BOOK
Psychiatric Care in Primary Care Practice, An Issue of Primary Care: Clinics in Office Practice, E-Book
(2016)
Additional Information
Book Details
Abstract
This issue of Primary Care: Clinics in Office Practice, guest edited by Dr. Janet Albers, is devoted to Psychiatric Care in Primary Care Practice. Articles in this issue include: Integrating Behavioral Health in the Medical Home Model – The Role of the Interdisciplinary Team; Behavioral Health in Prevention and Chronic Illness Management – Motivational Interviewing; Childhood Sexual Abuse and Mental Health Screening in Primary Care; Autism Spectrum/Pervasive Developmental Disorders; Pearls in Working with Patients Diagnosed with Personality Disorders; Psychopharmacology in Primary Care Settings; Depression: Screening, Diagnosis, Treatment Across Populations; Anxiety Disorders in Primary Care; Bipolar Disorder; Eating Disorders; Substance Abuse Screening and Treatment; Pain Medication Seeking Behavior; Psychiatric Emergencies; and Physician Wellness Across the Professional Continuum.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Psychiatric Care\rin Primary Care Practice | i | ||
| Copyright | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITOR | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword: Objectivity and Compassion | vii | ||
| Preface: Integrating Psychiatric Care into Primary Care Practice | vii | ||
| Integrated Care and the Evolution of the Multidisciplinary Team | vii | ||
| Behavioral Health in Prevention and Chronic Illness Management: Motivational Interviewing | vii | ||
| Using Cognitive Behavior Therapy and Mindfulness Techniques in the Management of Chronic Pain in Primary Care | vii | ||
| Substance Abuse Screening and Treatment | viii | ||
| Depression Screening, Diagnosis, and Treatment Across the Lifespan | viii | ||
| Anxiety Disorders in Primary Care | viii | ||
| Pearls for Working with People Who Have Personality Disorder Diagnoses | viii | ||
| Bipolar Disorder | ix | ||
| Autism Spectrum/Pervasive Developmental Disorder | ix | ||
| Eating Disorders in the Primary Care Setting | ix | ||
| Childhood Sexual Abuse: Identification, Screening, and Treatment Recommendations in Primary Care Settings | ix | ||
| Psychopharmacology in Primary Care Settings | x | ||
| Psychiatric Emergencies | x | ||
| Physician Wellness Across the Professional Spectrum | x | ||
| PRIMARY CARE:\rCLINICS IN OFFICE PRACTICE | xi | ||
| FORTHCOMING ISSUES | xi | ||
| September 2016 | xi | ||
| December 2016 | xi | ||
| March 2017 | xi | ||
| RECENT ISSUES | xi | ||
| March 2016 | xi | ||
| December 2015 | xi | ||
| September 2015 | xi | ||
| Foreword:\rObjectivity and Compassion | xiii | ||
| Preface:\rIntegrating Psychiatric Care into Primary Care Practice | xv | ||
| Integrated Care and the Evolution of the Multidisciplinary Team | 177 | ||
| Key points | 177 | ||
| INTRODUCTION | 177 | ||
| Patient-Centered Care | 177 | ||
| Health Care Teams | 178 | ||
| Team Composition | 179 | ||
| BEHAVIORAL HEALTH | 181 | ||
| Components of Behavioral Health | 181 | ||
| Expansion of the Primary Care Team | 182 | ||
| Programmatic Gaps | 182 | ||
| INTEGRATED CARE | 183 | ||
| Components of Integrated Care | 183 | ||
