Therapists who work primarily with specific populations or adhere to a particular therapeutic orientation may have limited exposure to alternative therapeutic approaches. Other health care professionals, such as primary care physicians, may have little exposure to the principles and procedures used with various therapies. For such individuals who wish to better understand numerous forms of psychotherapy, Current Psychotherapies is an invaluable resource. Chapters in the text describe common therapies, such as cognitive therapy, behavioral therapy, psychoanalytic therapy, and existential therapy. Additional therapeutic approaches are also described, however, with which the reader is less likely to be familiar, such as bioenergetic analysis and psychodrama. While most of the therapeutic approaches relate to individual psychotherapy, there is also a chapter on family therapy. Although psychological therapies often have principles and terminology that make them difficult to comprehend, the information presented here is generally quite understandable. The text is well organized and consistent in the information it presents for each of the various therapies. Each chapter covers information useful for helping the reader understand the treatment approach, such as its history, the principles on which it is based, and the type of activities performed during the intervention. A case example demonstrating a therapeutic application is given along with a list of additional readings. Some information is also presented about the efficacy of the therapy and problems for which the approach has been utilized. The uniform presentation of information throughout allows ready comparison among the therapies on specific domains, promoting an understanding of the similarities and differences between them. There is also an outline that directs the reader to the topics covered for each form of psychotherapy. The text provides an overview of the therapies, rather than a description of how to perform them. Thus, it does not attempt to be a “how-to” manual. An issues chapter presents several important topics with which one must be familiar when conducting therapy. These issues primarily involve ethical issues, legal issues, and issues involved in working with certain populations. Although the coverage of these topics is brief, the chapter will alert the reader to an understanding of their importance. In addition to providing a survey of numerous psychotherapies, the text gives useful information that can be incorporated in the more general care of patients. Sections on personality in each chapter should facilitate an understanding of personality disorders and help the reader assess why a therapist might use a particular approach, depending on orientation. Numerous commonly used behavioral principles are reviewed, such as the importance of setting unambiguous and highly specific short-term goals for weight reduction rather than simply telling a patient to reduce
{"title":"Current Psychotherapies, 5th ed.","authors":"K. Reeder","doi":"10.4088/PCC.V01N0505B","DOIUrl":"https://doi.org/10.4088/PCC.V01N0505B","url":null,"abstract":"Therapists who work primarily with specific populations or adhere to a particular therapeutic orientation may have limited exposure to alternative therapeutic approaches. Other health care professionals, such as primary care physicians, may have little exposure to the principles and procedures used with various therapies. For such individuals who wish to better understand numerous forms of psychotherapy, Current Psychotherapies is an invaluable resource. \u0000 \u0000Chapters in the text describe common therapies, such as cognitive therapy, behavioral therapy, psychoanalytic therapy, and existential therapy. Additional therapeutic approaches are also described, however, with which the reader is less likely to be familiar, such as bioenergetic analysis and psychodrama. While most of the therapeutic approaches relate to individual psychotherapy, there is also a chapter on family therapy. Although psychological therapies often have principles and terminology that make them difficult to comprehend, the information presented here is generally quite understandable. \u0000 \u0000The text is well organized and consistent in the information it presents for each of the various therapies. Each chapter covers information useful for helping the reader understand the treatment approach, such as its history, the principles on which it is based, and the type of activities performed during the intervention. A case example demonstrating a therapeutic application is given along with a list of additional readings. Some information is also presented about the efficacy of the therapy and problems for which the approach has been utilized. \u0000 \u0000The uniform presentation of information throughout allows ready comparison among the therapies on specific domains, promoting an understanding of the similarities and differences between them. There is also an outline that directs the reader to the topics covered for each form of psychotherapy. The text provides an overview of the therapies, rather than a description of how to perform them. Thus, it does not attempt to be a “how-to” manual. \u0000 \u0000An issues chapter presents several important topics with which one must be familiar when conducting therapy. These issues primarily involve ethical issues, legal issues, and issues involved in working with certain populations. Although the coverage of these topics is brief, the chapter will alert the reader to an understanding of their importance. \u0000 \u0000In addition to providing a survey of numerous psychotherapies, the text gives useful information that can be incorporated in the more general care of patients. Sections on personality in each chapter should facilitate an understanding of personality disorders and help the reader assess why a therapist might use a particular approach, depending on orientation. Numerous commonly used behavioral principles are reviewed, such as the importance of setting unambiguous and highly specific short-term goals for weight reduction rather than simply telling a patient to reduce ","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"159 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116852342","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}
