Depression in Context: Strategies for Guided Action serves as a thorough guide for those who wish to understand and treat depression from a purely behavioral perspective. While the book is intended for specialists in psychotherapy, there are many attributes that make it useful for the primary care clinician. This book provides a complete understanding of behavioral psychotherapy for depression, addressing theoretical foundations of behaviorism and delving into therapeutic approaches. Helpful comparisons are offered of the authors' “behavioral activation” psychotherapy with other treatment approaches such as cognitive-behavioral psychotherapy and pharmacotherapy. The authors compare and contrast theoretical and philosophical underpinnings of various approaches. They also present evidence-based comparisons of their behavioral activation technique with the more complicated and popular cognitive-behavioral approach. Behavioral activation therapy for depression places an emphasis on increasing a patient's activity levels, thereby increasing positive reinforcement in the patient's life. According to behavioral theories of psychology, such an increase in positive reinforcement serves to decrease depressive symptoms such as lethargy, anhedonia, and avoidance. The book offers helpful guidelines on clinician-patient communication regarding in-session agenda-setting, overall goal-setting, and increasing patients' motivation for self-care. Clinical examples, including verbatim transcripts from therapy sessions, are provided throughout the book. These case excerpts are helpful in understanding the nuances of behavioral activation therapy and in offering practical examples of effective ways to communicate with depressed patients. The appendices offer sample homework activities and a self-help reading assignment that can be given to patients. Most primary care practitioners will not want to use the book for its intended purpose of helping the reader become a behavioral activation therapist. Another weakness from the primary care perspective is that the authors assert that their behavioral activation therapy is often sufficient as a sole approach to treating depression. While there are helpful comparisons of the behavioral activation model with other models, the efforts in explaining how behavioral therapy fits into the picture of the patient's overall health care are weak. This is an unfortunate shortcoming, as most patients with depression first turn to their primary care clinicians for help. In spite of this oversight, the book can be a significant resource for understanding behavioral and social dynamics in conceptualizing and treating depression. While the physiologic influences in depression are acknowledged, the authors take a conceptual view of depression, emphasizing environmental, psychological, and social elements of depression. An understanding of these influences on depression provides the reader with powerful tools in helping to empower pa
{"title":"Depression in Context","authors":"David Buyck","doi":"10.4088/PCC.V04N0508","DOIUrl":"https://doi.org/10.4088/PCC.V04N0508","url":null,"abstract":"Depression in Context: Strategies for Guided Action serves as a thorough guide for those who wish to understand and treat depression from a purely behavioral perspective. While the book is intended for specialists in psychotherapy, there are many attributes that make it useful for the primary care clinician. This book provides a complete understanding of behavioral psychotherapy for depression, addressing theoretical foundations of behaviorism and delving into therapeutic approaches. Helpful comparisons are offered of the authors' “behavioral activation” psychotherapy with other treatment approaches such as cognitive-behavioral psychotherapy and pharmacotherapy. The authors compare and contrast theoretical and philosophical underpinnings of various approaches. They also present evidence-based comparisons of their behavioral activation technique with the more complicated and popular cognitive-behavioral approach. \u0000 \u0000Behavioral activation therapy for depression places an emphasis on increasing a patient's activity levels, thereby increasing positive reinforcement in the patient's life. According to behavioral theories of psychology, such an increase in positive reinforcement serves to decrease depressive symptoms such as lethargy, anhedonia, and avoidance. The book offers helpful guidelines on clinician-patient communication regarding in-session agenda-setting, overall goal-setting, and increasing patients' motivation for self-care. Clinical examples, including verbatim transcripts from therapy sessions, are provided throughout the book. These case excerpts are helpful in understanding the nuances of behavioral activation therapy and in offering practical examples of effective ways to communicate with depressed patients. The appendices offer sample homework activities and a self-help reading assignment that can be given to patients. \u0000 \u0000Most primary care practitioners will not want to use the book for its intended purpose of helping the reader become a behavioral activation therapist. Another weakness from the primary care perspective is that the authors assert that their behavioral activation therapy is often sufficient as a sole approach to treating depression. While there are helpful comparisons of the behavioral activation model with other models, the efforts in explaining how behavioral therapy fits into the picture of the patient's overall health care are weak. This is an unfortunate shortcoming, as most patients with depression first turn to their primary care clinicians for help. In spite of this oversight, the book can be a significant resource for understanding behavioral and social dynamics in conceptualizing and treating depression. \u0000 \u0000While the physiologic influences in depression are acknowledged, the authors take a conceptual view of depression, emphasizing environmental, psychological, and social elements of depression. An understanding of these influences on depression provides the reader with powerful tools in helping to empower pa","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123845677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Schizophrenia Revealed offers an impressive approach to a very difficult, misunderstood, and frustrating illness. As the author, Michael Foster Green, states in his introduction, this book serves as a forum for reviewing what he calls “exciting developments” in the diagnosis and management of schizophrenia. There is no question that this book is thorough in its review of neuroanatomy and its explanation of potential neurochemical etiologies. Much of the content would be particularly useful for someone with a strong interest in this disease. From a clinical perspective, however, it is somewhat limited.
