This chapter defines seclusion and restraint; outlines the indications and contraindications for these procedures; and provides step-by-step guidelines for the implementation, documentation, and discontinuation of seclusion and restraint for patients. Medication for the agitated patient, which often accompanies seclusion and…
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The psychiatrist on call faces a number of emotional challenges in interacting with patients, families, and other medical personnel. This chapter focuses on some of the more difficult emotional reactions that may arise in the psychiatrist and outlines ways to…
On-call physicians are often asked by medical or surgical colleagues to evaluate their patients. This chapter addresses some of the major issues involved in such consultations. Being an Effective Consultant The job of being a psychiatric consultant can be exciting,…
The purpose of this book is to provide an organized overview of the knowledge and problem-solving approaches relevant to the most common emergencies that arise in the course of providing psychiatric care. Psychiatric providers inevitably face unexpected emergencies in outpatient…
Key Points Remission rates of 70%–90% have been reported in clinical trials of electroconvulsive therapy (ECT) and ECT is currently the most promising prospect for addressing the unmet worldwide need for effective treatment of individuals suffering from depression. The symptoms…
Key Points Somatic therapies are a group of device-based techniques that modulate disease-relevant structures of the nervous system via surgical ablation or electrical stimulation with the goal of therapeutically modifying pathological patterns of brain activity and circuit connectivity. Ablative limbic…
Key Points There is a high rate of psychiatric co-morbidity in patients with pain syndromes. Specific terminology is used to characterize pain and pain syndromes. Pain is transmitted in pathways involving the peripheral and central nervous systems. Psychiatric treatment can…
Key Points Incidence Depending on the drug used and the clinical setting, up to 50% of patients in mental-health treatment will have a co-occurring substance-use disorder. Epidemiology Substance abuse is a major public health problem that affects a large number…
Key Points Incidence Alcohol misuse is one of the leading causes of morbidity and mortality in the US. Epidemiology The highest rates of alcohol use, heavy binge use, and alcohol use disorders occur between the ages of 18 and 29…