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 (ISBN-13: 9780511282225)

Handbook of Liaison Psychiatry
Cambridge University Press
978-0-521-82637-2 - Handbook of Liaison Psychiatry - by Geoffrey Lloyd and Elspeth Guthrie
Index

Index



ABI see acquired brain injury

abnormal illness behaviour, psychological reactions to illness 79–80

abortion 650–1

academic issues 19–20

acne vulgaris 725

acquired brain injury (ABI) 332–7

cognitive deficits 335

emotional disorders 335

executive dysfunction 336

incidence 332

outcomes 333, 334

prognosis 336–7

PTA 333–5

severity measures 333

acute organic brain syndrome, legal issues 59

Addenbrooke's Cognitive Examination 314

adjustment difficulties

diabetes 462–3

physical illness 114, 115

renal disease 514–15

adjustment disorder

ICU 679–81, 685

psychological reactions to illness 72

adolescents

renal disease 521–2

self-harm 251

suicide 256

AED see antiepileptic drugs

affective dysprosodia, stroke 338

ageing effects

delirium 271

psychological reactions to illness 66–7

agnosia 313

AID see amputee identity disorder

AIDS see HIV infection

alcohol 149–64

acamprosate 166–7

alcohol-related diseases 149–52

anxiety 156–7, 168–9

benzodiazepines 159–60

blood test markers 154–6

brief intervention (BI) 163–8, 171–2

CAGE screening questionnaire 153–4

cardiovascular service 169–70

children 294–5

chlordiazepoxide 159

clomethiazole 159

delirium tremens 282

dementia 329

dependence detection 152

dependence symptoms 153

depression 156–7

detection 152–7

diabetes 459

diagnosis 152–4

diazepam 159

disulfiram 167–8

emergency department (ED) 170–2

Fast Alcohol Screening Test (FAST) 155

first seizure in adulthood 172–3

FRAMES 164

haloperidol 159

hazardous drinking 151–4

head injury 169

head/neck cancer 566

HIV infection 485–6

injury 169

interventions 161–8

liver disease 421–3

medication 159–60

motivational interviewing 164–6

obstetric service 170

older people 173

opiate antagonists 167

organizational issues 173

physical signs 154

presentations 150–1

requests for ‘drying out’ 171

screening 153–4

sexual problems 237

treatment 162–3

vitamins 160–1, 282, 331

Wernicke's syndrome 160–1

withdrawal 157–60, 200–1

WKS 331

alopecia areata 726

amineptine

amnesia

amnestic syndromes 331–2

PTA 333–5

TGA 332

amoxapine 774

amputee identity disorder (AID) 628

ancillary support, drug misuse 208

anorexia nervosa

diabetes 458–9

follow-up study 292–3

legal issues 61

psychological reactions to illness 78–9

anosagnosia, stroke 338

antidepressant drugs 768–76

depression 197–8

drug misuse 197–8

fibromyalgia 537

indications 776–7

liver disorders 428

pregnancy 775–6

puerperium 775–6

risks 774–5

side-effects 774–5

and women 660

antiepileptic drugs (AED) 352–3

mood stabilizers 788–90

anxiety

alcohol 156–7, 168–9

cancer 556–7

causes 93

CHD 367–8

children 293

detection 91–4

diabetes 459–60

eliciting mood symptoms 92

genitourinary disorders 740–1

head/neck cancer 568, 575

history 93–4

HIV infection 484–5

management 603–4

palliative care 602–4

Parkinson's disease 344

physical illness 113

pregnancy 648–9

problem case 827–30

psychological reactions to illness 65–6, 72–4

renal disease 516

stroke 340

symptoms 93

treatment 648–9

apathy, stroke 338

aphasia

delirium 276

stroke 338

apraxia 313

arithmetic, neurological disorders 312–13

assessment/intervention liaison service 36

asthma

COPD 375–6

panic disorder 379–80

psychological illness 379–80

asylum psychiatrists (alienists), specialization beginnings 5

atopic dermatitis 727–8

attention, neurological disorders 309–10

back pain see chronic low back pain

BDD see body dysmorphic disorder

Beck Depression Inventory (BDI) 97

Beck Suicidal Intent Scale 255

behaviour, abnormal illness behaviour 79–80

behaviour changes, physical illness 114

benzodiazepines 791

alcohol 159–60

delirium 281–2

drug misuse 198

mood stabilizers 789–90

symptoms 199

withdrawal 199

bereavement, children 297–8

best interests

see also capacity

legal issues 55, 59, 61–2

bipolar disorder

perinatal management 644–5

pregnancy 642–5

treatment 642–5

body dysmorphic disorder (BDD)

