Manual of Psychiatric Care for the Medically Ill

by Antoinette Ambrosino Wyszynski MD, Bernard Wyszynski MD

Overview

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.

Product Details

ISBN-13:	9781585626885
Publisher:	American Psychiatric Publishing, Incorporated
Publication date:	05/20/2008
Sold by:	Barnes & Noble
Format:	eBook
Pages:	416
File size:	10 MB
Age Range:	18 Years

About the Author

Antoinette Ambrosino Wyszynski, M.D., is a graduate of New York University School of Medicine in New York City. She completed her residency in psychiatry at Bellevue-N.Y.U. Medical Centers, and was a Fellow at Memorial Sloan-Kettering Cancer Center. She divides her time between treating medically ill outpatients suffering psychiatric disorders and teaching psychosomatic medicine in the N.Y.U.-Bellevue residency program. Dr. Wyszynski is also on the Faculty of The Psychoanalytic Institute at N.Y.U. Medical Center.

Bernard Wyszynski, M.D., is a graduate of the University of Pennsylvania School of Medicine. He completed his residencies in neurology and in psychiatry at Mt. Sinai Hospital in New York City. He is currently Inpatient Director and Unit Chief, Inpatient Psychiatry, at Montefiore Hospital and Medical Center, Bronx, New York. He teaches neuropsychiatry to medical students and psychiatric residents at Albert Einstein College of Medicine.

They are co-authors of A Case Approach to Medical-Psychiatric Practice (APPI, 1996)

Table of Contents

ContributorsPrefaceAcknowledgmentsDedicationChapter 1. The Delirious PatientChapter 2. The Patient With Hepatic Disease, Alcohol Dependence, and Altered Mental StatusChapter 3. The Patient With Cardiovascular DiseaseChapter 4. The Patient With Kidney DiseaseChapter 5. The Patient With Pulmonary DiseaseChapter 6. The Patient With GI Symptoms and Psychiatric DistressChapter 7. The Obstetrics PatientChapter 8. The Patient Using SteroidsChapter 9. The HIV-Infected PatientChapter 10. The Patient With Hepatitis CChapter 11. A Primer on Solid Organ Transplant PsychiatryChapter 12. Assessing Decisional Capacity and Informed Consent in Medical Patients: A Short, Practical GuideChapter 13. Psychological Issues in Medical Patients: Autonomy, Fatalism, and Adaptation to IllnessChapter 14. When Patients Ask About the Spiritual: A PrimerChapter 15. The Seriously Ill Patient: Physician Factors in the Doctor-Patient Relationship: A Short, Practical GuideChapter 16. Epilogue: The Physician as ComforterAppendix 1: American Psychiatric Association Guidelines for Assessing the Delirious Patient: ChecklistAppendix 2: Worksheet for Organizing Medical Chart Information: The Initial Psychiatric ConsultationAppendix 3: Decision Tree for Psychiatric Differential Diagnosis of Medically Ill PatientsAppendix 4: "VINDICTIVE MADS": Differential Diagnosis of Mental Status ChangesAppendix 5: A Short, Practical Guide to Treating Dementia-Related Behavioral Problems in the Medical SettingAppendix 6: A Guide to Herbal Supplements in the Medical SettingAppendix 7: Worksheet for Diagnosing and Comparing Serotonin Syndrome and Neuroleptic Malignant SyndromeAppendix 8: Delirium Rating Scale-Revised-98Appendix 9: The Confusion Assessment Method (CAM) InstrumentAppendix 10: Memorial Delirium Assessment Scale (MDAS)Appendix 11: Risk Factors for Torsades de PointesAppendix 12: Guidelines for Adult Psychotropic Dosing in Renal FailureAppendix 13: Commonly Used Drugs With Sedative-Hypnotic PropertiesAppendix 14: Electroconvulsive Therapy in Medical Illness: Practice Guidelines of the American Psychiatric AssociationAppendix 15: Diagnosing Depression in the Medically IllAppendix 16: Screening Worksheet for Bipolar Spectrum DisordersAppendix 17: Neuropsychiatric Effects of Electrolyte and Acid-Base ImbalanceAppendix 18: Worksheet for Monitoring Patients Receiving Atypical AntipsychoticsAppendix 19: Case Vignettes and Study GuideIndex

What People are Saying About This

Robert Cancro

Psychiatrists are increasingly being called upon to act in the role of physician and healer in medically ill patients. Most training programs have not adequately prepared residents for this responsibility. This volume successfully addresses the need. It is practical, useful, and in addition contains wisdom as well as solid clinical advice.