When confronted with a psychosocial problem in the office, nothing is more frustrating to me than an unintelligible reference text. The DSM-IV and DSM-IV-PC are excellent resources, but I frequently find myself wondering if the people that wrote them were previously employed to write the ICD-9 and CPT code books. When I encourage our resident physicians to use the DSM-IV, they frequently give me a look as if to ask “What language is this thing written in?” In a world where legalese, medicalese, and behavioralese books are common, Primary Care Psychiatry and Behavioral Medicine is a refreshing exception. This excellent resource for clinicians working in a primary care setting is very readable, easily referenced, and full of clinically useful advice. This textbook is formatted into 3 distinct parts: “Psychiatric Disorders in Primary Care,” “Behavioral Medicine in Primary Care,” and “Psychosocial Treatments in Primary Care.” The first part addresses the most common psychiatric disorders that the clinician in private practice will encounter. These chapters are practical in their approach to accurate diagnosis and treatment. Common clinical presentations, symptoms, and treatment options are clearly outlined. The text is supplemented with multiple charts, figures, and algorithms that will more than meet the needs of the visual learner. The text provides a valuable service in outlining successful treatments for common psychiatric disorders. Medical management and psychotherapy treatment options are referenced for each diagnosis. The clinical guides make this textbook a “must” for the practicing clinician. The information on physician-patient interactions makes this work exceptional, even though, occasionally, the discussion becomes convoluted. It is sometimes difficult to determine “who” is reacting to “what” behavior in “what” way. The positive aspect of this dialogue is that the physician is identified as an important player in the therapeutic relationship. Common foibles in that relationship are discussed, and practical insights are given on when and how to evaluate the patient's need for referral. The second part discusses “Behavioral Medicine in Primary Care.” This part of the text opens with a valuable discussion of cardiovascular risk behavior. Recent publications have identified depression as a significant marker of post–myocardial infarction mortality. This chapter outlines timely recommendations to cardiologists and primary care clinicians managing patients with atherosclerotic heart disease. Women's health care issues that impact mental health are also discussed. Appropriate diagnosis and management of endocrine-related mood and behavior disorders are reviewed. Medication, diet, and education are discussed. This section ends with a valuable overview of death and dying. Guidance is given for developing the clinical skills necessary in sharing bad news compassionately. The final section, “Psychosocial Treatments in Primary Care,” op
{"title":"Primary Care Psychiatry and Behavioral Medicine: Brief Office Treatment and Management Pathways","authors":"Rob Houston","doi":"10.4088/PCC.v01n0405","DOIUrl":"https://doi.org/10.4088/PCC.v01n0405","url":null,"abstract":"When confronted with a psychosocial problem in the office, nothing is more frustrating to me than an unintelligible reference text. The DSM-IV and DSM-IV-PC are excellent resources, but I frequently find myself wondering if the people that wrote them were previously employed to write the ICD-9 and CPT code books. When I encourage our resident physicians to use the DSM-IV, they frequently give me a look as if to ask “What language is this thing written in?” In a world where legalese, medicalese, and behavioralese books are common, Primary Care Psychiatry and Behavioral Medicine is a refreshing exception. This excellent resource for clinicians working in a primary care setting is very readable, easily referenced, and full of clinically useful advice. \u0000 \u0000This textbook is formatted into 3 distinct parts: “Psychiatric Disorders in Primary Care,” “Behavioral Medicine in Primary Care,” and “Psychosocial Treatments in Primary Care.” The first part addresses the most common psychiatric disorders that the clinician in private practice will encounter. These chapters are practical in their approach to accurate diagnosis and treatment. Common clinical presentations, symptoms, and treatment options are clearly outlined. The text is supplemented with multiple charts, figures, and algorithms that will more than meet the needs of the visual learner. \u0000 \u0000The text provides a valuable service in outlining successful treatments for common psychiatric disorders. Medical management and psychotherapy treatment options are referenced for each diagnosis. The clinical guides make this textbook a “must” for the practicing clinician. The information on physician-patient interactions makes this work exceptional, even though, occasionally, the discussion becomes convoluted. It is sometimes difficult to determine “who” is reacting to “what” behavior in “what” way. The positive aspect of this dialogue is that the physician is identified as an important player in the therapeutic relationship. Common foibles in that relationship are discussed, and practical insights are given on when and how to evaluate the patient's need for referral. \u0000 \u0000The second part discusses “Behavioral Medicine in Primary Care.” This part of the text opens with a valuable discussion of cardiovascular risk behavior. Recent publications have identified depression as a significant marker of post–myocardial infarction mortality. This chapter outlines timely recommendations to cardiologists and primary care clinicians managing patients with atherosclerotic heart disease. Women's health care issues that impact mental health are also discussed. Appropriate diagnosis and management of endocrine-related mood and behavior disorders are reviewed. Medication, diet, and education are discussed. This section ends with a valuable overview of death and dying. Guidance is given for developing the clinical skills necessary in sharing bad news compassionately. \u0000 \u0000The final section, “Psychosocial Treatments in Primary Care,” op","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130154423","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 