| Clinical Aspects of Integrated Care | 184 | ||
| The Role of the Psychiatrist | 186 | ||
| SYSTEMIC ASPECTS OF INTEGRATED CARE | 186 | ||
| Logistics | 186 | ||
| Stigma and Discomfort | 187 | ||
| Communication and Language | 187 | ||
| Administration | 187 | ||
| OUTCOMES AND IMPLICATIONS | 187 | ||
| Clinical Care | 187 | ||
| Medical Education | 188 | ||
| Health Care Policy | 188 | ||
| REFERENCES | 189 | ||
| Behavioral Health in Prevention and Chronic Illness Management | 191 | ||
| Key points | 191 | ||
| INTRODUCTION | 191 | ||
| DEFINITION | 192 | ||
| IMPORTANCE OF THE TOPIC: SCOPE | 192 | ||
| SUPPORTING EVIDENCE | 193 | ||
| Obesity | 194 | ||
| Physical Activity | 194 | ||
| Treatment Engagement | 195 | ||
| Chronic Pain | 195 | ||
| Diabetes Mellitus | 195 | ||
| Systematic Review of Multiple Conditions in General Medical Settings | 196 | ||
| Cultural Variability | 196 | ||
| APPLICATION | 197 | ||
| PRACTICAL ISSUES | 199 | ||
| OUTCOMES | 200 | ||
| SUMMARY/DISCUSSION | 200 | ||
| REFERENCES | 201 | ||
| Using Cognitive Behavior Therapy and Mindfulness Techniques in the Management of Chronic Pain in Primary Care | 203 | ||
| Key points | 203 | ||
| INTRODUCTION | 203 | ||
| SCREENING/DIAGNOSIS | 204 | ||
| MANAGEMENT GOALS | 206 | ||
| PHARMACOLOGIC STRATEGIES | 207 | ||
| NONPHARMACOLOGIC STRATEGIES | 208 | ||
| SELF-MANAGEMENT STRATEGIES | 209 | ||
| EVALUATION, ADJUSTMENT, RECURRENCE | 212 | ||
| SUMMARY/DISCUSSION | 214 | ||
| REFERENCES | 215 | ||
| Substance Abuse Screening and Treatment | 217 | ||
| Key points | 217 | ||
| INTRODUCTION | 217 | ||
| SCREENING/DIAGNOSIS | 218 | ||
| MANAGEMENT GOALS | 221 | ||
| PHARMACOLOGIC STRATEGIES | 221 | ||
| Substitution Therapies | 222 | ||
| Blocking Therapies | 222 | ||
| Triggered Effect Therapies | 222 | ||
| Tapering Therapy | 222 | ||
| NONPHARMACOLOGIC AND SELF-MANAGEMENT STRATEGIES | 223 | ||
| COMORBIDITIES AND RECURRENCE | 225 | ||
| SUMMARY | 226 | ||
| REFERENCES | 226 | ||
| Depression Screening, Diagnosis, and Treatment Across the Lifespan | 229 | ||
| Key points | 229 | ||
| INTRODUCTION | 229 | ||
| COLLABORATIVE CARE: PRINCIPLES FOR ALL PRACTICES | 230 | ||
| SCREENING | 230 | ||
| Patient Health Questionaire-9 | 231 | ||
| Patient Health Questionaire-2 | 231 | ||
| Patient Health Questionnaire-M | 231 | ||
| Edinburgh Postnatal Depression Scale | 231 | ||
| DIAGNOSIS | 231 | ||
| Pregnant and Postpartum Women | 232 | ||
| Elderly Patients | 232 | ||
| TREATMENT | 232 | ||
| Stepped Care and Treat to Target | 232 | ||
| Persistent depressive symptoms and clinical inertia | 233 | ||
| Managing expectations | 233 | ||
| First Steps, Shared Decision Making, and Patient Engagement | 233 | ||
| Adolescents and young adults | 234 | ||
| Pregnant and postpartum women | 234 | ||
| Elderly patients | 236 | ||
| Mirtazapine for agitation and anorexia in the elderly | 236 | ||
| Patients with cognitive impairment | 236 | ||
| Patients who use tobacco | 236 | ||
| Patients with alcohol abuse and chemical dependency | 236 | ||
| Early Challenges: Close Follow-up and Patient Activation | 236 | ||
| Motivational interviewing and patient activation | 236 | ||
| Try Something Else: Switching, Augmentation, or Both? | 237 | ||