{"title":"Schizophrenia Revealed: From Neurons to Social Interactions.","authors":"R. Blackwelder","doi":"10.4088/PCC.V04N0208C","DOIUrl":"https://doi.org/10.4088/PCC.V04N0208C","url":null,"abstract":"Schizophrenia Revealed offers an impressive approach to a very difficult, misunderstood, and frustrating illness. As the author, Michael Foster Green, states in his introduction, this book serves as a forum for reviewing what he calls “exciting developments” in the diagnosis and management of schizophrenia. There is no question that this book is thorough in its review of neuroanatomy and its explanation of potential neurochemical etiologies. Much of the content would be particularly useful for someone with a strong interest in this disease. From a clinical perspective, however, it is somewhat limited.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131784099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With this issue of the Companion, we are beginning a new chapter in our publishing life. The Primary Care Companion to The Journal of Clinical Psychiatry is now the official publication of the Association of Medicine and Psychiatry. While the editorial control will remain in the hands of our capable Editor in Chief, J. Sloan Manning, M.D., we will rely on the insights and research efforts of the Association to bring an added dimension to our pages. It is fitting that the Companion carries this designation, as our missions are parallel. The Association was chartered in part to “enhance the integration of medical and psychiatric knowledge… [and] promote research advances at the interface of medicine and psychiatry.” Our mission is to provide the generalist with the most current, applicable peer-reviewed research to assist in the treatment of behavioral disorders. Our Editorial Board has been expanded to include the following members of the Association: Deputy Editor, Donna B. Greenberg, M.D.; Caroline Carney-Doebbeling, M.D.; Bradford L. Felker, M.D.; M. Kevin O'Connor, M.D.; L. Lee Tynes, M.D., Ph.D.; and Lawson R. Wulsin, M.D. Together, they will assist the Companion's original editorial group in articulating our vision and selecting top-quality scholarly articles within the scope of our publication. The pages of the Companion will offer a voice to leading researchers, teachers, and clinicians in both primary care and psychiatry and will serve to promote the latest developments in integrated care models and consultant-liaison environments. We welcome The Association of Medicine and Psychiatry to our publishing family and look forward to a long and productive partnership.
随着这一期的出版，我们的出版生涯开始了新的篇章。《临床精神病学杂志的初级保健指南》现在是医学和精神病学协会的官方出版物。虽然编辑控制权仍将掌握在我们有能力的主编J. Sloan Manning博士手中，但我们将依靠协会的洞察力和研究努力为我们的页面带来更多的维度。我们的任务是平行的，所以“同伴号”承载着这个称号是合适的。该协会的成立部分是为了“加强医学和精神病学知识的整合……[并]促进医学和精神病学交叉领域的研究进展。”我们的使命是为通才提供最新的、适用的同行评议研究，以协助治疗行为障碍。我们的编辑委员会已经扩大到包括以下协会成员:副编辑，Donna B. Greenberg，医学博士;Caroline Carney-Doebbeling，医学博士;Bradford L. Felker，医学博士;凯文·奥康纳，医学博士;L. Lee Tynes，医学博士;和Lawson R. Wulsin, M.D.一起，他们将协助《伴侣》的原始编辑团队阐明我们的愿景，并在我们的出版范围内选择高质量的学术文章。《指南》将为初级保健和精神病学领域的主要研究人员、教师和临床医生提供声音，并将促进综合护理模式和咨询联络环境的最新发展。我们欢迎医学和精神病学协会加入我们的出版大家庭，并期待着长期和富有成效的伙伴关系。
{"title":"A New Chapter.","authors":"John S. Shelton, Irving Shelton","doi":"10.4088/PCC.v04n0101","DOIUrl":"https://doi.org/10.4088/PCC.v04n0101","url":null,"abstract":"With this issue of the Companion, we are beginning a new chapter in our publishing life. The Primary Care Companion to The Journal of Clinical Psychiatry is now the official publication of the Association of Medicine and Psychiatry. While the editorial control will remain in the hands of our capable Editor in Chief, J. Sloan Manning, M.D., we will rely on the insights and research efforts of the Association to bring an added dimension to our pages. \u0000 \u0000It is fitting that the Companion carries this designation, as our missions are parallel. The Association was chartered in part to “enhance the integration of medical and psychiatric knowledge… [and] promote research advances at the interface of medicine and psychiatry.” Our mission is to provide the generalist with the most current, applicable peer-reviewed research to assist in the treatment of behavioral disorders. \u0000 \u0000Our Editorial Board has been expanded to include the following members of the Association: Deputy Editor, Donna B. Greenberg, M.D.; Caroline Carney-Doebbeling, M.D.; Bradford L. Felker, M.D.; M. Kevin O'Connor, M.D.; L. Lee Tynes, M.D., Ph.D.; and Lawson R. Wulsin, M.D. Together, they will assist the Companion's original editorial group in articulating our vision and selecting top-quality scholarly articles within the scope of our publication. The pages of the Companion will offer a voice to leading researchers, teachers, and clinicians in both primary care and psychiatry and will serve to promote the latest developments in integrated care models and consultant-liaison environments. \u0000 \u0000We welcome The Association of Medicine and Psychiatry to our publishing family and look forward to a long and productive partnership.