Pocket Handbook of Primary Care Psychiatry is a reasonable source of information for primary care physicians, particularly in areas of non–mood disorders such as schizophrenia, anorexia nervosa, or somatoform disorder. The book hits the major highlights, describing patient presentation, treatment, and symptoms requiring further investigation or hospitalization. The book is divided into 3 parts: (1) chapters covering the field of primary care psychiatry, (2) discussions of almost every psychiatric disorder that may be encountered in the office, and (3) strategies for treatment and management of psychiatric disorders. As an example, Chapter 9, titled “Schizophrenia and Other Psychotic Disorders,” begins with a definition of a brief psychotic disorder then lists the clinical features and diagnosis, interviewing and psychotherapeutic guidelines, evaluation and management, and drug treatment strategies for this illness. The chapter continues for all presentations related to schizophrenia such as hallucinations, illusions, and delusional disorder. I was somewhat disappointed to note that the book did not include a more in-depth examination and discussion of other illnesses often encountered by primary care physicians, namely bipolar II disorder and cyclothymia. However, given the authors' orientation as practicing psychiatrists and the novelty of bipolar illness as an important entity in primary care, this lack could be expected. The book would better serve primary care physicians if bipolar spectrum conditions and dysthymia were included. This book functions better as a quick reference for the major psychiatric illnesses that present in an emergency setting. However, for those illnesses that often present in the ambulatory setting, other sources will be needed for clinical guidance.
{"title":"Pocket Handbook of Primary Care Psychiatry.","authors":"Sheila M. Thomas","doi":"10.4088/PCC.V01N0306B","DOIUrl":"https://doi.org/10.4088/PCC.V01N0306B","url":null,"abstract":"The Pocket Handbook of Primary Care Psychiatry is a reasonable source of information for primary care physicians, particularly in areas of non–mood disorders such as schizophrenia, anorexia nervosa, or somatoform disorder. The book hits the major highlights, describing patient presentation, treatment, and symptoms requiring further investigation or hospitalization. The book is divided into 3 parts: (1) chapters covering the field of primary care psychiatry, (2) discussions of almost every psychiatric disorder that may be encountered in the office, and (3) strategies for treatment and management of psychiatric disorders. As an example, Chapter 9, titled “Schizophrenia and Other Psychotic Disorders,” begins with a definition of a brief psychotic disorder then lists the clinical features and diagnosis, interviewing and psychotherapeutic guidelines, evaluation and management, and drug treatment strategies for this illness. The chapter continues for all presentations related to schizophrenia such as hallucinations, illusions, and delusional disorder. \u0000 \u0000I was somewhat disappointed to note that the book did not include a more in-depth examination and discussion of other illnesses often encountered by primary care physicians, namely bipolar II disorder and cyclothymia. However, given the authors' orientation as practicing psychiatrists and the novelty of bipolar illness as an important entity in primary care, this lack could be expected. The book would better serve primary care physicians if bipolar spectrum conditions and dysthymia were included. \u0000 \u0000This book functions better as a quick reference for the major psychiatric illnesses that present in an emergency setting. However, for those illnesses that often present in the ambulatory setting, other sources will be needed for clinical guidance.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"191 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132245850","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 the advent of the women's movement, it seems that more and more medical research focuses on the necessity for improving women's health care. While we are moving forward in the area of postpartum mood disorders, the momentum seems to be slower here than in other areas of women's health research. This momentum gained speed when the DSM-IV finally included the postpartum modifier to several psychiatric entities. It is this reader's opinion that Postpartum Mood Disorders could be the ignition to spark interest and pick up the pace of research in this area of women's health care. After having recently plowed through a fair amount of the recent literature on postpartum depression, this book was a pleasure to read, offering much insight into the nature of the disorder. It is a compilation of the research, thoughts, and opinions of many persons from different medical backgrounds. Psychiatry faculty, social workers, postpartum support group facilitators, and even law professors have all contributed chapters.It is this very diversity that gives this publication its strength to inform and educate. The language is clear, understandable, and definitely targeted toward primary care givers. By their nature, postpartum mood disorders can be unclear or ill defined; however, this book does a very good job with succinct explanations, comparisons, and definitions. The treatment section offers in-depth strategies that seem to be lacking in some areas of the literature available. The most remarkable aspect of this book is its perceptive lessons in psychotherapy, which cover varying types, from interpersonal therapy to couples therapy to self-help therapy. The editors even go so far as to include a chapter on support groups and the great advances that have been made in treatment and prevention by volunteer persons, many of whom have no medical background but do have the background of personal experience. This text emphasizes psychotherapy as treatment with a limited amount of information regarding medical therapy. The reason for this limitation is the lack of information available, according to the author. Overall, if you are a practicing physician who treats obstetric patients or deals with postpartum patients, this book should find its way into your library.
