This book guides psychiatry trainees through some of the most common psychiatric consultation requests in the general medical hospital, using accessible, case-based narratives. Clinical case scenarios are used to demonstrate how to consider both medical and psychological factors involved in the consultation, and the approach to challenging interpersonal dynamics that may occur between the hospitalized patient and the primary medical team. Each case illustrates how to begin to think like a consultation-liaison psychiatrist in order to arrive at a diagnosis and formulate a treatment plan in complex clinical situations. Cases unfold in real time to highlight the critical role of the psychiatrist as liaison to the patient and medical team in order to guide psychiatric management and facilitate effective communication and treatment in the hospital. In addition to clinical cases, each chapter features a concise list of strategies to identify and address patient symptoms and behaviors, interpersonal dynamics, and barriers to care that arise in the hospital.
The Psychiatric Consult features resident-specific recommendations and a case-based format that make it a unique, realistic, and engaging learning tool.
Author(s): Alyson Gorun; Anna M Kim; Christian Umfrid; Janna Gordon-Elliott
Publisher: Springer
Year: 2022
Language: English
Pages: 250
City: Cham
Contents
Contributors
1: Introduction
Introduction
Nuts and Bolts: How to Do a Consult
Clarifying the Question
Review the Chart
Meet the Patient
History Taking
Obtaining Collateral
Seek Attending Supervision
Communicating Recommendations to the Team
Write the Note
Follow-Up
2: Delirium
Clinical Scenario
Scenario 1: Delirium
Scenario 2: Hypoactive Delirium
Scenario 3: Neurocognitive Disorder
Summary Table
Suggested Readings
3: Altered Mental Status
Clinical Scenario
Scenario 1: Catatonia
Scenario 2: Neuroleptic Malignant Syndrome and Serotonin Syndrome
Scenario 3: Wernicke Encephalopathy
Summary Table
References
Suggested Reading
4: Substance Intoxication and Withdrawal
Clinical Scenario
Scenario 1: Opioid Withdrawal
Scenario 2: Pregnant Patient with Substance Use Disorder
Scenario 3: Alcohol-Induced Psychotic Disorder
Summary Table
References
5: Human Immunodeficiency Virus (HIV)
Clinical Scenario
Scenario 1: HIV and Major Depressive Disorder
Scenario 2: HIV and Severe and Persistent Mental Illness
Scenario 3: HIV and Post-traumatic Stress Disorder
Summary Table
References
Suggested Reading
6: The Postpartum Patient
Clinical Scenario
Scenario 1: Bipolar Disorder and Pregnancy
Scenario 2: Postpartum Psychosis WorkUp
Scenario 3: Postpartum Depression
Summary Table
References
Suggested Reading
7: Mood Disorders Secondary to a Medical Condition
Clinical Scenario
Scenario 1: Steroid-Induced Hypomania
Scenario 2: Cancer Pain-Induced Insomnia
Scenario 3: Cancer-Related Adjustment Disorder with Depressed/Anxious Mood
Summary Table
References
8: Somatic Symptom Disorder
Clinical Scenario
Scenario 1: Somatic Symptom Disorder
Scenario 2: Functional Neurological Symptom Disorder (Conversion Disorder)
Scenario 3: Factitious Disorder
Summary Table
References
9: Malingering
Clinical Scenario
Scenario 1: Malingering and Medical Illness
Scenario 2: Malingering in a Patient Who Uses Substances
Scenario 3: Malingering and Primitive Defenses
Summary Table
Reference
Suggested Readings
10: The Suicidal Patient
Clinical Scenario
Scenario 1: Major Depressive Episode
Scenario 2: Borderline Personality Disorder
Scenario 3: Coping with Medical Complications
Summary Table
References
11: Behaviors Interfering with Care
Clinical Scenario
Scenario 1: Psychological Factors Affecting Another Medical Condition
Scenario 2: Cultural and Communication Barriers
Scenario 3: Delirium
Summary Table
Reference
Suggested Readings
12: Adjustment Disorder
Clinical Scenario
Scenario 1: Demoralization
Scenario 2: Mood Disorder
Scenario 3: Psychological Response to a Medical Illness
Summary Table
References
13: Major Neurocognitive Disorder
Clinical Scenario
Scenario 1: Capacity Assessment
What Is Decision-Making Capacity?
How Is Decision-Making Capacity Assessed?
How Will the Decision-Making Capacity Assessment Impact Clinical Care?
Clinical Scenario
Scenario 2: Agitation
Clinical Scenario
Scenario 3: Failure to Thrive
Summary Table
References
Suggested Readings
Index