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131054062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Best Medicine is a collection of short stories about special patient/physician relationships. These real-life stories are unique in that they are told from the perspective of both the patient and the physician. Each story begins with a synopsis of the setting and the background of the patient followed by the patient's account of how the relationship with the physician developed. Patients' perceptions of the qualities and characteristics of the physicians who calmed their fears, engendered their trust, and solidified their relationships are very insightful. The second portion of each story begins with a description of the physician's background, training, specialty, interests, and philosophical precepts that shaped his or her approach to life and to medicine. This is followed by the physician's account of how the special relationship with the patient developed and progressed. In almost every case, the central themes of openness, honesty, humanity, connectedness, and respect for patients can be found. I was impressed with the diversity of both patients and physicians that was encompassed in these short stories. In every story, I gained insight into the ways in which each physician encourages the building of trusting relationships with his or her patients. In addition, each physician revealed the things he/she had learned from the patient and the relationship. The book demonstrates that the patient/physician relationship transcends all specialties, genders, socioeconomic strata, and family structures. It stresses the importance of the emotional aspect of the physician, debunking the myth of the cold intellectual who only analyzes tests and prescribes treatment. The book also underscores the concept that a strong patient/physician relationship is therapeutic and leads to better outcomes. Often, the patient/physician relationships described took in family members, who were then enlisted as members of the support team. Each patient's trust allowed the physician to have special insights into symptoms and treatment responses that helped the physician know how to better help the patient. One of my favorite stories is under the section entitled “Lessons in Love.” Ms. Alvarez is a mother of 4 children, 2 of whom are retarded and 1 of whom is autistic. She developed a strong bond with Dr. Elisa Nicholas. From this patient/physician pair, I learned that parents are frequently stronger and wiser after having gone through such suffering. It seems that these persons are more apt to understand what is important in life. Dr. Nicholas relates the story of being invited to lunch at the home of one of her patients. While most doctors wouldn't go, she went and was truly blessed. One of Dr. Nicholas' profound observations was that when you invest in relationships with families, they allow you access into their lives, which allows you in turn to gain insight into how to live your own life. These relationships help keep physicians from becoming burned out an
{"title":"The Best Medicine","authors":"D. Roberts","doi":"10.4088/PCC.V04N0110B","DOIUrl":"https://doi.org/10.4088/PCC.V04N0110B","url":null,"abstract":"The Best Medicine is a collection of short stories about special patient/physician relationships. These real-life stories are unique in that they are told from the perspective of both the patient and the physician. Each story begins with a synopsis of the setting and the background of the patient followed by the patient's account of how the relationship with the physician developed. Patients' perceptions of the qualities and characteristics of the physicians who calmed their fears, engendered their trust, and solidified their relationships are very insightful. \u0000 \u0000The second portion of each story begins with a description of the physician's background, training, specialty, interests, and philosophical precepts that shaped his or her approach to life and to medicine. This is followed by the physician's account of how the special relationship with the patient developed and progressed. In almost every case, the central themes of openness, honesty, humanity, connectedness, and respect for patients can be found. I was impressed with the diversity of both patients and physicians that was encompassed in these short stories. \u0000 \u0000In every story, I gained insight into the ways in which each physician encourages the building of trusting relationships with his or her patients. In addition, each physician revealed the things he/she had learned from the patient and the relationship. The book demonstrates that the patient/physician relationship transcends all specialties, genders, socioeconomic strata, and family structures. It stresses the importance of the emotional aspect of the physician, debunking the myth of the cold intellectual who only analyzes tests and prescribes treatment. The book also underscores the concept that a strong patient/physician relationship is therapeutic and leads to better outcomes. Often, the patient/physician relationships described took in family members, who were then enlisted as members of the support team. Each patient's trust allowed the physician to have special insights into symptoms and treatment responses that helped the physician know how to better help the patient. \u0000 \u0000One of my favorite stories is under the section entitled “Lessons in Love.” Ms. Alvarez is a mother of 4 children, 2 of whom are retarded and 1 of whom is autistic. She developed a strong bond with Dr. Elisa Nicholas. From this patient/physician pair, I learned that parents are frequently stronger and wiser after having gone through such suffering. It seems that these persons are more apt to understand what is important in life. Dr. Nicholas relates the story of being invited to lunch at the home of one of her patients. While most doctors wouldn't go, she went and was truly blessed. One of Dr. Nicholas' profound observations was that when you invest in relationships with families, they allow you access into their lives, which allows you in turn to gain insight into how to live your own life. These relationships help keep physicians from becoming burned out an","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2002-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134477795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As family physicians become more integrated into the care of patients with mood disorders, the need for information pertaining to the armamentarium of psychologically useful drugs increases. Essential Psychopharmacology, by Stephen M. Stahl, M.D., Ph.D., is