{"title":"Postpartum Mood Disorders","authors":"Christa Andrews-Fike","doi":"10.4088/PCC.v01n0306a","DOIUrl":"https://doi.org/10.4088/PCC.v01n0306a","url":null,"abstract":"With the advent of the women's movement, it seems that more and more medical research focuses on the necessity for improving women's health care. While we are moving forward in the area of postpartum mood disorders, the momentum seems to be slower here than in other areas of women's health research. This momentum gained speed when the DSM-IV finally included the postpartum modifier to several psychiatric entities. It is this reader's opinion that Postpartum Mood Disorders could be the ignition to spark interest and pick up the pace of research in this area of women's health care. \u0000 \u0000After having recently plowed through a fair amount of the recent literature on postpartum depression, this book was a pleasure to read, offering much insight into the nature of the disorder. It is a compilation of the research, thoughts, and opinions of many persons from different medical backgrounds. Psychiatry faculty, social workers, postpartum support group facilitators, and even law professors have all contributed chapters.It is this very diversity that gives this publication its strength to inform and educate. \u0000 \u0000The language is clear, understandable, and definitely targeted toward primary care givers. By their nature, postpartum mood disorders can be unclear or ill defined; however, this book does a very good job with succinct explanations, comparisons, and definitions. The treatment section offers in-depth strategies that seem to be lacking in some areas of the literature available. The most remarkable aspect of this book is its perceptive lessons in psychotherapy, which cover varying types, from interpersonal therapy to couples therapy to self-help therapy. The editors even go so far as to include a chapter on support groups and the great advances that have been made in treatment and prevention by volunteer persons, many of whom have no medical background but do have the background of personal experience. \u0000 \u0000This text emphasizes psychotherapy as treatment with a limited amount of information regarding medical therapy. The reason for this limitation is the lack of information available, according to the author. Overall, if you are a practicing physician who treats obstetric patients or deals with postpartum patients, this book should find its way into your library.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127752524","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}
Physicians Postgraduate Press is pleased to announce that it has earned accreditation for its CME program for another 4 years. This reaccreditation represents an important milestone in the development of our CME Department and means that we can continue to provide meaningful CME opportunities to both the readers of our enduring materials and the participants in our live activities. We wish to take this opportunity to thank those who have served as faculty for our CME activities and who have helped to create the information. We also wish to express our gratitude to our External CME Advisory Board for their insights and continued support in the development, execution, and evaluation of our activities. However, our greatest debt of gratitude is to the outstanding Physicians Postgraduate Press CME Department and staff of editors who, together, have the expertise and knowledge required to plan and execute meaningful activities.
{"title":"Physicians Postgraduate Press Earns Full 4-Year CME Accreditation","authors":"J. Shelton, Irving Shelton","doi":"10.4088/PCC.V01N0200","DOIUrl":"https://doi.org/10.4088/PCC.V01N0200","url":null,"abstract":"Physicians Postgraduate Press is pleased to announce that it has earned accreditation for its CME program for another 4 years. This reaccreditation represents an important milestone in the development of our CME Department and means that we can continue to provide meaningful CME opportunities to both the readers of our enduring materials and the participants in our live activities. \u0000 \u0000We wish to take this opportunity to thank those who have served as faculty for our CME activities and who have helped to create the information. We also wish to express our gratitude to our External CME Advisory Board for their insights and continued support in the development, execution, and evaluation of our activities. However, our greatest debt of gratitude is to the outstanding Physicians Postgraduate Press CME Department and staff of editors who, together, have the expertise and knowledge required to plan and execute meaningful activities.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124836832","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}
From the Physician… The pervasiveness of mood disorders is striking and well known to primary care practitioners. Treatment of these disorders is complicated by lack of public awareness about and prejudice against admitting to having such a condition. For example, the single mother who saw me last week to treat her child's attention deficit had attributed the last 5 years of intense mood swings to the stress of raising a hyperactive child. It is Dr. Quinn's admirable ambition to clear up some of this confusion for lay people. While writing from a strongly biological perspective, he commits to giving a balanced view of varied approaches including pharmacologic, psychotherapeutic, and natural. A prime goal of this education is to “give the reader hope” that his or her symptoms are treatable and can be greatly improved, if not cured. This is a worthy ambition, partly realized, but falls short of the ideal. The first chapters, which attempt to orient the reader to the variety of mood disorders, need better organization. The book is liable to be of limited use to patients seeking to get acquainted