Practical Guide to the Care of the Psychiatric Patient, Practical Guide Series, 3rd Edition

Practical Guide to the Care of the Psychiatric Patient

3rd Edition Practical Guide Series

By Richard J. Goldberg, MD, MS, Professor, Department of Psychiatry and Human Behavior and Department of Medicine, Brown University Medical School; Psychiatrist-in-Chief, Rhode Island Hospital and Miriam Hospital, Providence, RI


1. Role of Psychiatric Factors in Medical Practice

1.1 Prevalence of Mental Health and Substance Abuse Disorders
1.2 Utilization of Psychiatric Services
1.3 Functional and Economic Impact of Mental Health and Substance Abuse Disorders
1.4 Prevalence of Mental Health and Substance Abuse Disorders in Medical Practice
1.5 Psychiatric Problems in Primary Care
1.6 Impact of Mental Health and Substance Abuse Problems on Medical Costs
1.7 Cost-Benefit Issues Involving Mental Health and Substance Abuse Services
1.8 Strategic Questions for Assessing Integration of Medical and Psychiatric Services

2. Psychiatric Interview and Database

2.1 Psychiatric Interview
2.2 Psychiatric Database
2.3 Mental Status Examination (MSE)

3. Medical Evaluation of Psychiatric Symptoms

3.1 Medical Causes of Symptoms
3.2 Diagnostic Testing

4. Delirium, Dementia, Amnestic Disorders, and Other Cognitive Disorders

4.1 Delirium
4.2 Dementia
4.3 Amnestic Disorders
4.4 Cognitive Mental Status Examination

5. Alzheimer?s Disease: Diagnosis and Treatment

5.1 Overview
5.2 Behavioral Symptoms of Alzheimer?s Disease
5.3 Medications to Treat Agitation and Psychosis in Alzheimer?s Disease
5.4 Cognitive Symptoms of Alzheimer?s Disease
5.5 Anxiety in Alzheimer?s Disease (Occurs in 5% to 35%)
5.6 Depression in Alzheimer?s Disease
5.7 Some Common Medical Issues in Alzheimer?s Disease Patients
5.8 OBRA Regulations
5.9 Resources

6. Depression: Identification and Diagnosis

6.1 General Issues of Identification
6.2 Strategy for Evaluation of Depression
6.3 Mood Disorder Due to a General Medical Condition
6.4 Major Depressive Disorder (Major Depression)
6.5 Adjustment Disorder with Depressed Mood
6.6 Dysthymic Disorder
6.7 Mixed Anxiety-Depression
6.8 Premenstrual Dysphoric Disorder (PMDD)
6.9 Minor Depression (Subthreshold Depression)

7. Antidepressants

7.1 Overview
7.2 Specific Issues in Using Antidepressants
7.3 Tricyclic Antidepressants
7.4 Second Generation Antidepressants
7.5 Uncommon (But Important) Medical Complication of the SSRIs and SNRIs
7.6 Stimulants as Antidepressants
7.7 Monoamine Oxidase Inhibitors (MAOIs)

8. Bipolar (Manic-Depressive) Disorder and Mood Stabilizing Drugs

8.1 Bipolar Disorder
8.2 Manic, Hypomanic, Mixed, Cyclothymic, and Rapid Cycling Episodes
8.3 Lithium
8.4 Valproic Acid
8.5 Carbamazepine
8.6 Oxcarbazepine
8.7 Lamotrigine
8.8 Atypical Antipsychotics
8.9 Benzodiazepines
8.10 Non-Medication Dimensions of Treatment
8.11 Electroconvulsive Therapy (ECT)

9. Anxiety Disorders: Diagnosis and Management

9.1 Overview and Background
9.2 Diagnostic Approach to Anxiety Symptoms
9.3 Panic Disorder
9.4 Obsessive-Compulsive Disorder
9.5 Generalized Anxiety Disorder
9.6 Phobias
9.7 Adjustment Disorder with Anxiety
9.8 Acute Stress Disorder
9.9 Posttraumatic Stress Disorder

10. Treatment of Anxiety: Antianxiety Medications and Behavioral Therapies

10.1 Benzodiazepines
10.2 Azapirones
10.3 Comparison of Benzodiazepines and Azapirones
10.4 Antidepressants for Anxiety
10.5 Other Sedative-Hypnotics
10.6 Cognitive-Behavoiral Therapies (CBT)