CBT 627–8

cosmetic procedures 620–8

in cosmetic surgery clinics 623–6

in psychiatric clinics 622–3

psychocutaneous disorders 722–4

screening 621

Bolam test, Common Law 56

Borderline Personality Disorder (BPD), childhood experiences 291

BR see breathing retraining

breathing disorders 380–3

breathing retraining (BR) 381–3

Brief Symptom Inventory (BSI) 97–8

Broca's dysphasia 311–12

BSI see Brief Symptom Inventory

bulimia

diabetes 458–9

psychological reactions to illness 78–9

bupropion 771

burn trauma 697–711

delirium 707

early intervention 707–8

later intervention 708–9

liaison service 709–11

management 707–9

predictors, psychological reactions 704–5

prevalence, psychological symptoms 699–701

psychiatric sequelae 697–704

relatives 706–7

self-inflicted 705–6

burning mouth syndrome

see also functional somatic syndromes

treatment 140–1

business case, liaison service 42–4

buspirone, COPD 383

CAM see complementary and alternative medicine

cancer 547–61

see also head/neckcancer

anxiety 556–7

CAM 561

communication 553–4

counselling 558–9

delirium 556

depression 560–1

effects of treatment 549–50

emotional support 557–8

factors predisposing to psychiatric disorders 548–55

fertility 551

gastrointestinal 408–10

information provision 559

management 556–61

nature of the illness 548–9

organic factors 551–2

problem cases 827–30, 833–6

prognosis influencing 555–6

psychiatric disorders 556–61

psychological therapies 559–60

screening 554–5

sexual problems 231–2, 551, 557

stress 552–3

suicide 557

treatment effects 549–50

cannabis

differential diagnosis 203

pharmacotherapy 196–7

symptoms 199

treatment 203

withdrawal 199

capacity

see also best interests

assessment 54, 606–7

assumption 53

Mental Capacity Act (2005) 56–8

mental capacity assessment 606–7, 611

carbamazepine 788

cardiac rehabilitation (CR) 372–3

cardiorespiratory disorders 365–83

cardiovascular disorders 365–9

see also coronary heart disease

drug treatment 374–5

sexual problems 230

care aspects, nursing 115

care planning, nursing 112–13

catastrophic reactions, stroke 341

causes

anxiety 93

depression 76

CBD see corticobasal degeneration

CBT see cognitive behaviour therapy

cerebellar dysfunction 317

cervical smear 658–9

CHD see coronary heart disease

child abuse 291–2

childhood experiences 290–9

BPD 291

FSS 133

childhood factors, frequent attendance 885–7

childhood influences 291–5

children

adjustment 293–4

alcohol 294–5

anxiety disorders 293

bereavement 297–8

Common Law 54–5

comorbidity 290–1

current practice variation 18

depression 290–1, 293

depression, maternal 296–7

drug misuse 209–10, 294–5

eating disorders 292–3

eating disorders, maternal 297

HIV infection 295, 479

implications for the adult liaison psychiatrist 298–9

mental health difficulties, parental 296–7

parental influences 295–8

physical illness 293–4

physical illness, parental 295–6

psychiatric disorders 292–5

PTSD 293

sexual abuse 291–2

somatization 293–4

chorea 315

Huntington's disease 323–4

chronic fatigue syndrome

see functional somatic syndromes; persistent medically unexplained symptoms

interventions 854–6

treatment 139

chronic inflammatory skin disease 726–8

chronic low back pain (CLBP) 539

depression 539–40

psychological distress 539–40

treatment 540–1

chronic obstructive airways disease, problem case 819–22

chronic obstructive pulmonary disease (COPD) 375–8

asthma 375–6

depression 378

drug treatment 383

psychological illness 376–7

chronic pancreatitis (CP) 405–7

CJD see Creutzfeldt–Jakob disease

CL see consultation-liaison psychiatry

CLBP see chronic low back pain

cognition-improving drugs 790–2

cognitive approaches, sexual problems 240

cognitive behaviour therapy (CBT)

BDD 627–8

HIV infection 494

physical illness 810–12

PMUS 855–6

problem case 821–2

cognitive behavioural approach, drug misuse 207

common disorders, detection, psychiatric disorders 86–96

Common Law 52–6

best interests 55

Bolam test 56

capacity assessment 54

capacity assumption 53

children 54–5

duty of care 55

necessity 51

principles 53

communication

cancer 553–4

decision making 71

dissatisfaction 70

good 70

liaison psychiatry 842–3

physical illness 114, 116

psychological reactions to illness 70–1

comorbidity

children 290–1

physical illness 113

psychiatric disorder, FSS 131

comparisons, international 12–13

competencies, nursing 105–6

complementary and alternative medicine (CAM)