with mood disorders for the first time or to answer the question that these chapters seem to address, namely, “Could I have a medical problem, and if so, what type?” Even to one familiar with the broad categories of these illnesses, the outline is perplexing and lacking parallelism, blurring the distinctions between diagnoses. It would have been better first to define, say, bipolar disorder and cyclothymia clearly, before showing how the boundaries between them are not always clear. There is also a lack of conscious acknowledgment of the fuzzy border between normal and abnormal. This distinction is implicit in the biographical sketches of historical figures and modern celebrities, but the big question lingers. What separates illness, which should be treated medically, from character and life trials, which demand effort and force of will to overcome? This issue is not explicitly addressed. Van Gogh may not have died so early if he had taken lithium instead of absinthe, but would the world have seen The Starry Night? In treating individuals in distress, the ethical responsibility of the mental health provider is clear, but what are the cultural and societal consequences of taking a biological, largely deterministic approach to these types of problems? Such a discussion is beyond Dr. Quinn's scope. The book leaves me with a nagging feeling that we are at risk of losing the mystery and heroism of the human struggle. In looking at the array of different approaches to these problems, the book will be more helpful to sophisticated readers already diagnosed (or having a family member diagnosed) with a mood disorder. At times, Dr. Quinn is a little strident. The chapter “Medication for Depression” takes the point of view that each imagined question or doubt about the pharmacologic approach can be dismissed quickly. But on the whole, a variety of approache
{"title":"The Depression Sourcebook.","authors":"Joshua Gettinger","doi":"10.4088/PCC.V01N0206B","DOIUrl":"https://doi.org/10.4088/PCC.V01N0206B","url":null,"abstract":"From the Physician… \u0000 \u0000The pervasiveness of mood disorders is striking and well known to primary care practitioners. Treatment of these disorders is complicated by lack of public awareness about and prejudice against admitting to having such a condition. For example, the single mother who saw me last week to treat her child's attention deficit had attributed the last 5 years of intense mood swings to the stress of raising a hyperactive child. It is Dr. Quinn's admirable ambition to clear up some of this confusion for lay people. While writing from a strongly biological perspective, he commits to giving a balanced view of varied approaches including pharmacologic, psychotherapeutic, and natural. A prime goal of this education is to “give the reader hope” that his or her symptoms are treatable and can be greatly improved, if not cured. This is a worthy ambition, partly realized, but falls short of the ideal. \u0000 \u0000The first chapters, which attempt to orient the reader to the variety of mood disorders, need better organization. The book is liable to be of limited use to patients seeking to get acquainted with mood disorders for the first time or to answer the question that these chapters seem to address, namely, “Could I have a medical problem, and if so, what type?” Even to one familiar with the broad categories of these illnesses, the outline is perplexing and lacking parallelism, blurring the distinctions between diagnoses. It would have been better first to define, say, bipolar disorder and cyclothymia clearly, before showing how the boundaries between them are not always clear. \u0000 \u0000There is also a lack of conscious acknowledgment of the fuzzy border between normal and abnormal. This distinction is implicit in the biographical sketches of historical figures and modern celebrities, but the big question lingers. What separates illness, which should be treated medically, from character and life trials, which demand effort and force of will to overcome? This issue is not explicitly addressed. Van Gogh may not have died so early if he had taken lithium instead of absinthe, but would the world have seen The Starry Night? In treating individuals in distress, the ethical responsibility of the mental health provider is clear, but what are the cultural and societal consequences of taking a biological, largely deterministic approach to these types of problems? Such a discussion is beyond Dr. Quinn's scope. The book leaves me with a nagging feeling that we are at risk of losing the mystery and heroism of the human struggle. \u0000 \u0000In looking at the array of different approaches to these problems, the book will be more helpful to sophisticated readers already diagnosed (or having a family member diagnosed) with a mood disorder. At times, Dr. Quinn is a little strident. The chapter “Medication for Depression” takes the point of view that each imagined question or doubt about the pharmacologic approach can be dismissed quickly. But on the whole, a variety of approache","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129005972","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}