one such source for information pertaining to drugs that are available to the practicing physician in the fight against psychiatric disorders. In this second edition, Dr. Stahl uses his years of experience in internal medicine, neurology, and psychiatry to explain the physiology and pharmacology of psychiatric disorders. The layout of the book is very user friendly. It begins with the foundation upon which the actions of psychiatric drugs work—chemical structure, enzymatic activity, and interactions with neurotransmitter receptors. Next, individual disorders are reviewed with respect to their pathophysiology and how the classes of drugs act to countermand neurophysiologic perturbation, resulting in clinical efficacy. Each chapter stands alone, allowing the reader to pick and choose his/her areas of interest. Individual chapters are also presented in such a way that the strictly clinical reader can readily access relevant information without getting bogged down in the physiologic and neurologic theories about disease. An appendix allows readers to complete a posttest for continuing medical education credit (which helps elevate the value of the text relative to its cost). I did find the book lacking in treatment guidelines. Brief explanations of the classes of drugs used for individual disorders are given, but information regarding dosages and clinical aspects of the drugs seems sparse. As a family medicine resident, I would have liked for the most important facts and indications for drugs to be easier to locate. I do realize, however, that providing comprehensive information regarding drug indications was not the primary purpose of this text. Overall, this is an excellent resource for primary care specialists who are interested in understanding the psychopharmacology, neurotransmission, and current biomechanical theories regarding the pathophysiology underlying the major psychiatric disorders. However, it does not serve the clinician as an all-in-one reference for treating these disorders. Family physicians seeking evidence-based treatment guidelines would be well served by complementing this text with other sources more tailored to that need.
随着家庭医生越来越多地参与到情绪障碍患者的护理中，对有关心理有用药物装备的信息的需求也在增加。Stephen M. Stahl, m.d.， Ph.D.所著的《精神药理学基础》就是这样一个与药物有关的信息来源，可供执业医师在与精神疾病的斗争中使用。在这第二版，斯塔尔博士用他多年的经验，在内科，神经病学和精神病学解释生理和药理学的精神障碍。这本书的排版非常便于使用。它从精神药物起作用的基础开始——化学结构、酶活性和与神经递质受体的相互作用。接下来，回顾了个体疾病的病理生理学，以及药物如何作用于神经生理扰动，从而产生临床疗效。每一章都是独立的，允许读者选择他/她感兴趣的领域。个别章节也以这样一种方式呈现，即严格的临床读者可以很容易地获得相关信息，而不会陷入关于疾病的生理学和神经学理论。附录允许读者完成继续医学教育学分的后测(这有助于提高文本相对于其成本的价值)。我确实发现这本书缺少治疗指南。简要说明了用于个体疾病的药物类别，但关于药物剂量和临床方面的信息似乎很少。作为一名家庭医学住院医师，我希望最重要的事实和药物适应症更容易找到。然而，我确实意识到，提供有关药物适应症的全面信息并不是本文的主要目的。总的来说，对于有兴趣了解精神药理学、神经传递和当前生物力学理论的初级保健专家来说，这是一个很好的资源，这些理论与主要精神疾病的病理生理学有关。然而，它并不能作为临床医生治疗这些疾病的综合参考。寻求循证治疗指导方针的家庭医生可以通过补充其他更适合这种需要的资源来更好地服务于本文本。
{"title":"Essential Psychopharmocology: Neuroscientific Basics and Practical Applications, 2nd ed.","authors":"Brian M. McCarver","doi":"10.4088/PCC.V03N0607","DOIUrl":"https://doi.org/10.4088/PCC.V03N0607","url":null,"abstract":"As family physicians become more integrated into the care of patients with mood disorders, the need for information pertaining to the armamentarium of psychologically useful drugs increases. Essential Psychopharmacology, by Stephen M. Stahl, M.D., Ph.D., is one such source for information pertaining to drugs that are available to the practicing physician in the fight against psychiatric disorders. In this second edition, Dr. Stahl uses his years of experience in internal medicine, neurology, and psychiatry to explain the physiology and pharmacology of psychiatric disorders. \u0000 \u0000The layout of the book is very user friendly. It begins with the foundation upon which the actions of psychiatric drugs work—chemical structure, enzymatic activity, and interactions with neurotransmitter receptors. Next, individual disorders are reviewed with respect to their pathophysiology and how the classes of drugs act to countermand neurophysiologic perturbation, resulting in clinical efficacy. Each chapter stands alone, allowing the reader to pick and choose his/her areas of interest. Individual chapters are also presented in such a way that the strictly clinical reader can readily access relevant information without getting bogged down in the physiologic and neurologic theories about disease. An appendix allows readers to complete a posttest for continuing medical education credit (which helps elevate the value of the text relative to its cost). \u0000 \u0000I did find the book lacking in treatment guidelines. Brief explanations of the classes of drugs used for individual disorders are given, but information regarding dosages and clinical aspects of the drugs seems sparse. As a family medicine resident, I would have liked for the most important facts and indications for drugs to be easier to locate. I do realize, however, that providing comprehensive information regarding drug indications was not the primary purpose of this text. \u0000 \u0000Overall, this is an excellent resource for primary care specialists who are interested in understanding the psychopharmacology, neurotransmission, and current biomechanical theories regarding the pathophysiology underlying the major psychiatric disorders. However, it does not serve the clinician as an all-in-one reference for treating these disorders. Family physicians seeking evidence-based treatment guidelines would be well served by complementing this text with other sources more tailored to that need.