cancer 561

fibromyalgia 537

comprehensive liaison service 37–8

consent, guidance 56

consultation-liaison psychiatry (CL), development 8–13

consultation models 15

consultee-oriented consultation 15

conversational model therapy 804

conversion/somatoform disorders 357–9

COPD see chronic obstructive pulmonary disease

coping strategies, psychological reactions to illness 64–5

coronary heart disease (CHD) 365–6

anxiety 367–8

depression 366–8

hostility 367

psychosocial interventions 370–1

psychosocial risk factors 366

psychosocial work characteristics 368

social support 368–9

Type A behaviour (TAB) 367

corticobasal degeneration (CBD) 326

corticosteroid induced psychiatric syndromes, RA 530

cosmetic procedures 617–26

AID 628

assessment 618–19, 626

availability 617–19

BDD 620–8

body sculpting 628–9

contraindications 619–21

decision criteria 618–19

DIY 625–7

eating disorders 620

psychosocial effects 619–22

cost effectiveness, liaison service 27

costs

drug misuse 194–5

self-harm 261–2

counselling

cancer 558–9

drug misuse 205–7

HIV infection 494

physical illness 799–800

CP see chronic pancreatitis

CR see cardiac rehabilitation

Creutzfeldt–Jakob disease (CJD) 326–7

crisis-oriented, therapeutic consultation 15

Crohn's disease 393–7

current practice variation 13–19

children 18

clinical methods 14–15

clinical problem types 13, 14

emergency department (ED) 17

inpatients 16, 17

other disciplines 18–19

outpatients 16–17

primary care 17–18

service models 16

settings 16–18

sub-specialization 18

trends 14

DALT see Drug and Alcohol Liaison Team

decision making, communication 71

delirium 270–8

acute psychotic states 276

aetiology 272

ageing effects 271

aphasia 276

benzodiazepines 281–2

burn trauma 707

cancer 556

causes 272

causes, finding 279–80

classification 277–9

clinical features 272–7

clinical management 279–84

clonidine 282

concept 270

death risk 277

defining 277

delirium tremens 282

delusions 274

dementia 275–6, 318

diagnosis 275–7

diagnostic criteria 278

differential diagnosis 275–7

donepezil 282

ECT 282

EEG abnormalities 275

endogenous causes 273

environmental interventions 282–3

epidemiology 270–2

exogenous causes 273

hallucinations 274

haloperidol 280–1

HIV infection 272

ICU 676–9

immunology 282

liaison issues 283–4

management 605

medications 273, 280

mood disturbances 274–5

morbidity 277

neurological symptoms 275

neurovegetative symptoms 275

non-pharmacological interventions 282–3

older people 271

outcomes 276–7

palliative care 604–5

phenothiazines 281

physostigmine 282

pre-existing brain condition 271

prevention 279

prognosis 272–7

psychomotor disturbances 274

psychopharmacological intervention 280–2

risk factors 270–2

sleep–wake cycle 274

stroke 337

surgery 271

therapeutic issues 279–84

demand estimation, liaison service 27–34

dementia 318–30

alcohol 329

atypical 322

causes 320–1

causes, reversible 322

CBD 326

CJD 326–7

cortical vs. subcortical 319

delirium 275–6, 318

diagnosis 318–19, 325

DLB 343

FTDs 325–6

HIV infection 482

Huntington's disease 323–4

infective 326–7

inflammatory 327–8

inherited 323–5

investigations 319–23

leucodystrophies 325

miscellaneous causes 329

neoplastic 328

OSA 329

palliative care 605–6

Pick's disease 325–6

primary degenerative 325–6

pseudodementia 329–30

PSP 326

reversible causes 322

structural 328

subcortical vs. cortical 319

traumatic 328

vitamins 329

Wilson's disease (hepatolenticular degeneration) 324

dementia with Lewy bodies (DLB) 343

depression

see also antidepressant drugs

alcohol 156–7

cancer 560–1

causes 75

CHD 366–8

children 290–1, 293

CLBP 539–40

COPD 378

detection, psychiatric disorders 86–91

diabetes 456–8

diagnosis 598–9

diagnostic criteria 90

differential diagnosis 599

drug misuse 197–8

ECT 777

eliciting mood symptoms 87

epilepsy 352–3

HADS 94, 97, 568

head/neck cancer 568, 575, 581

HIV infection 484

ICU 674–5, 685–6

impact 600

liver disorders 418–19

medications 89

MI 369–70

myths 87–8

palliative care 597–602

Parkinson's disease 343–4

perinatal management 640–1

physical illness 74–7, 88–91, 113–14

pregnancy 638–42

prevalence, advanced disease 599–600

problem case 827–30

prognosis 600

psychological reactions to illness 74–7

psychotherapy 602

psychotropic drugs 601–2

RA 528–32

recognition 599

renal disease 512–14

screening 599

stress 89

stroke 338–9

symptoms 76, 90–1

treatment 600–2

dermatitis artefacta 718–19

dermatological disorders see psychocutaneous disorders

detection, psychiatric disorders 83–98

anxiety 91–4

clinical skills 83–6

common disorders 86–96