| Serotonin Syndrome: Increasingly Common with More Intense Treatments | 237 | ||
| Augmentation Strategies for Specific Symptoms | 238 | ||
| Bupropion augmentation for sexual dysfunction or persistent fatigue | 238 | ||
| Serotonin-norepinephrine reuptake inhibitor or TCA augmentation for chronic pain complicating depression | 238 | ||
| Trazodone or mirtazapine augmentation for persistent sleep disturbance | 238 | ||
| Thyroid augmentation for persistent fatigue and vegetative symptoms | 238 | ||
| Lithium augmentation for mood stabilization | 238 | ||
| Buspirone augmentation for persistent anxiety | 238 | ||
| Bright light therapy for seasonal depression | 239 | ||
| Hold the Gains: Prevention and Treatment of Relapse | 239 | ||
| Selective serotonin reuptake inhibitor discontinuation syndrome | 239 | ||
| SUMMARY | 239 | ||
| REFERENCES | 239 | ||
| Anxiety Disorders in Primary Care | 245 | ||
| Key points | 245 | ||
| INTRODUCTION | 245 | ||
| SCREENING | 246 | ||
| INITIAL EVALUATION | 248 | ||
| GENERALIZED ANXIETY DISORDER | 248 | ||
| SOCIAL ANXIETY DISORDER | 249 | ||
| PANIC DISORDER | 249 | ||
| OBSESSIVE-COMPULSIVE DISORDER | 250 | ||
| POSTTRAUMATIC STRESS DISORDER | 250 | ||
| COMORBIDITY | 251 | ||
| TREATMENT STRATEGIES | 251 | ||
| Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors | 251 | ||
| Tricyclic Antidepressants and Monoamine Oxidase Inhibitors | 251 | ||
| Buspirone | 252 | ||
| Benzodiazepines | 252 | ||
| Other Second-Line Agents | 252 | ||
| Special Populations | 253 | ||
| Nonpharmacologic Strategies | 253 | ||
| Alternative Medicine | 256 | ||
| Collaborative Care | 257 | ||
| Discussion | 258 | ||
| REFERENCES | 258 | ||
| Pearls for Working with People Who Have Personality Disorder Diagnoses | 263 | ||
| Key points | 263 | ||
| INTRODUCTION | 263 | ||
| SCREENING AND DIAGNOSIS | 264 | ||
| MANAGEMENT GOALS | 265 | ||
| PHARMACOLOGIC STRATEGIES | 266 | ||
| SELF-MANAGEMENT STRATEGIES | 266 | ||
| SUMMARY/DISCUSSION | 267 | ||
| REFERENCES | 268 | ||
| Bipolar Disorder | 269 | ||
| Key points | 269 | ||
| INTRODUCTION | 269 | ||
| SCREENING AND DIAGNOSIS | 270 | ||
| MANAGEMENT AND GOALS | 273 | ||
| PHARMACOLOGIC STRATEGIES | 274 | ||
| NONPHARMACOLOGIC STRATEGIES | 282 | ||
| SELF-MANAGEMENT STRATEGIES | 282 | ||
| EVALUATION ADJUSTMENT RECURRENCE | 283 | ||
| SUMMARY/DISCUSSION | 283 | ||
| REFERENCES | 283 | ||
| Autism Spectrum/Pervasive Developmental Disorder | 285 | ||
| Key points | 285 | ||
| INTRODUCTION | 285 | ||
| SCREENING/DIAGNOSIS | 286 | ||
| Terminology and Diagnostic Criteria | 286 | ||
| EPIDEMIOLOGY | 286 | ||
| ROLE OF PRIMARY CARE PHYSICIAN | 287 | ||
| COMPREHENSIVE EXAMINATION: PERSONAL/FAMILY HISTORY | 290 | ||
| PHYSICAL EXAMINATION | 290 | ||
| ANCILLARY TESTING | 291 | ||
| ADDITIONAL EVALUATION | 291 | ||
| SURVEILLANCE/SCREENING: EARLY INDICATORS | 292 | ||
| OTHER RED FLAGS | 292 | ||
| SURVEILLANCE/SCREENING: FORMAL TOOLS | 293 | ||
| MANAGEMENT GOALS | 294 | ||
| PHARMACOLOGIC STRATEGIES | 295 | ||
| Inattention and Hyperactivity | 295 | ||
| Maladaptive Behaviors | 296 | ||
| Repetitive Behaviors | 296 | ||
| Anxiety | 296 | ||
| Dysregulated Mood | 296 | ||
| Depressive Mood | 296 | ||
| Other Conditions | 296 | ||
| NONPHARMACOLOGIC STRATEGIES | 296 | ||