From the Patient… When first diagnosed with bipolar disorder, I immediately went into denial because I felt it was a grave flaw in my personality. The fact that I might have to take medication the rest of my life scared me. I set out to prove the diagnosis false. A year later (a turbulent one, I might add), I was beginning to take steps toward proper treatment. Over the years, I have gained greater knowledge about my condition. Just being able to identify with someone with the illness has helped fight the stigmas. My doctor recently gave me a copy of The Depression Sourcebook. I would recommend that people suffering from mood disorders take the time to read this book. It reads facilely and is loaded with extremely beneficial information. Although the book has a simplistic quality, its insights into depressive illness are not. The explanations are sound. In the introduction, Dr. Quinn explicitly states his goals to (1) help readers determine if they suffer from a depressive illness, (2) provide a resource of information for patients and doctors, (3) offer insight into various approaches to treatment, and (4) give hope. The directness with which Dr. Quinn has stated his goals is similar to the direct approach he uses to write the book. The outlining style allows use of this resource as a reference guide. For example, frequently asked questions are italicized. Most importantly, Dr. Quinn provides clear descriptions of the illness. He emphasizes the need to be aware of depression, its various causes, and the wide range of solutions. Also provided is an excellent guideline for patients to use when searching for help. The author wants people to be aware of themselves and the doctors with whom they are entrusting their well-being. From a patient's point of view, Dr. Quinn's approach to describing depressive illness is strong and fascinating. The repetition of symptoms and the various scenarios act as an effective teaching aid. The reader is taken step-by-step through the onset of depression and how it may deepen if not treated properly. Hypothetical situations make for interesting reading, but the use of misplaced pronouns weakens the writing. That, however, is of minor importance in comparison to the valuable information provided. The descriptions of how others may perceive the actions of those suffering from the illness are personally comforting. I have been given a glimpse of myself through different eyes. I want my family to read the book so they can better understand what is happening to me and why. It is important to have those closest to me aware of the illness and break down their misconceptions.
{"title":"The Depression Sourcebook.","authors":"Yancey Allison","doi":"10.4088/PCC.V01N0206C","DOIUrl":"https://doi.org/10.4088/PCC.V01N0206C","url":null,"abstract":"From the Patient… \u0000 \u0000When first diagnosed with bipolar disorder, I immediately went into denial because I felt it was a grave flaw in my personality. The fact that I might have to take medication the rest of my life scared me. I set out to prove the diagnosis false. A year later (a turbulent one, I might add), I was beginning to take steps toward proper treatment. Over the years, I have gained greater knowledge about my condition. Just being able to identify with someone with the illness has helped fight the stigmas. \u0000 \u0000My doctor recently gave me a copy of The Depression Sourcebook. I would recommend that people suffering from mood disorders take the time to read this book. It reads facilely and is loaded with extremely beneficial information. Although the book has a simplistic quality, its insights into depressive illness are not. The explanations are sound. In the introduction, Dr. Quinn explicitly states his goals to (1) help readers determine if they suffer from a depressive illness, (2) provide a resource of information for patients and doctors, (3) offer insight into various approaches to treatment, and (4) give hope. \u0000 \u0000The directness with which Dr. Quinn has stated his goals is similar to the direct approach he uses to write the book. The outlining style allows use of this resource as a reference guide. For example, frequently asked questions are italicized. Most importantly, Dr. Quinn provides clear descriptions of the illness. He emphasizes the need to be aware of depression, its various causes, and the wide range of solutions. Also provided is an excellent guideline for patients to use when searching for help. The author wants people to be aware of themselves and the doctors with whom they are entrusting their well-being. \u0000 \u0000From a patient's point of view, Dr. Quinn's approach to describing depressive illness is strong and fascinating. The repetition of symptoms and the various scenarios act as an effective teaching aid. The reader is taken step-by-step through the onset of depression and how it may deepen if not treated properly. Hypothetical situations make for interesting reading, but the use of misplaced pronouns weakens the writing. That, however, is of minor importance in comparison to the valuable information provided. \u0000 \u0000The descriptions of how others may perceive the actions of those suffering from the illness are personally comforting. I have been given a glimpse of myself through different eyes. I want my family to read the book so they can better understand what is happening to me and why. It is important to have those closest to me aware of the illness and break down their misconceptions.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"85 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132286921","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}
Strong evidence exists that primary care physicians underdiagnose psychiatric disorders and substance abuse in their patients. Over half of patients with depression, for example, are misdiagnosed by their doctors.1 The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Primary Care Version (DSM-IV-PC) goes a long way toward helping doctors identify these common problems in their patients. Future editions would benefit from a number of revisions and additions that would help the primary care physician make correct diagnoses. The authors of the DSM-IV-PC have managed to condense and rearrange the 800-page DSM-IV into a format that busy primary care physicians can easily use to help them diagnose psychiatric disorders. The manual is laid out so that the physician faced with a patient suffering from, say, depressed mood can turn to a “quick reference algorithm”—a flowchart with minimal diagnostic criteria and information—or to a section with more detailed information