depression 86–91

psychosis 95–6

questionnaires 94, 96–8

diabetes 454–67

adjustment difficulties 462–3

alcohol 459

anxiety 459–60

clinical features 454–5

depression 456–8

drug misuse 459

eating disorders 458–9

family factors 463

health beliefs 463

hypoglycaemia fear 462

interventions 464–6

personality disorders 461

pharmacological interventions 464

psychiatric disorders 456–61

psychological problems 462–3

psychotherapy 464–6

psychotic disorders 460–1

self-harm 463

sexual problems 230–1

diagnosis consequences, physical illness 113–14

diagnostic criteria, depression 90

disability, defining 306

disaster planning 896–911

aftermath 907–8

emergency plans 896–7

general hospital plan 904

immediate psychosocial response 906–7

information sources 911

interventions 899–903

medications 903

planning services 904–8

prevalence, psychiatric disorders 897–8

PTSD 897–903

DLB see dementia with Lewy bodies

doctor–patient relationship, FSS 131–2

Drug and Alcohol Liaison Team (DALT) 214

drug misuse 180–215

abstinence syndromes 198–205

accident and emergency units 185

acute general medical settings 185–6

acutely disturbed patients 201–3

addiction, pharmacotherapy for 196–7

Addicts Index 187

alcohol withdrawal syndromes 200–1

ancillary support 208

antidepressant drugs 197–8

antipsychotics 197

assessment 188–93

benzodiazepines 198

cannabis differential diagnosis 203

cannabis pharmacotherapy 196–7

cannabis treatment 203

children 209–10, 294–5

classes, Misuse of Drugs Act (1971) 212

classification 181

cognitive behavioural approach 207

compulsory treatment 211

convulsions 201

costs 194–5

counselling 205–7

criteria 182–3

DALT 214

dependence syndrome 183

depression 197–8

diabetes 459

diagnosis 181, 203–5

differential diagnosis 203–5

emergency department (ED) 752–3

epidemiology 182–4

evidence base 194–6

family therapy 207

group therapies 207–8

hallucinogens differential diagnosis 203

hallucinogens treatment 203

health care professionals 209

HIV infection 485–6

liaison team 214

Misuse of Drugs Regulations (2001) 213

morbidity 182–4

mortality 182

motivational interviewing 206–7

obstetric units 187–8

older people 210–11

opiate abstinence syndrome 198–200

opiates pharmacotherapy 196

outcome research 194–6

paediatric units 187–8

pain management 205

pharmacotherapy for addiction 196–7

phencyclidine differential diagnosis 204

phencyclidine treatment 204

planning services 214

police liaison 211

policy initiatives 180

pregnant users 208–9

prevalence 185–8

psychiatric disorders and drug treatment 197–8

psychiatric patients 186–7

psychological interventions 205–7

questions 189–92

residential treatments 207–8

sedative abstinence syndrome 200

sedatives differential diagnosis 204–5

sedatives treatment 204–5

self-harm 184

service delivery framework 188

severe mental illness 194

social network behaviour therapy 207

solvents differential diagnosis 205

solvents treatment 205

special groups 208

stimulants differential diagnosis 203–4

stimulants pharmacotherapy 196–7

stimulants treatment 203–4

suicide prevention 184

symptoms 181, 199

treatment 203–5

twelve-step programmes 207–8

withdrawal 198–205

drugs

and women 660

overdoses 681–2

pharmacodynamics 763–764

pharmacogenetics 767

pharmacokinetics 765–7

psychotropic drugs 764, 767–76

selection principles 764

drugs, recreational, sexual problems 237

dying/death

see also palliative care

HIV infection 479

dyskinesias, neurological examination 315

dyspepsia, functional 397–405

diagnosis 399

dysphasias 311–12

classification 312

dyspraxia 313

dystonias 315, 354–5

eating disorders

see also anorexia nervosa; bulimia

BDD 620

children 292–3

cosmetic procedures 620

diabetes 458–9

ECT see electroconvulsive treatment

Ekbom's disease 715–17

elderly see older people

electroconvulsive treatment (ECT), depression 777

elements, liaison service 33–4

eliciting mood symptoms

anxiety 92

depression 87

panic disorder 92

emergency department (ED) 764–5

alcohol 170–2

clinical skills 753–5

current practice variation 17

drug misuse 752–3

epidemiology 763–7

management 755–8

outcomes 758–60

presentations 752–3

resourcing 755–8

emotionalism, stroke 340

endocrine disorders 432–49

acromegaly 449

Addison's disease 435, 437, 439, 447–8

clinical aspects 433–9

clinical relevance, psychiatric syndromes 434–5

correlation, biochemical variables 436–7

Cushing's syndrome 435, 437, 439, 445–7

diabetes 434

epidemiology 432–3

hyperparathyroidism 434, 439, 442–4

hyperprolactinaemia 435, 437, 439, 445

hyperthyroidism 436, 439, 441–2

hypoparathyroidism 435, 439, 444–5

