Massachusetts General Hospital Comprehensive Clinical Psychiatry

The Neurological Examination

Key Points Cognitive impairment, behavioral changes, and psychiatric symptoms occur frequently in association with neurological conditions. A well-performed mental status and neurological examination are essential for the identification of medical and neurological conditions that impact cognition, behavior, and mood. The…

Geriatric Psychiatry

Key Points Depression in the elderly carries a very high risk of suicide. Symptoms of alcoholism and substance abuse are often confused with those of medical illness. The differential diagnosis of dementia is broad and the behavior problems challenging to…

Child and Adolescent Psychiatric Disorders

Key Points Psychopathology often begins and manifests, sometimes differently than in adults, in childhood and adolescence. Assessment of children and adolescents requires developmentally-sensitive adjustments to diagnostic criteria. Co-morbidities and symptoms from other disorders require consideration and sometimes targeted treatment interventions.…

Managed Care and Psychiatry

Key Points The finance of mental health care in the US has evolved from primarily a state-run asylum system to a mix of inpatient and outpatient care that is paid for by public and private funds. The US system of…

Community Psychiatry

Key Points Background The four principles of community mental health are population responsibility, prevention, community-based care with citizen involvement, and continuity of care. History Community psychiatry, the “third psychiatric revolution,” has an undulant history of reform and neglect. From the…

Culture and Psychiatry

Key Points Background Cultural differences in the presentation of psychiatric illnesses exist and include most if not all psychiatric disorders, including depression and psychosis. Cultural aspects can play a fundamental role in the manifestation of symptoms and the appearance of…

Aggression and Violence

Key Points Background The etiology of violence is multi-factorial: it has biological, environmental, and psychosocial components. The best predictor of violence in a patient is prior acts of violence. History The initial psychiatric evaluation for all patients should include an…