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"1467 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124786570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"House Calls: Recollection of a Family Physician","authors":"J. E. Delzell","doi":"10.4088/PCC.V03N0505","DOIUrl":"https://doi.org/10.4088/PCC.V03N0505","url":null,"abstract":"","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116159542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As is the case with many famous persons, Dr. William Osler was a man at the right place at the right time. He came to medicine in an era when the epicenter of medicine was shifting from Europe (a place where medicine was practiced more as a tradition) to North America (a place where medicine was becoming practiced more as a science). This unique crossroads in medical culture gave rise to one of the most respected, well-known clinicians in the history of the medical profession. Michael Bliss does an excellent job of telling Dr. Osler's story from his birth in rural, backwoods Canada, through his meteoric rise to the top of his field, to his death from pneumonia, “the old man's friend” (a phrase Osler coined). His research is thorough and his footnotes informative. He has done his job so exhaustively that some parts of the book become a little burdensome to read, as he becomes bogged down in the many small details that his research uncovered. These overly detailed parts, however, are few and far between, and this biography flows smoothly overall. William Osler's rise to the pinnacle of medicine was due mainly to his strong desire to learn. He was obsessed with knowing. Although famous as a clinician, he started in medicine as a pathologist. He took every chance he could during his early years in medicine to do an autopsy. His boundless enthusiasm for this means of discovery even led to rumors of grave robbing to get “good” cases. As he learned how disease had ravaged the bodies of the dead, he turned his interests to treating the living. At a time when most physicians were fairly snobbish and would diagnose patients from across the room, Dr. Osler advocated and taught his students the art of laying hands on the patient and was a pioneer in physical examination. At a time when most physicians were content to pursue “traditional” medicine such as mustard plasters and leeches, Dr. Osler advocated the use of evidence-based medicine and was one of the first to advocate the use of morphine. If treatments did not work, he abandoned them. If a treatment might work, he was willing to try something new. He was a true pioneer and a world-renowned expert in the treatment of not 1 or 2 diseases, but almost every major disease of his time. Bliss does a superb job of detailing Osler's contributions to his field. Obsessive-compulsive almost to a fault, Osler was not a perfect physician, and in fairness Bliss also details Osler's imperfections. A workaholic, Osler endangered his own health on several occasions. Dr. Osler was not a perfect clinician either. Like every doctor before and since, he made mistakes. One interesting story tells of a patient whom Osler examined, felt the tumor in the patient's abdomen, and declared the patient would be dead within weeks. A surgeon rounding on the same patient later that day inserted a catheter into the patient's bladder, the “tumor” vanished, and the patient was discharged. William Osler: A Life in Medicine is fill
{"title":"William Osler: A Life in Medicine","authors":"M. S. Craig","doi":"10.4088/PCC.V03N0305","DOIUrl":"https://doi.org/10.4088/PCC.V03N0305","url":null,"abstract":"As is the case with many famous persons, Dr. William Osler was a man at the right place at the right time. He came to medicine in an era when the epicenter of medicine was shifting from Europe (a place where medicine was practiced more as a tradition) to North America (a place where medicine was becoming practiced more as a science). This unique crossroads in medical culture gave rise to one of the most respected, well-known clinicians in the history of the medical profession. \u0000 \u0000Michael Bliss does an excellent job of telling Dr. Osler's story from his birth in rural, backwoods Canada, through his meteoric rise to the top of his field, to his death from pneumonia, “the old man's friend” (a phrase Osler coined). His research is thorough and his footnotes informative. He has done his job so exhaustively that some parts of the book become a little burdensome to read, as he becomes bogged down in the many small details that his research uncovered. These overly detailed parts, however, are few and far between, and this biography flows smoothly overall. \u0000 \u0000William Osler's rise to the pinnacle of medicine was due mainly to his strong desire to learn. He was obsessed with knowing. Although famous as a clinician, he started in medicine as a pathologist. He took every chance he could during his early years in medicine to do an autopsy. His boundless enthusiasm for this means of discovery even led to rumors of grave robbing to get “good” cases. As he learned how disease had ravaged the bodies of the dead, he turned his interests to treating the living. At a time when most physicians were fairly snobbish and would diagnose patients from across the room, Dr. Osler advocated and taught his students the art of laying hands on the patient and was a pioneer in physical examination. At a time when most physicians were content to pursue “traditional” medicine such as mustard plasters and leeches, Dr. Osler advocated the use of evidence-based medicine and was one of the first to advocate the use of morphine. If treatments did not work, he abandoned them. If a treatment might work, he was willing to try something new. He was a true pioneer and a world-renowned expert in the treatment of not 1 or 2 diseases, but almost every major disease of his time. Bliss does a superb job of detailing Osler's contributions to his field. \u0000 \u0000Obsessive-compulsive almost to a fault, Osler was not a perfect physician, and in fairness Bliss also details Osler's imperfections. A workaholic, Osler endangered his own health on several occasions. Dr. Osler was not a perfect clinician either. Like every doctor