When Psychological Problems Mask Medical Disorders: A Guide for Psychotherapists

by James Morrison MD

Overview

Widely regarded as a standard clinical resource, this book helps practitioners think outside the mental health box and recognize when a client may need a medical evaluation. Part I provides an accessible overview of symptoms that can be observed in a standard mental status examination and may point to medical illness. Engaging case vignettes and interviewing pointers help readers hone their diagnostic skills. Part II presents concise facts--including basic medical information and physical and mental symptoms--on more than 60 diseases and syndromes. An easy-to-read chart in Part III cross-tabulates all of the disorders and symptoms for quick reference and comparison.
 
New to This Edition
*Reflects more than 15 years of advances in medical and mental health knowledge. 
*Updated throughout for DSM-5.
*Additional medical disorders: celiac disease, traumatic brain injury, heavy-metal toxicity, and others.
*Updated links to further reading on each health condition.

Winner (First Place)--American Journal of Nursing Book of the Year Award, Psychiatric and Mental Health Nursing Category

Product Details

ISBN-13:	9781462521791
Publisher:	Guilford Publications, Inc.
Publication date:	07/17/2015
Sold by:	Barnes & Noble
Format:	eBook
Pages:	247
File size:	4 MB

About the Author

James Morrison, MD, is Affiliate Professor of Psychiatry at Oregon Health and Science University in Portland. HIs long career includes extensive experience in both the private and public sectors. With his acclaimed practical books--including DSM-5-TR Made Easy; Diagnosis Made Easier, Third Edition; The First Interview, Fourth Edition; and others--Dr. Morrison has guided hundreds of thousands of mental health professionals and students through the complexities of clinical evaluation and diagnosis.

Table of Contents

Introduction
I. A Review of Symptoms
The Need for Evaluation
Observing the Mental Status
Appearance and Behavior
Mood (Affect)
Speech
Content of Thought
Intellectual Resources
Insight and Judgment
Personality Change
Diagnostic Principles
II. 66 Disorders
Adrenal Insufficiency
AIDS
Altitude Sickness
Amyotrophic Lateral Sclerosis
Antidiuretic Hormone, Inappropriate Secretion
Brain Abscess
Brain Tumor
Cancer
Carcinoid Syndrome
Cardiac Arrhythmias
Celiac Disease
Cerebrovascular Accident (Stroke)
Chronic Obstructive Lung Disease
Congestive Heart Failure
Cryptococcosis
Cushing's Syndrome
Diabetes Mellitus
Epilepsy
Fibromyalgia
Heavy-Metal Toxicity
Herpes Encephalitis
Homocystinuria
Huntington's Disease
Hyperparathyroidism
Hypertensive Encephalopathy
Hyperthyroidism
Hypoparathyroidism
Hypothyroidism
Kidney Failure
Klinefelter's Syndrome
Liver Failure
Lyme Disease
Ménière's Syndrome
Menopause
Metachromatic Leukodystrophy
Migraine
Mitral Valve Prolapse
Multiple Sclerosis
Myasthenia Gravis
Neurocutaneous Disorders
Normal-Pressure Hydrocephalus
Parasitism
Parkinson's Disease
Pellagra
Pernicious Anemia
Pheochromocytoma
Pneumonia
Polycystic Ovary Syndrome
Porphyria
Postoperative Delirium
Premenstrual Syndrome
Prion Disease
Progressive Supranuclear Palsy
Protein Energy Malnutrition
Pulmonary Thromboembolism
Rheumatoid Arthritis
Sensory Deficit
Sickle-Cell Disease
Sleep Apnea
Substance Intoxication and Withdrawal
Syphilis
Systemic Infection
Systemic Lupus Erythematosus
Thiamine Deficiency
Traumatic Brain Injury
Wilson's Disease
III. Symptom Summaries

Editorial Reviews

"At once a primer on the collaboration of psychotherapist and physician and a useful reference book for this purpose. Although it is intended for psychotherapists with limited medical training, it may also be useful to primary care physicians and other medical clinicians who may be the first contact for patients who present with psychiatric symptoms." (on the first edition)

Psychiatric Services

"James Morrison's book is a gem. He addresses common medical illnesses that produce psychological symptoms in a refreshing manner, making the book an excellent review text for fellow psychiatrists and nonphysician psychotherapists....His occasionally tongue-in-cheek style makes for pleasant readability without minimizing the importance of his message....Tables...are laid out in easily readable form and useful for quick cross-referencing....This is book worth its weight in gold: it is eminently readable and can save some lives and bring improvement to many others." (on the first edition)