11. Sleep Problems and the Use of Hypnotics

11.1 Overview
11.2 Evaluation of Sleep Problems
11.3 Hypersomnia
11.4 Insomnia
11.5 Sleep Disorders Related to Another Mental Disorder
11.6 Sleep Disorders Associated with Medications
11.7 Parasomnias
11.8 Hypnotic Drugs

12. Psychotic Symptoms, Schizophrenia, and Antipsychotic Agents

12.1 Identification of Psychotic Symptoms
12.2 Differential Diagnosis of Psychotic Symptoms
12.3 Schizophrenia
12.4 Antipsychotic Agents Used for the Treatment of Schizophrenia and Other Psychotic Disorders
12.5 Alternatives to Antipsychotics for Psychotic Symptoms of Schizophrenia
12.6 Non-Pharmacological Aspects of Treating Schizophrenia

13. Somatoform Disorders

13.1 Overview
13.2 Somatization Disorder
13.3 Acute Somatized Symptoms
13.4 Conversion Disorder
13.5 Pain Disorder
13.6 Hypochondriasis
13.7 Body Dysmorphic Disorder
13.8 Factitious Disorder
13.9 Malingering
13.10 Somatoform Disorders Not Otherwise Specified (NOS)

14. Behavioral Emergencies: Agitation, Suicide, Violence, and Forensic Issues

14.1 Behavioral Emergencies
14.2 Suicide Evaluation
14.3 Evaluation of the Violent or Homicidal Patient
14.4 Use of Physical Restraints
14.5 Commitment Under Mental Health Statutes
14.6 Competence Evaluations

15. Alcohol and Substance Abuse

15.1 Alcohol Abuse
15.2 Alcohol Dependence
15.3 Alcohol Intoxication
15.4 Alcoholic Paranoia
15.5 Pathologic Intoxication
15.6 Wernicke-Korsakoff Syndrome (Alcohol Amnestic Syndrome)
15.7 Alcoholic Hallusinosis
15.8 Alcoholic Dementia
15.9 Hepatic Encephalopathy
15.10 Fetal Alcohol Syndrome
15.11 Alcohol Co-morbidities
15.12 Alcohol and Sedative Withdrawal
15.13 Blood Alcohol Level
15.14 Cocaine (and stimulants including amphetamine) Abuse
15.15 Hallucinogens
15.16 Issues in Narcotic Use
15.17 Psychotropics as Analgesic Augmentors
15.18 Marijuana Abuse

16. Electroconvulsive Therapy (ECT)

16.1 Overview
16.2 Indications
16.3 Contraindications
16.4 Adverse Effects
16.5 Drug Interactions
16.6 Electroconvulsive Therapy Procedure
16.7 Considerations with Specific Medical Diseases

17. Personality Disorders

17.1 Overview
17.2 Paranoid Personality Disorder
17.3 Schizoid or Schizotypal Personality Disorder
17.4 Antisocial Personality Disorder
17.5 Borderline Personality Disorder
17.6 Histrionic Personality Disorder
17.7 Narcissistic Personality Disorder
17.8 Avoidant Personality Disorder
17.9 Dependent Personality Disorder
17.10 Obsessive-Compulsive Personality Disorder
17.11 Depressive Personality Disorder
17.12 Passive-Aggressive (Negativistic) Personality Disorder

18. Eating Disorders, Obesity, and Nicotine Dependence

18.1 Anorexia Nervosa
18.2 Bullimia Nervosa
18.3 Obesity
18.4 Nicotine Dependence

19. Sexual Disorders

19.1 Phases of Sexual Function
19.2 Sexual History
19.3 Sexual Dysfunction
19.4 Paraphilias
19.5 Gender Identity Disorder

20. The P-450 System: Drug Interactions

20.1 Definition
20.2 P-450 System Terminology
20.3 Genetic Polymorphism
20.4 Age Effects
20.5 P-450 Inhibitors
20.6 P-450 Substrates
20.7 P-450 Inducers
20.8 Therapeutic Implications

21. Child and Adolescent Psychiatry

21.1 General Principles
21.2 Anxiety Disorders
21.3 Attention Deficit Hyperactivity Disorder (ADHD)
21.4 Disruptive Behavior Disorders
21.5 Depressive Disorders
21.6 Learning Disorders
21.7 Mental Retardation (MR) and Developmental Disabilities

22. Formulary