before and since, he made mistakes. One interesting story tells of a patient whom Osler examined, felt the tumor in the patient's abdomen, and declared the patient would be dead within weeks. A surgeon rounding on the same patient later that day inserted a catheter into the patient's bladder, the “tumor” vanished, and the patient was discharged. William Osler: A Life in Medicine is fill","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133625148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this era of managed care and fixed consciousness, primary care physicians have received weakened training in psychiatry. This book demonstrates that psychiatry is a specialty that does not stand alone but continues to be intricately involved in all areas of patient care. An effective collaboration between family medicine and psychiatry educators and clinicians, this text capably examines the nuances of the physician-patient relationship while remaining practical. It covers each subject thoroughly while remaining true to its title and presenting clearly written discussions on brief office treatment and management of both medical and psychiatric illnesses. The guidelines on how to focus each office visit are particularly relevant in this era of brief patient encounters. The book is divided into 3 parts: the common psychiatric disorders encountered in primary care, the utilization of behavioral medicine theory in primary care, and the psychosocial treatments used in the primary care setting. All 3 sections are anchored to a framework of different psychosocial models without confining the reader to one specific model, allowing the clinician to explore which model is most effective for his or her practice and education. Part I lays out the psychiatric disorders in primary care as classified by the DSM-IV-PC. I found the discussion of anxiety disorders, including the differential diagnosis of coexisting medical disorders, particularly helpful. The depression chapter includes useful suggestions on conducting an effective clinical interview and outlines appropriate triggers for a mental health professional referral. Substance abuse, a topic usually covered with an outlook of defeatism, is addressed with optimism, and useful advice is given on interventions and patient feedback. The table pairing patient's stages of change with appropriate questions is particularly helpful. Chapter 7 gives important information on assessing and controlling a potentially violent situation and addresses relevant legal issues. The table in chapter 8 detailing office-based management of personality disorders is comprehensive and useful. Chapter 9 covers schizophrenia and other psychotic disorders, providing enough information for a primary care physician to approach the initial management of these patients, but emphasizes the need for a low threshold for consulting a mental health professional. A notable weakness in this section was the absence of a discussion of eating disorders. Part II shifts the focus from psychiatric disorders encountered in primary care to the role of behavioral modification therapy in common medical illnesses. Chapter 12 discusses the relationship between stress, hostility, depression, and coronary artery disease, emphasizing the need for physicians to address their patients' social support and coping mechanisms. Chapter 13 has useful health risk assessments and critical pathways concerning many of the components of cardiovascular diseas
{"title":"Primary Care Psychiatry and Behavioral Medicine","authors":"K. Charles","doi":"10.4088/PCC.V03N0106","DOIUrl":"https://doi.org/10.4088/PCC.V03N0106","url":null,"abstract":"In this era of managed care and fixed consciousness, primary care physicians have received weakened training in psychiatry. This book demonstrates that psychiatry is a specialty that does not stand alone but continues to be intricately involved in all areas of patient care. \u0000 \u0000An effective collaboration between family medicine and psychiatry educators and clinicians, this text capably examines the nuances of the physician-patient relationship while remaining practical. It covers each subject thoroughly while remaining true to its title and presenting clearly written discussions on brief office treatment and management of both medical and psychiatric illnesses. The guidelines on how to focus each office visit are particularly relevant in this era of brief patient encounters. \u0000 \u0000The book is divided into 3 parts: the common psychiatric disorders encountered in primary care, the utilization of behavioral medicine theory in primary care, and the psychosocial treatments used in the primary care setting. All 3 sections are anchored to a framework of different psychosocial models without confining the reader to one specific model, allowing the clinician to explore which model is most effective for his or her practice and education. \u0000 \u0000Part I lays out the psychiatric disorders in primary care as classified by the DSM-IV-PC. I found the discussion of anxiety disorders, including the differential diagnosis of coexisting medical disorders, particularly helpful. The depression chapter includes useful suggestions on conducting an effective clinical interview and outlines appropriate triggers for a mental health professional referral. Substance abuse, a topic usually covered with an outlook of defeatism, is addressed with optimism, and useful advice is given on interventions and patient feedback. The table pairing patient's stages of change with appropriate questions is particularly helpful. Chapter 7 gives important information on assessing and controlling a potentially violent situation and addresses relevant legal issues. The table in chapter 8 detailing office-based management of personality disorders is comprehensive and useful. Chapter 9 covers schizophrenia and