hypothyroidism 434, 439–41

phaeochromocytoma 448–9

prevalence, psychiatric disorders 436–7

prevalence, psychiatric syndromes 434–5

problem case 833–6

somatic symptoms 439

epilepsy 346–53

absence seizures 348–9

antiepileptic drugs (AED) 352–3, 788–90

complex partial seizures 348

depression 352–3

EEG 351

etiology 346–7

incidence 346

NEAD 349–51

partial seizures 347

prevalence 346

pseudo seizures 349–51

psychiatric aspects 351–3

psychogenic 349–51

tonic-clonic seizures 347

euthanasia

legal issues 58, 609

palliative care 609–11

executive function

neurological disorders 311

stroke 341

expanded psychiatric consultation 15

‘expert patients’ 66

extrapyramidal signs 317

eye movement abnormalities 315–16

factitious disorders, problem case 839–41

family therapy, drug misuse 207

Fast Alcohol Screening Test (FAST) 155

fatigue

see also functional somatic syndromes; persistent medically unexplained symptoms

chronic fatigue syndrome 139

interventions 854–6

liver disorders 418

multiple sclerosis 345–6

problem case 836–9

fertility

cancer 551

treatment 636–7

fibromyalgia 533–8

see also functional somatic syndromes

aetiology 534–5

antidepressant drugs 537

CAM 537

clinical features 533

clinical management 536–8

course 534

diagnosis 533

prevalence 533–4

problem case 822–4

psychiatric disorders 535–6

treatment 139–40

finance see funding issues

focus of care 15

foetal anomaly 651

frequent attendance 871–92

childhood adversity 885–6

childhood factors 885–7

childhood illness experience 886–7

concepts 871–2

definitions 871–2

interventions 889–92

models of attendance 887–9

outcomes 884–5

physical illness 880–1

prevalence 872–5

psychiatric disorders 877–9

psychiatric morbidity 872–80

psychosocial factors 881–3

qualitative models 888–9

quantitative models 887–8

resource use 883–4

sociodemographic factors 872–5

theoretical models 888–9

frontal lobe disorders 311

frontal release signs 316

frontotemporal dementias (FTDs) 325–6

FSS see functional somatic syndromes

FTDs see frontotemporal dementias

functional gastrointestinal disorders 397–405

functional somatic syndromes (FSS) 125–41

aetiology 132–8

central dysfunction 136–7

childhood experiences 133

comorbid psychiatric disorder 131

conceptual issues 125–32

deconditioning 135

defining 125

doctor–patient relationship 131–2

epidemiology 129–30

five-factor model 127–8

gender 130–1

genetics 132–3

heterogeneity 128

illness beliefs 137–8

infection 134

injury 134

maintaining factors 134–8

neuroendocrine changes 135

precipitating factors 134

predisposing factors 132–3

social factors 138

by specialities 126

stress 134

symptom amplification 137–8

symptomatic overlap 127–9

symptoms 126–7

terminology 125

treatment 139

funding issues

cost effectiveness 27

liaison service 40–2

gabapentin 789

gait

abnormalities 315

neurological examination 314

gastrointestinal disorders 390–2

abuse 403

cancer 408–10

CP 405–7

functional 397–405

GORD 397

IBS 140, 397–405

inflammatory bowel disease 393–7

palliative care 409–10

pathophysiological mechanisms 401

peptic ulcer disease 390–2

prevalence 399–400

psychological factors 401–4

reviews 405

Rome criteria 397–9

stomas 407–8

stress 401

treatment 404–5

gastro-oesophageal reflux disease (GORD) 397

GCS see Glasgow Coma Scale

gender reassignment, problem case 841–2

genetics, FSS 132–3

genitourinary disorders 733–6

affective illnesses 739–40

anxiety 740–1

assault 742–3

clinical recommendations 748–9

epidemiology 744–5

explanations/aetiology of psychological distress 743–7

herpes genitalis 746–7

historical perspective 733–5

hypochondriacal disorders 740–1

illness behaviour 744

personality disorders 742

prevalence of psychiatric morbidity in GUM clinics 735–7

prevalence, psychiatric problems 763–92

psychotic illnesses 737–9

qualitative studies 745

recognition, psychological distress 747–8

referrals 747–8

sexual dysfunction 742–3

sexual risk taking behaviour 745–6

somatoform/conversion disorders 740–1

syphilophobia 733–5

Gilles de la Tourette's syndrome (GTS) 353–4

Glasgow Coma Scale (GCS) 309, 310

ABI 333

GORD see gastro-oesophageal reflux disease

group therapies, drug misuse 207–8

GTS see Gilles de la Tourette's syndrome

gynaecological disorders 632–45

HADS see Hospital Anxiety and Depression Scale

hallucinogens

differential diagnosis 203

treatment 203

haloperidol

alcohol 159

delirium 280–1

handicap, defining 306

head injury

see also acquired brain injury

alcohol 169

outcomes 334

head/neck cancer 564–76

alcohol 566

anxiety 568, 575

appearance 578–9

