Psychiatric Dimensions of Medical Practice: What Primary-Care Physicians Should Know about Delirium, Demoralization, Suicidal Thinking, and Competence to Refuse Medical Advice

Overview

In this book, Johns Hopkins psychiatrist Phillip R. Slavney, M.D., offers a concise guide that will help primary-care physicians evaluate and treat patients who are delirious, demoralized, thinking of suicide, or refusing to follow medical advice.

Although these patients exhibit emotional distress, cognitive disturbance, or maladaptive behavior, the cause of the problem is often their medical illness and treatment. For that reason, many such patients can receive excellent care ...

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Overview

In this book, Johns Hopkins psychiatrist Phillip R. Slavney, M.D., offers a concise guide that will help primary-care physicians evaluate and treat patients who are delirious, demoralized, thinking of suicide, or refusing to follow medical advice.

Although these patients exhibit emotional distress, cognitive disturbance, or maladaptive behavior, the cause of the problem is often their medical illness and treatment. For that reason, many such patients can receive excellent care from their own physicians—physicians who, given the resistance of managed care companies to specialist referrals, must now bear that responsibility in any event. After an introductory chapter on clinical assessment, Slavney discusses each of these common problems as it occurs in the clinical setting, with illustrative cases and specific advice about evaluation and treatment.

"Dr. Slavney has written lucidly and carefully about these very important issues, clarifying his exposition through a series of case examples. This book should be enormously useful not only to students and house staff but also to practicing physicians and faculty, especially those making the rounds on clinical services. One wishes, in fact, that it were possible to have Dr. Slavney along on rounds; this volume is a useful move in that direction."—Jeremiah A. Barondess, M.D., from the foreword

Johns Hopkins University Press

"...helps physicians to gain insight into the assessment and treatment of four common psychiatric problems: delirium, demoralization, suicidal thinking, and refusal of medical treatment...includes illustrative case studies." Appropriate for: Primary Care Providers, Family Practice Physicians.

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Editorial Reviews

Doody's Review Service
Reviewer: Nancy Schell, MD (Rush University Medical Center)
Description: This is a succinct, practical book that aids evaluation and treatment of patients who are delirious, demoralized, contemplating suicide, or refusing medical advice.
Purpose: The main purpose is to help adult primary physicians to understand, differentiate, and deal with the above situations. The author also wishes to demonstrate that the patient's experience of illness may be the most important factor in his/her treatment.
Audience: The stated audience is adult primary care physicians, although this book is extremely useful for students and residents of general medicine, as well as psychiatry.
Features: It is composed of separate chapters on delirium, demoralization, suicidal thinking, and competence to refuse medical treatment. In each, clinical assessment with key differentiating points and case histories clearly delineates how to identify and manage these problems. Current references are provided at the end of each chapter. Tables and illustrations complement the text.
Assessment: This is a sorely needed volume. It is small enough for ease of use, yet thorough and explanatory. It should be of enormous value to the student, resident, and practicing physician and is highly recommended.
Family Medicine

The book is wonderfully down to earth and humane. This will prove to be a useful teaching and reference text for both residents and experienced practitioners.

Psychological Medicine
I know many physicians who would like their own liaison psychiatrist in their pocket (in more ways than one). Those who work at Johns Hopkins now have just that. This book comprises the portable advice of the Johns Hopkins Professor of Psychiatry and Medicine to help physicians with some of the commonest psychiatric issues they encounter.

— Eleanor Feldman

Psychological Medicine - Eleanor Feldman

I know many physicians who would like their own liaison psychiatrist in their pocket (in more ways than one). Those who work at Johns Hopkins now have just that. This book comprises the portable advice of the Johns Hopkins Professor of Psychiatry and Medicine to help physicians with some of the commonest psychiatric issues they encounter.

Booknews
A consultant psychiatrist often called to evaluate patients, Slavney (psychiatry and behavioral sciences, Johns Hopkins U.) offers adult primary care physicians guidelines by which they can provide care for patients with cognitive disturbances, emotional distress, or maladaptive behavior by recognizing and accounting for the psychiatric dimensions of their condition. He does not cover medical situations with psychiatric implications that are widely known. The arrangement is by the symptoms listed. The principles are illustrated with many case studies. Annotation c. by Book News, Inc., Portland, Or.
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Product Details

  • ISBN-13: 9780801859069
  • Publisher: Johns Hopkins University Press
  • Publication date: 9/28/1998
  • Edition number: 1
  • Pages: 144
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.43 (d)

Meet the Author

Phillip R. Slavney, M.D., is Eugene Meyer III Professor of Psychiatry and Medicine at the Johns Hopkins University School of Medicine. He is the author of Perspectives on "Hysteria" and co-author, with Paul R. McHugh, M.D., of The Perspectives of Psychiatry, also available from Johns Hopkins.

Johns Hopkins University Press

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Table of Contents

Foreword
Preface and Acknowledgments
1 Clinical Assessment 1
2 Delirium 9
3 Demoralization 63
4 Suicidal Thinking 77
5 Competence to Refuse Medical Advice 97
Index 121
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