Clinical Manual of Emergency Psychiatry

Clinical Manual of Emergency Psychiatry

by Michelle B. Riba

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One of the most challenging clinical settings any psychiatrist faces is in the area of psychiatric emergency services. Clinical Manual of Emergency Psychiatry is designed to help medical students, residents, and clinical faculty chart the appropriate course of treatment in a setting where an incorrect assessment can have life and death implications.



One of the most challenging clinical settings any psychiatrist faces is in the area of psychiatric emergency services. Clinical Manual of Emergency Psychiatry is designed to help medical students, residents, and clinical faculty chart the appropriate course of treatment in a setting where an incorrect assessment can have life and death implications.

Written collaboratively by residents, students, and faculty from various departments of psychiatry in the United States and Canada, Clinical Manual of Emergency Psychiatry covers those topics that are generally the most important and practical in any busy psychiatric emergency department. Equally important, the chapters are arranged by chief complaint rather than by psychiatric diagnosis, and each contains an important summary that can provide clarity quickly when seconds count. This format gives the trainee the ability to quickly find key points for treating the clinical situation. In addition, this text serves as a backup to faculty, and combines the approach of accomplished psychiatry trainees with the views of senior practitioners in the field.

Trainees working in the high-stress psychiatric emergency setting often only have backup supervision by phone rather than in-person oversight. Evaluation of patients in busy psychiatry emergency departments, where first- and second-year residents are quickly trying to address complicated clinical situations with patients who are very ill, is a challenging and difficult process. In response to the specific demands of the psychiatric emergency setting, the authors, under the editorship of Drs. Michelle B. Riba and Divy Ravindranath, made this manual easy to read and clearly focused on presenting complaints. In Clinical Manual of Emergency Psychiatry, trainees and faculty will find: • Case vignettes of applicable clinical scenarios.• A reflection of widespread practices in various academic centers.• Chapters arranged by chief complaint rather than psychiatric diagnosis.• Key point summaries at the end of each chapter.• An integrated perspective from trainees and experienced psychiatrists.

In addition, many of the chapters in this book underscore the potential for "medical mimics" to cause the presenting complaints, including anxiety, depression, psychosis, catatonia, and cognitive impairment. The recognition that comorbid conditions are often present is critical to the complete assessment of patients in a psychiatric emergency setting.

This book is a must-have for any psychiatric trainee or faculty who works in the often tense and high-stakes psychiatric emergency setting. Patients and families are anxious and fearful, and available clinical information may be sparse or unavailable. The guidelines and approaches outlined in this handbook will be useful to psychiatric students and teachers alike as they work to provide excellent care in the difficult clinical psychiatric emergency situations they encounter.

Editorial Reviews

Doody Reviews
Reviewer: Aaron Plattner, MD (Rush University Medical Center)
Description: This is a comprehensive guide to applying evidence-based psychiatric treatment in a psychiatric emergency setting.
Purpose: Because the psychiatric emergency setting is a vital part of psychiatric treatment and training of psychiatrists, the authors strive to educate readers on the various conditions they will encounter in patients in this setting and give them the tools for providing the best possible care.
Audience: Although the audience includes any healthcare providers who directly care for patients with mental health disorders in an emergency setting, psychiatric resident physicians and attending psychiatrists who work in these settings will derive the most benefit.
Features: The book reviews several chief psychiatric complaints in an emergency room including suicide, violence, catatonia, various mood disorders, psychosis, and patients under the influence of substance abuse. Chapters are devoted to specific age groups, such as children and adolescents and the elderly. Other chapters cover the practical topics of the general approach in an emergency room, restraints, discharge planning, legal issues, the transfer of patients from an outpatient setting to an emergency setting, and supervision of medical students and resident physicians. Each chapter has helpful charts and graphs with appropriate case examples that enable readers to follow a case as it progresses. Chapters end with a summary of the key points, references, and suggestions for further reading, and the book ends with a helpful index.
Assessment: During my training, I was provided with a variety of articles and chapters on this topic from several different sources. This book efficiently summarizes the various issues that arise in a psychiatric emergency setting, with additional chapters that provide more practical information that is not specifically covered in other books. The arrangement of the chapters, based on chief complaints rather than specific psychiatric diagnoses, enables readers to better translate the information into clinical practice. Based on my experience, both as a resident in an academic setting and moonlighting at a county hospital, the majority of the cases I encountered are adequately covered in this book, However, a separate chapter on how to properly address and treat patients with malingering behavior should be included in subsequent editions.
Doody's Review Service
Reviewer: Aaron Plattner, MD (Pine Rest Christian Mental Health Services)
Description: An update of a 2010 edition, this book examines common psychiatric issues and conditions in an emergency setting.
Purpose: There is a high prevalence of psychiatric care that occurs in an emergency setting. The authors' goal is to educate readers on how to make clinically appropriate decisions in this context. From my experience of providing psychiatric care in multiple different emergency room settings, I strongly advocate for more education about psychiatric topics in emergency settings. The authors are successful in achieving this.
Audience: The authors identify "trainees and clinicians" who encounter patients with psychiatric conditions in emergency settings as their audience. While anyone who encounters psychiatric emergencies would find this book helpful, resident psychiatry and emergency room physicians will likely benefit the most. The authors are psychiatric residents and fellows who co-wrote the chapters with a senior faculty member.
Features: The book identifies common psychiatric conditions and issues that are seen in an emergency setting including: mood symptoms, agitation, suicidality, substance abuse, seclusion and restraints, and considerations for different population such as children and adolescents. Each chapter has graphics and case vignettes, and concludes with key points.
Assessment: Overall, this is a solid book that is easy to read and is thorough in addressing the various psychiatric clinical situations that I have encountered in my practice. I reviewed the first edition, and this update is necessary to reflect recent research findings and updates from the DSM 5. Reading this book for a second time, I realized that most attending psychiatrists should already be aware of a great deal of this information and therefore will likely not find this book nearly as helpful as will psychiatry residents or early-career psychiatrists. I would still recommend it for those who desire to further their knowledge of psychiatry in emergency settings.

This book is highly recommended reading for trainees. Of note, editing was done with care to ensure that chapters read well together and avoid contradictions. Suitable for any emergency room, the Clinical Manual of Emergency Psychiatry is clinically focused and practical enough to be useful for residents, medical students, and clinical social workers interested in building competency in handling psychiatric emergencies.

Product Details

American Psychiatric Publishing, Incorporated
Publication date:
Sold by:
Barnes & Noble
File size:
5 MB
Age Range:
18 Years

Meet the Author

Michelle B. Riba, M.D., M.S., is Professor of Psychiatry and Associate Chair for Integrated Medicine and Psychiatric Services in the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan. Dr. Riba is Zonal Representative (Area 2, USA) of the World Psychiatric Association and Past President of the American Psychiatric Association.

Divy Ravindranath, M.D., M.S., is a Psychosomatic Medicine Fellow in the Department of Psychiatry at the University of Michigan in Ann Arbor, Michigan.

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