chemoprevention 566

depression 568, 575, 581

diagnosis, psychological morbidity 567–9

diet 566

HADS 568

high-risk behaviour 576–7

information provision 572–3

investigations 565

moderators, psychological distress 569

oral hygiene 567

prevention 566

psychological interventions 580–2

psychological morbidity 567–9

public health issues 565–7

quality of life studies 569–72

recurrence fears 573–5

recurrence reactions 577–8

risk factors 566–7

screening for depression 581

self-care behaviour 575–6

sexual practices 567

smoking 576–7

social support 579–80

statistics 564

tobacco 566

treatment 565

treatment, psychological morbidity 567–9

headache 355–7

cervicogenic 356

chronic 355–6

cluster 356–7

migraine 355

SAH 355

heart disease see coronary heart disease

heart transplantation, psychiatric aspects 375

hepatic encephalopathy 417–8

hepatitis 419–20

hepatolenticular degeneration 324

herpes genitalis 746–7

HIV infection 474–95

adverse effects, medication 491

affective disorders 484

alcohol 485–6

alternative medications 490

anticonvulsants 491

antipsychotics 490–1

anxiety 484–5

anxiolytics 491

assessment 486–7

biological aspects 475

CBT 494

children 295, 479

clinical presentations, psychiatric illnesses 476

cognitive impairment 483

counselling 494

delirium 272

dementia 482

depression 484

drug misuse 485–6

dying/death 479

epidemiology, psychiatric morbidity 474–6

general management 487

interactions, drug 491–3

landmark events 476

lifestyle issues 485

mania 484

models of care 495

monoamine oxidase inhibitors 488

mood stabilizers 491

neuropsychiatric disorders 480–3

older people 480

opportunistic infections 477–8

organic disorders 480–3

outcomes 495

personality issues 485

pharmacotherapy 487–91

physical treatments 487

problem case 830–3

professionals involved 487

prognosis 495

psychiatric disorders 481

psychological aspects 475

psychological treatments 492–4

psychosis 483–4

psychotherapy 494

sexual problems 235

side-effects, medication 489

social aspects 475

social interventions 494–5

SSRIs 488–90

suicide 486

test notification 476–7

treatment 486–95

tricyclic antidepressants 488

hormone replacement therapy (HRT) 657–8

Hospital Anxiety and Depression Scale (HADS) 94

head/neck cancer 568

HPV see human papilloma virus

HRT see hormone replacement therapy

human papilloma virus (HPV) 658–9

Huntington's disease 323–4

Hypericum perforatum (St John's wort) 774

hypertension 373–4

hyposexuality, stroke 341

IBS see irritable bowel syndrome

ICU see intensive care unit

impairment, defining 306

inflammatory bowel disease 393–7

information gathering skills 83–4

information provision

cancer 559

head/neck cancer 572–3

information sources

disaster planning 911

PTSD 911

inpatients

current practice variation 16

liaison service 37

intensive care unit (ICU) 673–92

adjustment disorder 679–81, 685

approaches, psychiatric liaison 691–2

delirium 676–9

depression 674–5, 685–6

discharge 684–9

epidemiology 674–6

ICU psychosis 682–3

ICU syndrome 682–3

mechanical ventilation 683–4

neurocognitive deficits 688–9

overdoses 681–2

psychiatric reactions 676–82

PTSD 675–6, 686–8

quality of life studies 676

relatives' distress 690–1

sedatives 680

staff psychiatric problems 689–90

stress 679–81

suicide 681–2

interactions, drug 91, 491–3

neuroleptics 781

international comparisons 12–13

interpersonal therapy (IPT) 803

intervention

liaison service 36

nursing 114–15

physical illness 118

interviewing patients

see also motivational interviewing

single item screening interview 98

skills 84–5

IPT see interpersonal therapy

irritable bowel syndrome (IBS) 397–405

see also functional somatic syndromes

diagnosis 399

treatment 140

job descriptions, liaison service 39–40

job plans, liaison service 39–40

lamotrigine 789

language, neurological disorders 311–12

legal issues 47–58

acute organic brain syndrome 59

anorexia nervosa 61

best interests 55, 59, 61–2

clinical situations 58–62

Common Law 52–6

euthanasia 58, 609

Mental Capacity Act (2005) 56–8

MHA 47–52

schizophrenia 61

self-harm 59–61

Statute Law 47–8

treatment refusal 47–58

leucodystrophies 325

liaison psychiatry

defining 3

role 3

liaison service

assessment/intervention 36

business case 42–4

comprehensive 37–8

cost effectiveness 27

demand estimation 27–34

discussions 26–7

elements 33–4

establishing 24–33

funding issues 40–2

initial negotiations 25–7

job descriptions 39–40

job plans 39–40

limited 38

location 34

management issues 40–2

models 16, 34–7

multidisciplinary team 38–9

personnel 25–6

preparatory work 25–7

referrals 27–34