to begin considering likely diagnoses. Alternatively, the physician can go to an index, find a symptom, and be directed to several parts of the manual to explore various diagnostic possibilities. There is a separate chapter on the diagnosis of disorders typically first seen in infants, children, and adolescents. All of the DSM-IV-PC algorithms begin by advising the physician to rule out medical illness or substance abuse as a cause of a patient's psychiatric symptoms. The manual includes a section on clues that will alert the physician to the possible presence of a medical masquerade of psychiatric symptoms. It would be wise to highlight and add to this section in future editions. Anyone using the DSM-IV-PC (or the DSM-IV, for that matter) must keep in mind that DSM-IV labels are not etiologic diagnoses. Patients with psychiatric symptoms need to have their physicians do a thoughtful and thorough differential diagnostic workup to rule out organic illness. The flowcharts in the DSM-IV-PC are useful for helping the physician make diagnostic decisions. In future editions, the authors of the DSM-IV-PC should provide physicians with more specific advice on the type of information they need to gather to make an expert differential diagnosis. For example, it will be especially important to revise the depressed mood algorithm. Physicians should be explicitly advised to consider the possibility of bipolar disorder when a patient presents with symptoms of depression. As it now stands, step 1 of the depressed mood flowchart merely suggests that the physician consider “another mental disorder” to explain a patient's depressed mood. If the doctor does not consult the more detailed information after the flowchart and is not aware that a large proportion of affectively ill patients in primary care may suffer from bipolar illness,2 he or she might diagnose a patient with bipolar depression as suffering from unipolar depression. This is a potentially serious error. Primary ca
{"title":"Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Primary Care Version","authors":"Brian P. Quinn","doi":"10.4088/PCC.V01N0206A","DOIUrl":"https://doi.org/10.4088/PCC.V01N0206A","url":null,"abstract":"Strong evidence exists that primary care physicians underdiagnose psychiatric disorders and substance abuse in their patients. Over half of patients with depression, for example, are misdiagnosed by their doctors.1 The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Primary Care Version (DSM-IV-PC) goes a long way toward helping doctors identify these common problems in their patients. Future editions would benefit from a number of revisions and additions that would help the primary care physician make correct diagnoses. \u0000 \u0000The authors of the DSM-IV-PC have managed to condense and rearrange the 800-page DSM-IV into a format that busy primary care physicians can easily use to help them diagnose psychiatric disorders. The manual is laid out so that the physician faced with a patient suffering from, say, depressed mood can turn to a “quick reference algorithm”—a flowchart with minimal diagnostic criteria and information—or to a section with more detailed information to begin considering likely diagnoses. Alternatively, the physician can go to an index, find a symptom, and be directed to several parts of the manual to explore various diagnostic possibilities. There is a separate chapter on the diagnosis of disorders typically first seen in infants, children, and adolescents. \u0000 \u0000All of the DSM-IV-PC algorithms begin by advising the physician to rule out medical illness or substance abuse as a cause of a patient's psychiatric symptoms. The manual includes a section on clues that will alert the physician to the possible presence of a medical masquerade of psychiatric symptoms. It would be wise to highlight and add to this section in future editions. Anyone using the DSM-IV-PC (or the DSM-IV, for that matter) must keep in mind that DSM-IV labels are not etiologic diagnoses. Patients with psychiatric symptoms need to have their physicians do a thoughtful and thorough differential diagnostic workup to rule out organic illness. \u0000 \u0000The flowcharts in the DSM-IV-PC are useful for helping the physician make diagnostic decisions. In future editions, the authors of the DSM-IV-PC should provide physicians with more specific advice on the type of information they need to gather to make an expert differential diagnosis. For example, it will be especially important to revise the depressed mood algorithm. Physicians should be explicitly advised to consider the possibility of bipolar disorder when a patient presents with symptoms of depression. As it now stands, step 1 of the depressed mood flowchart merely suggests that the physician consider “another mental disorder” to explain a patient's depressed mood. If the doctor does not consult the more detailed information after the flowchart and is not aware that a large proportion of affectively ill patients in primary care may suffer from bipolar illness,2 he or she might diagnose a patient with bipolar depression as suffering from unipolar depression. This is a potentially serious error. Primary ca","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126514776","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 recent defeat of a referendum to legalize physician-assisted suicide in Michigan (not to mention the performance of euthanasia on national television by a prominent pathologist) has underscored continued public interest in issues surrounding medical care delivered at the end of life. In a manner similar to its relative silence during the abortion debate in the 1980s, the medical community has been generally reticent to forward cogent arguments supporting viable models of end-of-life care. The group of essays compiled by Steinberg and Youngner are a welcome aberration to this disturbing trend.
