Overview Alcohol remains one of the most prevalent and clinically relevant drugs of abuse, with an estimated 75 million people worldwide meeting criteria for an alcohol use disorder (AUD) in 2004. In the United States, two-thirds of all adults consume…
Overview Clinical challenges in the diagnosis and treatment of anxiety are abundant in the general hospital setting: discerning normal from pathologic anxiety, differentiating medical from psychiatric causes, and choosing effective therapeutic approaches. In addition to a knowledge of medical and…
Psychosis , broadly defined, is a gross impairment of reality testing. Psychosis can result from a wide range of psychiatric and medical disturbances and may take several forms. The elderly woman, who lies quietly in bed listening to Satan whisper,…
As life expectancy extends and the baby boomer generation begins to reach geriatric age, we will confront an epidemic of neurocognitive disorders (NCDs) in general hospitals. The number of cases of Alzheimer's disease (AD), the most common cause of NCD,…
Delirium has probably replaced syphilis as “the great imitator” because its varied presentations have led to misdiagnoses among almost every major category of mental illness. Delirium is a syndrome caused by an underlying physiologic disturbance and marked by a fluctuating…
Overview A major depressive disorder (MDD) serious enough to warrant professional care affects approximately 16% of the general population during their life-time. Both the Epidemiological Catchment Area (ECA) study and the National Comorbidity Survey study have found that MDD is…
Although the interview and the mental status examination compose the primary diagnostic tools in psychiatry, the use of standardized rating scales and laboratory tests provides important adjunctive data. In addition to ruling out medical and neurologic explanations for psychiatric symptoms,…
Overview Psychological and neuropsychological assessments can be invaluable in cases where there is a question regarding differential diagnosis, a change in functioning from a premorbid baseline, or when a baseline is needed to assess the efficacy of planned treatments. Clinical…
Introduction First appearing in 1987 in an internally published collection of essays celebrating the 50th anniversary of the Massachusetts General Hospital Department of Psychiatry, George Murray's “Limbic Music” is a rare example of the medical literature producing actual literature .…
For the psychiatric consultant, the neurologic examination is an important component of every patient evaluation. By reviewing the main components of the standard examination and attempting to relate them to anatomic constructs, the consulting psychiatrist may gain a theoretical and…