other psychotic disorders, providing enough information for a primary care physician to approach the initial management of these patients, but emphasizes the need for a low threshold for consulting a mental health professional. A notable weakness in this section was the absence of a discussion of eating disorders. \u0000 \u0000Part II shifts the focus from psychiatric disorders encountered in primary care to the role of behavioral modification therapy in common medical illnesses. Chapter 12 discusses the relationship between stress, hostility, depression, and coronary artery disease, emphasizing the need for physicians to address their patients' social support and coping mechanisms. Chapter 13 has useful health risk assessments and critical pathways concerning many of the components of cardiovascular diseas","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114172895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As The Primary Care Companion to The Journal of Clinical Psychiatry begins its third year of publishing, we want to take this opportunity to thank all of those who have become regular readers. Your numbers are growing, and, thanks to you, we have become a valued member of the community of peer reviewed medical journals. During the past 2 years, our submissions have increased, and our offerings now include clinically relevant supplements and special features. We intend to continue to increase both the depth and breadth of the Companion this coming year. As a harbinger of our intent, this issue has a new look—we now have a spine, which means bigger issues. In addition, this coming year will feature more supplements than ever before, as we continue to attract new projects with relevant information for our readers. We have also increased our circulation and now mail each issue to approximately 36,500 physicians. Our latest additions range from those of you who treat children who suffer from psychiatric disorders to those who minister to the elderly who suffer from cognitive problems. Both of these circulation additions underline the fact that psychiatric disorders are seen throughout a patient's lifetime and require knowledge and understanding. Additionally, we offer our subscribers the myriad advantages of Web connectivity—rapid search capabilities, interactive programs, and direct links to resources—along with electronic access to the Companion's sister journal, The Journal of Clinical Psychiatry. We invite you to explore, at your leisure, the expanding world of electronic information tailored to meet your needs at www.primarycarecompanion.com. We are especially pleased with the fine efforts of our Editors, Associate Editors, and staff. Through their tireless work, the Companion has made its mark and has become a source of thoughtful and useful articles, meaningful supplemental reading, and intriguing features. As we celebrate this important occasion, we renew our commitment to bring you the unique information you need to become more informed and better prepared practitioners.
{"title":"Three Years and Growing","authors":"J. Shelton, Irving Shelton","doi":"10.4088/PCC.V03N0101","DOIUrl":"https://doi.org/10.4088/PCC.V03N0101","url":null,"abstract":"As The Primary Care Companion to The Journal of Clinical Psychiatry begins its third year of publishing, we want to take this opportunity to thank all of those who have become regular readers. Your numbers are growing, and, thanks to you, we have become a valued member of the community of peer reviewed medical journals. \u0000 \u0000During the past 2 years, our submissions have increased, and our offerings now include clinically relevant supplements and special features. We intend to continue to increase both the depth and breadth of the Companion this coming year. As a harbinger of our intent, this issue has a new look—we now have a spine, which means bigger issues. In addition, this coming year will feature more supplements than ever before, as we continue to attract new projects with relevant information for our readers. \u0000 \u0000We have also increased our circulation and now mail each issue to approximately 36,500 physicians. Our latest additions range from those of you who treat children who suffer from psychiatric disorders to those who minister to the elderly who suffer from cognitive problems. Both of these circulation additions underline the fact that psychiatric disorders are seen throughout a patient's lifetime and require knowledge and understanding. \u0000 \u0000Additionally, we offer our subscribers the myriad advantages of Web connectivity—rapid search capabilities, interactive programs, and direct links to resources—along with electronic access to the Companion's sister journal, The Journal of Clinical Psychiatry. We invite you to explore, at your leisure, the expanding world of electronic information tailored to meet your needs at www.primarycarecompanion.com. \u0000 \u0000We are especially pleased with the fine efforts of our Editors, Associate Editors, and staff. Through their tireless work, the Companion has made its mark and has become a source of thoughtful and useful articles, meaningful supplemental reading, and intriguing features. As we celebrate this important occasion, we renew our commitment to bring you the unique information you need to become more informed and better prepared practitioners.