restricted/unrestricted 35

size/workload 11

types 16, 34–7

liaison team, drug misuse 214

limbs, neurological examination 314–15

limited liaison service 38

lithium 787–8

liver disorders 416–29

alcoholic liver disease 421–3

antidepressant drugs 428

antipsychotics 428–9

anxiolytics 429

chronic hepatocerebral degeneration 419

cirrhosis 420–1

depression 418–19

fatigue 418

hepatic encephalopathy 417–18

hepatitis 419–20

hepatolenticular degeneration 324

hypnotics 429

liver transplantation 424–7

primary biliary cirrhosis 420–1

psychiatric symptoms 416–19

psychotropic drugs 427–9

Wilson's disease (hepatolenticular degeneration) 324, 423–4

location, liaison service 34

lower motor neurone signs 317

malformed infants 652

management issues, liaison service 40–2

MAOI see monoamine oxidase inhibitors

MDP see monosymptomatic delusion of parasitosis

medically unexplained symptoms (MUS) 847–64

see also persistent medically unexplained symptoms

memory, neurological disorders 310–1

menopause 653–5

menstrual disturbances 655

menstruation 633–6

Mental Capacity Act (2005) 56–8

Mental Health Act (1983) (MHA) 47–52

holding orders 49–50

managerial arrangements 52

place of safety orders 51–2

police 51–2

role 48–9

section 63; 25–6

mental health liaison nurse (MHLN) 102–19

see also nursing

mental state examination

sexual problems 226

skills 86

mentoring 842–3

MHA see Mental Health Act (1983)

MHLN see mental health liaison nurse

MI see myocardial infarction

migraine see headache

Mini-Mental State Examination (MMSE) 275, 309–10, 313–14

minors see children

mirtazapine (Remergil®) 772–3

miscarriage 650–1

Misuse of Drugs Act (1971), classes

Misuse of Drugs Regulations (2001), schedules 213

MMSE see Mini-Mental State Examination models

consultation 15

liaison service 16

monoamine oxidase inhibitors 773–4

monosymptomatic delusion of parasitosis (MDP) 715–17

mood disorders

postnatal 652–3

pregnancy 638–42

mood disturbances

delirium 274–5

multiple sclerosis 345

Parkinson's disease 344

mood stabilizers 787–8

HIV infection 491

motivational interviewing

alcohol 164–6

drug misuse 206–7

multidisciplinary team, liaison service 38–9

multiple sclerosis 344–6

cognitive impairment 345

fatigue 345–6

mood disturbances 345

pain 346

problem case 824–7

MUS see medically unexplained symptoms

musculo-skeletal disorders 527–41

CLBP 539

fibromyalgia 533–8

OA 538–9

RA 527–33

myocardial infarction (MI)

advice 371–2

depression 369–70

health beliefs 371

myoclonus 315

myths, depression 87–8

NARIs see selective noradrenaline reuptake inhibitors

narratives, patient 799

NEAD see non-epileptic attack disorder

nervous disorder, specialization beginnings 5–6

neuroleptic malignant syndrome (NMS) 784–5

neuroleptics 777–87

choosing 778–80

DA-antagonistic effects 779

dose 780–1

indications 778

interactions, drug 781

liaison settings 786–7

longer term effects

NMS 784–5

pregnancy 785

puerperium 785

side-effects 781–5

neurological disorders 305–59

ABI 332–7

amnestic syndromes 331–2

clinical assessment 306–18

conversion/somatoform disorders 357–9

dementias 318–30

dystonias 354–5

epilepsy 346–53

headache 355–7

multiple sclerosis 344–6

Parkinson's disease 342–4

sexual problems 231

somatoform/conversion disorders 357–9

stroke 337–42

tic disorders 353–4

neurological examination 314–15

neuropsychiatric history 307–9

NMS see neuroleptic malignant syndrome

non-epileptic attack disorder (NEAD) 349–51

NRIs see selective noradrenaline reuptake inhibitors

nursing 102–19

activities 106

aims 104–5

assessment 115

care aspects 115

care planning 112–13

competencies 105–6

development 103–4

focus of clinical practice 107–13

holistic approach 103–4

intervention point 114–15

physical illness 113–15

practice 104–15

practice domains 106–7

rehabilitation 114–15

risk assessment 110–13

role 102–19

self-harm 107–10

skills 105–6

suicide prevention 107–10

suicide risk assessment 114

OA see osteoarthritis

obsessive-compulsive disorder (OCD), stroke 341

obstructive sleep apnoea (OSA) 329

OCD see obsessive-compulsive disorder

olanzapine 783

older people

alcohol 173

delirium 271

drug misuse 210–11

HIV infection 480

self-harm 257

suicide 257

oncology see cancer

opiates

abstinence syndrome 198–200

antagonists, alcohol 167

pharmacotherapy 196

symptoms 199

withdrawal 199

orientation, neurological disorders 309

OSA see obstructive sleep apnoea

osteoarthritis (OA) 538–9

outpatients, current practice variation 16–17

Paediatric Autoimmune Neuropsychiatric Disorders associated with Streptococcal Infection (PANDAS) 353–4