{"title":"End-of-Life Decisions: A Psychosocial Perspective.","authors":"W. Jackson","doi":"10.4088/PCC.V01N0106A","DOIUrl":"https://doi.org/10.4088/PCC.V01N0106A","url":null,"abstract":"The recent defeat of a referendum to legalize physician-assisted suicide in Michigan (not to mention the performance of euthanasia on national television by a prominent pathologist) has underscored continued public interest in issues surrounding medical care delivered at the end of life. In a manner similar to its relative silence during the abortion debate in the 1980s, the medical community has been generally reticent to forward cogent arguments supporting viable models of end-of-life care. The group of essays compiled by Steinberg and Youngner are a welcome aberration to this disturbing trend.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128774681","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}
I approached the review of this paperback with a smattering of trepidation. Since such handbooks frequently are obsequious reiterations of the DSM, overrun with obfuscation and tenuous usefulness (much like this introduction), I was pleasantly surprised with the utility and breadth of this volume. The book consists of 78 concisely and readably written chapters averaging 8 pages each. Individual topics are “co authored by a primary care professional and a psychiatrist,” and this formula appears to be an effective one. Every chapter clearly identifies and defines key terms, criteria for diagnosis, and approach to treatment. Given the relative brevity of each chapter, several suggested readings are appended to aid the interested party in further study. Topics addressed include the expected approaches to the depressed patient and the anxious patient, but quickly branch off to explore items like smoking cessation, fatigue, headaches, chronic steroid use, and PMS. These frequently encountered problems, while widely understood to have psychiatric aspects, often receive short shrift in similar handbooks. The editors go on to include sections on less common scenarios, providing excellent “quick studies” to aid in patient management. Among others, approaches to the patient who has been sexually assaulted, who is awaiting organ transplantation, or who has celebrity status are all standouts. A healthy dose of pharmacotherapeutics rounds out this selection. The book is not without fault. There is some variability between chapters—some are written in skeleton outline format, while others are in a more friendly, yet still succinct prose. More troubling is that, although the book has a 1998 publication date, several recent (but not novel) chemotherapeutic agents and treatment strategies are glaringly absent, even from cursory mention. Finally, while a few chapters may feel a bit wanting, one should approach the guide not as a comprehensive text, but rather as a handy, focused review that ably directs further study when indicated. When used in this manner, this book deserves a place on every physician's bookshelf.
{"title":"The MGH Guide to Psychiatry in Primary Care","authors":"Christian G. Wolff","doi":"10.4088/PCC.v01n0106b","DOIUrl":"https://doi.org/10.4088/PCC.v01n0106b","url":null,"abstract":"I approached the review of this paperback with a smattering of trepidation. Since such handbooks frequently are obsequious reiterations of the DSM, overrun with obfuscation and tenuous usefulness (much like this introduction), I was pleasantly surprised with the utility and breadth of this volume. \u0000 \u0000The book consists of 78 concisely and readably written chapters averaging 8 pages each. Individual topics are “co authored by a primary care professional and a psychiatrist,” and this formula appears to be an effective one. Every chapter clearly identifies and defines key terms, criteria for diagnosis, and approach to treatment. Given the relative brevity of each chapter, several suggested readings are appended to aid the interested party in further study. \u0000 \u0000Topics addressed include the expected approaches to the depressed patient and the anxious patient, but quickly branch off to explore items like smoking cessation, fatigue, headaches, chronic steroid use, and PMS. These frequently encountered problems, while widely understood to have psychiatric aspects, often receive short shrift in similar handbooks. The editors go on to include sections on less common scenarios, providing excellent “quick studies” to aid in patient management. Among others, approaches to the patient who has been sexually assaulted, who is awaiting organ transplantation, or who has celebrity status are all standouts. A healthy dose of pharmacotherapeutics rounds out this selection. \u0000 \u0000The book is not without fault. There is some variability between chapters—some are written in skeleton outline format, while others are in a more friendly, yet still succinct prose. More troubling is that, although the book has a 1998 publication date, several recent (but not novel) chemotherapeutic agents and treatment strategies are glaringly absent, even from cursory mention. \u0000 \u0000Finally, while a few chapters may feel a bit wanting, one should approach the guide not as a comprehensive text, but rather as a handy, focused review that ably directs further study when indicated. When used in this manner, this book deserves a place on every physician's bookshelf.","PeriodicalId":371004,"journal":{"name":"The Primary Care Companion To The Journal of Clinical Psychiatry","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1999-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122669049","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：