psychosomatic Medicine is designed to aid today's busy clinicians with bedside and office consultation. This manual, which presents the distilled wisdom of two highly experienced consultation-liaison psychiatrists, provides quick access to critical information on how to diagnose and treat psychiatric disorders in medical-surgical patients. Because the work of consultation-liaison psychiatrists has been proven to reduce mortality, morbidity, length of stay, and hospital costs in general hospital patients and medical-surgical outpatients, their role in ensuring the effective treatment of these patients is more vital than ever."--Résumé de l'éditeur "Clinical Manual of Psychosomatic Medicine is designed to aid today's busy clinicians with bedside and office consultation. This manual, which presents the distilled wisdom of two highly experienced consultation-liaison psychiatrists, provides quick access to critical information on how to diagnose and treat psychiatric disorders in medical-surgical patients. Because the work of consultation-liaison psychiatrists has been proven to reduce mortality, morbidity, length of stay, and hospital costs in general hospital patients and medical-surgical outpatients, their role in ensuring the effective treatment of these patients is more vital than ever."--BOOK JACKET This book is designed to aid today's busy clinicians with bedside and office consultation. This manual presents the distilled wisdom of two highly experienced consultation-liaison psychiatrists and includes many illustrative figures and tables that offer quick, easy access to critical information about how to diagnose and treat psychiatric disorders in medical-surgical patients.