James L. Levenson

The Manual of Psychiatric Care for the Medically Ill, like its predecessor A Case Approach to Medical-Psychiatric Practice, combines at-the-bedside utility with illustrative case examples, practice guidelines, and citation of the key literature. The Wyszynskis and their colleagues have achieved their aims of brevity and practicality. Every chapter is a string of clinical pearls, concise, up-to-date, and clinically relevant.

Jimmie C. Holland

This manual, which covers the major comorbid psychiatric disorders of the common medical illnesses, is a gem—it uses algorithms, tables, and short cuts to get to the heart of the problems quickly. I love the chapter on delirium, which is particularly pithy and succinct. The book will be a hit with psychiatrists in managing their patients with medical illnesses, and with medical students. Physicians increasingly deal with patients with chronic illnesses in our aging population. Psychiatric disorders are common and complicate care. This book is a guide that will be widely used.

Gregory Fricchione

This Manual by Wyszynski and Wyszynski does what it promises to do. It gives the busy psychiatrist working in the medical-surgical setting a wealth of practical information invaluable for state-of-the-science care of important conditions at the bedside. It is an outstanding contribution to the medical psychiatry literature.

Thomas N. Wise

This is a remarkable book that must be in the libraries of all psychiatrists. Its use of clinical vignettes illuminates comprehensive discussions of commonly seen situations in patients with medical and psychiatric disorders. Its practical yet scholarly approach will be invaluable to clinicians in all stages of training and practice!

Editorial Reviews

3 Stars from Doody

Reviewer: Joseph Beck, MD (Rush University Medical Center)
Description: This large, spiral-bound manual for the psychiatric care of the medically ill allows easy access to its chapters, appendixes, and tables.
Purpose: The authors state that they wished to publish a clear and succinct manual for dealing with comorbid illness. There is a need for this, according to the authors, because the speed with which modern-day healthcare care delivery must be carried out. These are worthy objectives and the authors have attempted to accomplish this to the best of their ability. However, most of these difficult patients will not leave the hospital in an expedient fashion despite these efforts.
Audience: The book is written for psychiatric residents and practitioners. The book would be uniquely suited for consultation/liaison fellows and psychiatrists and those who are dual trained in medicine and psychiatry. Inpatient hospitalists and psychiatrists would also benefit and sections of this book should be required reading for any participant in a combined med/psych unit capacity.
Features: The book is divided into sections based on specific comorbid diagnoses. Each chapter starts with patient examples. The manual is clear, succinct, and very readable. It will mostly be referred to on a chapter basis and not read as a whole. It contains a plethora of appendixes (such as important drug interactions) and worksheets that will enable physicians to communicate in a superior fashion with both colleagues and staff. It is heavy on inpatient difficulties, and could use more information about medical disease symptom recognition in the psychiatric outpatient.
Assessment: This is an extremely useful book, especially for inpatient consultation. I will definitely use it as a resource.

Doody's Review Service

This is a good book.... You can find your way around. The logical structure, with largely predictable and systematic coverage of different systems, is an advantage both for psychiatrists with limited medical knowledge and for physicians with little mental health experience.

British Journal of Psychiatry

The Wyszynskis have done it again! The Manual of Psychiatric Care for the Medically Ill is a practical, concise, case-based approach to the medicine-psychiatry interface-a fitting update to their highly regarded 1996 manual A Case Approach to Medical-Psychiatric Practice.

Journal of Clinical Psychiatry