| COMPLEMENTARY AND ALTERNATIVE MEDICINE | 297 | ||
| SUMMARY | 297 | ||
| REFERENCES | 298 | ||
| Eating Disorders in the Primary Care Setting | 301 | ||
| Key points | 301 | ||
| DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, 5TH EDITION, AND EATING DISORDERS | 302 | ||
| SCREENING FOR EATING DISORDERS | 304 | ||
| ANOREXIA NERVOSA | 304 | ||
| BULIMIA NERVOSA | 307 | ||
| BINGE EATING DISORDER | 308 | ||
| ROLE OF MEDICATIONS | 308 | ||
| LEVELS OF CARE | 308 | ||
| THE EATING DISORDER TREATMENT TEAM | 310 | ||
| THE OFFICE VISIT | 310 | ||
| WHEN TO REFER | 311 | ||
| REFERENCES | 311 | ||
| Childhood Sexual Abuse | 313 | ||
| Key points | 313 | ||
| INTRODUCTION | 314 | ||
| Definition of Childhood Sexual Abuse | 314 | ||
| Prevalence and Incidence of Childhood Sexual Abuse | 314 | ||
| SCREENING FOR CHILDHOOD SEXUAL ABUSE HISTORY AND RELATED SYMPTOMS | 315 | ||
| To Screen or Not to Screen? | 315 | ||
| Screening for Childhood Sexual Abuse History | 315 | ||
| Screening for Abuse-Related Symptoms | 316 | ||
| TREATMENT OPTIONS | 319 | ||
| Pharmacologic Strategies | 319 | ||
| Selective serotonin reuptake inhibitors | 319 | ||
| Central alpha-adrenergic agonists | 320 | ||
| Beta-adrenergic blockers | 320 | ||
| Tricyclic antidepressants | 320 | ||
| Antiepileptics | 320 | ||
| Atypical antipsychotics | 320 | ||
| Nonpharmacologic Strategies | 320 | ||
| Trauma-focused mental health treatments | 320 | ||
| LONG-TERM PHYSICAL AND MENTAL HEALTH EFFECTS OF CHILDHOOD SEXUAL ABUSE | 321 | ||
| ANTICIPATORY GUIDANCE | 322 | ||
| MANDATED REPORTING | 322 | ||
| SUMMARY AND DISCUSSION | 322 | ||
| REFERENCES | 323 | ||
| Psychopharmacology in Primary Care Settings | 327 | ||
| Key points | 327 | ||
| INTRODUCTION | 327 | ||
| ANTIDEPRESSANTS | 329 | ||
| BENZODIAZEPINES | 332 | ||
| NONBENZODIAZEPINE ANXIOLYTICS | 333 | ||
| NEUROLEPTICS | 334 | ||
| BIPOLAR DISORDER MEDICATIONS | 336 | ||
| SUMMARY | 338 | ||
| REFERENCES | 338 | ||
| Psychiatric Emergencies | 341 | ||
| Key points | 341 | ||
| INTRODUCTION | 341 | ||
| SCREENING/DIAGNOSIS: PSYCHIATRIC AND MEDICAL ASSESSMENTS | 342 | ||
| Acute Psychosis and Mania | 342 | ||
| Suicidal and Homicidal Ideation | 344 | ||
| MANAGEMENT GOALS | 346 | ||
| Acute Psychosis, Mania, and Agitated or Homicidal Patients | 346 | ||
| Suicidal Ideation | 346 | ||
| NONPHARMACOLOGIC STRATEGIES | 347 | ||
| Acute Psychosis, Mania, and Agitated or Homicidal | 347 | ||
| Suicidal Ideation | 347 | ||
| PHARMACOLOGIC STRATEGIES | 348 | ||
| Acute Psychosis, Mania, and Agitation or Homicidal Ideation | 348 | ||
| Suicidal Ideation | 348 | ||
| SELF-REGULATION STRATEGIES FOR PATIENTS | 350 | ||
| DEBRIEFING AND TEAM-MANAGEMENT STRATEGIES | 351 | ||
| LEGAL CONSIDERATIONS | 351 | ||
| SUMMARY/DISCUSSION | 352 | ||
| REFERENCES | 353 | ||
| Physician Wellness Across the Professional Spectrum | 355 | ||
| Key points | 355 | ||
| INTRODUCTION | 355 | ||
| WELLNESS AND BURNOUT | 356 | ||
| CAREER STAGE AND WELLNESS | 357 | ||
| Medical School | 357 | ||
| Residency | 357 | ||
| Practicing Physicians | 358 | ||
| RECOGNITION | 358 | ||
| DESTIGMATIZE | 358 | ||
| SCREENING | 359 | ||
| METHODS FOR IMPROVEMENT | 359 | ||
| FUTURE GOALS | 360 | ||
| SUMMARY | 360 | ||
| REFERENCES | 360 |