Journal of the American Medical Association

"This factual, current, and well-written guide is necessary reading for all clinicians who desire to sharpen their diagnostic skills. Morrison addresses the problems presented by psychiatric patients who may suffer from medical disorders, helping the clinician make sense of symptom presentations that are often confusing and on occasion mysterious and baffling. With tables, lists, and detailed explanations, this book establishes order and method in the examination of the complex patient. This second edition carries on the quality of the first, but is greatly enhanced by more information, new insights and clinical revelations, and a pragmatic interpretation of the latest findings."—Rodrigo A. Muñoz, MD, Department of Psychiatry, University of California, San Diego; past president, American Psychiatric Association

“The ability to differentiate medical and psychological sources of psychological symptoms is a core competency in case formulation and treatment planning. Morrison's succinct book helps clinicians with this critical task better than any other. The book is cross-indexed so information is rapidly available. It is replete with case examples and interesting historical references, and benefits from Morrison's wit and humor. An outstanding contribution.”—Tracy D. Eells, PhD, Department of Psychiatry and Behavioral Sciences, University of Louisville

"The second edition of this authoritative work covers a topic that is far too often ignored in the training and practice of mental health practitioners. The book is comprehensive, well organized, and easy to read. Morrison’s engaging style and inclusion of numerous summary tables make the book particularly accessible. This is an essential resource that should be on every clinician’s bookshelf or e-reader."—Martin M. Antony, PhD, ABPP, Department of Psychology, Toronto Metropolitan University, Canada

"I used the first edition for many years to train doctoral students in clinical psychology, and found it to greatly enhance their training. I have no doubt that the second edition also will be extremely popular among students. The text is compelling and easy to read. It helps students and busy professionals quickly explore alternative diagnoses to avoid misdiagnosing medical disorders as psychological illnesses."—Leslie A. Robinson, PhD, Director, Clinical Health Track; Director, Center for Health Promotion and Evaluation, Department of Psychology, University of Memphis

"Although most therapists are not medical specialists, we do not treat disembodied persons. Morrison alerts us to the most common mental symptoms that might be due to physical disorders, and heightens our diagnostic acumen. His efficient presentation, using both narrative and tables, can alert us to problems we might not have asked about and make treatment more comprehensive and effective. This updated second edition—written in the intelligent, experienced, and modest voice we have come to expect from Morrison—is a foundational resource for all therapists."—Edward L. Zuckerman, PhD, author of Clinician's Thesaurus

From the Publisher

Reviewer: Brett C. Plyler, M.D.(Northwestern Memorial Hospital)
Description: This is intended as a guide for psychotherapists to increase their awareness of medical problems that may present as psychological issues. The first edition was published in 1999.
Purpose: The purpose is to make mental health clinicians more aware of medical problems that may initially present as emotional disorders. The book meets the objective to some degree, but not completely.
Audience: The audience is mental health practitioners.
Features: After an introduction to the purpose of the book and how to use it, the first section reviews the initial evaluation and each of the categories involved therein — age, presentation, speech, hygiene, intellectual function, etc. The author describes possible medical conditions and how they may present in each area (e.g. shuffling gait can be Parkinson's disease), in order to demonstrate the different parts of the initial interview. The second section covers 66 different physical illnesses and the important psychological signs/symptoms associated with each. The chapter on each disorder has a nice summary table of frequency, physical and mental presentation, age of onset, gender, and who the patient should be referred to. After that there is a longer discussion of the illness state that ends with the possible treatments and long-term outlook. The last section is a long table that cross references all of the disorders listed with their presenting symptomatology. It is intended as an easy reference to symptoms or disease state. The book concludes with suggested readings.
Assessment: I found this book to be both more and less than I wanted it to be. The section on the initial interview is good and would be useful to medical students or new residents interviewing psychiatric patients. The clinical vignettes are important reminders not to ignore the whole person when treating a patient. As medical professionals, psychiatrists are trained on the medical model first and hopefully are quick to refer for medical evaluation if the presentation seems odd or the patient is not improving as expected. In that case, this book really does not provide anything new except that I possibly should be checking my patients for metachromatic leukodystrophy more often. If this book is directed at nonmedical mental health professionals, then I think it asks too much of them. Yes, paying attention to different signs and symptoms is valuable, but this felt like Googling a symptom and then following that down a rabbit hole to an unlikely medical diagnosis. While I have certainly seen cases in which anxiety/tremor ended up being Parkinson's, most of the time it is an anxiety issue. Therapists approach the patient from a therapy model and not a medical one, so to expect them to critically evaluate every physical symptom with this book to guide them is not feasible. It may be useful for mental health practitioners to review the book to make themselves more aware of what's possible medically, but it is not something I would strongly encourage.

Doody's Review Service