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133186816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Love Must Be Tough: Proven Hope for Families in Crisis is a layman's text on dealing with relationships in crisis. The author states that when a spouse strays, loses interest in his or her partner, or develops destructive habits that harm the bond between the partners, the most productive course is for the wounded party to act decisively to stop the disrespectful acts instead of engaging in passive behavior. The author feels that to effectively save a relationship the wounded party must clarify that the undesired behavior will result in the termination of the relationship. This willingness to end a relationship is the very essence of freedom and independence. The concept of 2 individuals working together for the benefit of the other is at the heart of a good relationship, and when the balance of power switches so that one person has undue control, the potential for abuse of that power becomes imminent. Once individuals have the opportunity to do anything with the tacit acceptance of their partner, they have carte blanche to engage in destructive patterns of behavior without fear of losing the benefits of the relationship. The book gives many examples of couples in which one partner engaged in sexual affairs or used illicit substances. When the other partner accepts this behavior to attempt to maintain the relationship, trust and respect diminish until the relationship eventually ends. The author's approach to ending destructive behavior is to confront the behavior and give the partner a choice between the relationship and the act. The author believes that accepting behavior allows the relationship to end slowly and fails to salvage the union. Therefore, it is better to present the partner with a choice to continue the undesired behavior or continue the relationship at the beginning of any problem than to let the problem cause a slow destruction of the bonds between 2 people, fostering increased resentment and psychosocial morbidity. In my family practice setting, it is not uncommon for patients to seek a physician's advice on familial problems and expect wisdom and insight into their situation. In my experience, the problems seem to stem from an imbalance of power and a permissive atmosphere in the relationship. For these patients, I recommend that they read this book to realize that they are sanctioning their partner's behaviors by accepting them. They are, therefore, allowed to become proactive by learning how to help themselves, rather than expecting me to conduct long sessions of cognitive therapy. This book is on a basic level and does not engage in any deep psychoanalysis of the individuals mentioned as examples. It has a common-sense approach that is appealing. The author speaks from a Christian perspective, which may not be to everyone's liking, but religious conversion is not the author's intent. The book is often redundant, but that is sometimes a necessary feature. Having recommended this book to several individuals and having
{"title":"Love Must Be Tough","authors":"Nancy Moultrie Rockstroh","doi":"10.4088/PCC.V02N0605","DOIUrl":"https://doi.org/10.4088/PCC.V02N0605","url":null,"abstract":"Love Must Be Tough: Proven Hope for Families in Crisis is a layman's text on dealing with relationships in crisis. The author states that when a spouse strays, loses interest in his or her partner, or develops destructive habits that harm the bond between the partners, the most productive course is for the wounded party to act decisively to stop the disrespectful acts instead of engaging in passive behavior. The author feels that to effectively save a relationship the wounded party must clarify that the undesired behavior will result in the termination of the relationship. This willingness to end a relationship is the very essence of freedom and independence. The concept of 2 individuals working together for the benefit of the other is at the heart of a good relationship, and when the balance of power switches so that one person has undue control, the potential for abuse of that power becomes imminent. Once individuals have the opportunity to do anything with the tacit acceptance of their partner, they have carte blanche to engage in destructive patterns of behavior without fear of losing the benefits of the relationship. \u0000 \u0000The book gives many examples of couples in which one partner engaged in sexual affairs or used illicit substances. When the other partner accepts this behavior to attempt to maintain the relationship, trust and respect diminish until the relationship eventually ends. The author's approach to ending destructive behavior is to confront the behavior and give the partner a choice between the relationship and the act. The author believes that accepting behavior allows the relationship to end slowly and fails to salvage the union. Therefore, it is better to present the partner with a choice to continue the undesired behavior or continue the relationship at the beginning of any problem than to let the problem cause a slow destruction of the bonds between 2 people, fostering increased resentment and psychosocial morbidity. \u0000 \u0000In my family practice setting, it is not uncommon for patients to seek a physician's advice on familial problems and expect wisdom and insight into their situation. In my experience, the problems seem to stem from an imbalance of power and a permissive atmosphere in the relationship. For these patients, I recommend that they read this book to realize that they are sanctioning their partner's behaviors by accepting them. They are, therefore, allowed to become proactive by learning how to help themselves, rather than expecting me to conduct long sessions of cognitive therapy. \u0000 \u0000This book is on a basic level and does not engage in any deep psychoanalysis of the individuals mentioned as examples. It has a common-sense approach that is appealing. The author speaks from a Christian perspective, which may not be to everyone's liking, but religious conversion is not the author's intent. The book is often redundant, but that is sometimes a necessary feature. Having recommended this book to several individuals and having","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114440006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：