Extreme changes in body temperature in psychiatric inpatients should be a cause for concern. Depending on the working diagnosis and initial treatment, fever can be an early sign of an impending disease process, with accompanying morbidity and mortality. Even temperature…
Background Nausea is a subjective sensation of gastric discomfort resulting in aversion to oral intake. This is associated with the behavioral drive to remove the noxious ingestant by vomiting. These two related symptoms are relatively nonspecific and can arise from…
Phone call Questions 1. What are the patient’s vital signs? Have they changed? 2. Is the patient dyspneic, diaphoretic, or tachypneic? 3. When did the pain begin? How does the patient describe it? How does it relate to eating or…
Headaches are a common complaint on a psychiatric service and may be a symptom of a serious medical condition or a manifestation of a psychiatric disorder such as anxiety or depression. Primarily, headaches have been classified into two categories depending…
Insomnia is often a symptom of another disorder. The key to treating insomnia is to search for the underlying cause. As with any consultation, each patient deserves a complete evaluation and appropriate treatment. It is tempting to quickly prescribe sedating…
Substance withdrawal is commonly encountered in both psychiatric and medical patients. The psychiatrist on call is asked to evaluate and treat patients who are behaviorally difficult, have comorbid psychiatric diagnoses, suffer clinical stigmata of withdrawal, and/or complain of various subjective…
Substance abuse evaluation is an important component of a thorough psychiatric interview. Our understanding of the neurobiologic mechanisms of addiction has progressed rapidly. Although we now have a more complex understanding of the intricacies of substance use and substance-induced disorders,…
The psychiatrist on call may be asked to assess and manage the pregnant patient. In managing a peripartum patient, providers must be cognizant that treatment decisions affect both mother and the developing fetus. The on-call psychiatrist must carefully weigh the…
Victims of trauma may require urgent medical and psychiatric attention. Here, trauma is defined as “exposure to actual or threatened death, serious injury, or sexual violence,” as defined by criterion A for post-traumatic stress and acute stress disorders in Diagnostic…
The on-call evaluation of new, acute changes in speech or communication requires consideration of a broad differential diagnosis. Changes in speech and language may be caused by various psychiatric, medical, and neurologic etiologies. There are a variety of deficits in…