palliative care 592–608

anxiety 602–4

assessment 596–7

context 592–3

delirium 604–5

dementia 605–6

depression 597–602

disturbed behaviour 604–6

Endicott substitution criteria 598

euthanasia 609–11

gastrointestinal disorders 409–10

history 596–7

Kübler–Ross model 594

mental capacity assessment 606–7, 611

models of coping 593–6

presentations 597

psychotic illness 606

referrals 596

self-harm 607–9

spirituality 610

stages of dying 594

suicide 607–9

task-based models 594–6

will-to-live changes 609–10

pancreatitis, chronic 405–7

PANDAS see Paediatric Autoimmune Neuropsychiatric Disorders associated with Streptococcal Infection

panic disorder

asthma 379–80

eliciting mood symptoms 92

psychological reactions to illness 73

paranoid traits, psychological reactions to illness 66

Parkinson's disease 342–4

anxiety 344

depression 343–4

features 342

incidence 342

mood disturbances 344

patient-centred care, PMUS 849–51

patient narratives, physical illness 799

patient-oriented consultation 15

PCOS see polycystic ovary syndrome

pelvic pain 656–7

peptic ulcer disease 390–2

perception, neurological disorders 313

perinatal disorders 632–45

persistent medically unexplained symptoms (PMUS) 847–64

see also somatoform/conversion disorders

CBT 855–6

criteria 848

exercise 854–5

interventions 854–6

links 857

observational studies 852–3

outcomes 852

patient-centred care 849–51

primary care 849–51, 854–6, 863–4

reattribution 856–64

routine care 851

symptom beliefs 852–3

working models 849–51

personality disorders

diabetes 461

genitourinary disorders 742

phencyclidine

differential diagnosis 204

treatment 204

phenothiazines, delirium 281

phobic anxiety disorder, psychological reactions to illness 73

physical illness

adjustment difficulties 114, 115

anxiety 113

assessment 116

behaviour changes 114

CBT 804–9

comorbidity 113

cognitive factors 807

communication 114, 116

depression 74–7, 88–91, 113–14

diagnosis consequences 113–14

frequent attendance 880–1

intervention 118

nursing 113–15

preventive psychological care 116–17

psychiatric disorders following 72–80

psychological interventions 795–812

SCTF 796

stress 114

suicide risk assessment 91, 114

supportive techniques 798–801

therapeutic alliance 796

physician-assisted suicide 609–11

Pick's disease 325–6

planning services, drug misuse 214

PMDD see premenstrual dysphoric disorder

PMUS see persistent medically unexplained symptoms

police liaison, drug misuse 211

polycystic ovary syndrome (PCOS) 655–6

post-traumatic amnesia (PTA) 333–5

post-traumatic stress disorder (PTSD)

children 293

disaster planning 897–903

ICU 675–6, 686–8

information sources 911

psychological reactions to illness 73–4

postnatal mood disorders 652–3

practice domains, nursing 106–7

practice variation see current practice variation

praxis 313

pregnancy 637–8

antidepressant drugs 775–6

anxiety 648–9

bipolar disorder 642–5

depression 638–42

mood disorders 638–42

neuroleptics 785

schizophrenia 646–8

teenage 649–50

violence 650

pregnant users, drug misuse 208–9

premenstrual dysphoric disorder (PMDD) 634–6

criteria 634

symptoms 634

treatment 635–6

preventive psychological care

physical illness 116–17

suicide prevention 107–10

previous psychiatric illness, psychological reactions to illness 71–2

primary care

current practice variation 17–18

PMUS 849–51, 854–6, 863, 864

problem cases 818–43

anxiety 827–30

cancer 827–30, 833–6

chronic obstructive airways disease 819–22

depression 827–30

endocrine disorders 833–6

factitious disorders 839–41

fatigue 836–9

fibromyalgia 822–4

gender reassignment 841–2

HIV infection 830–3

multiple sclerosis 824–7

self-harm 822–4

somatoform/conversion disorders 824–7, 836–9

problem-solving therapy (PST), physical illness 800–1

progressive supranuclear palsy (PSP) 326

pruritus 720–2, 724–5

pseudodementia 329–30

psoriasis 726–7

PSP see progressive supranuclear palsy

PST see problem-solving therapy

psychiatric patients, drug misuse 186–7

psychocutaneous disorders 714–29

acne vulgaris 725

alopecia areata 726

BDD 722–4

chronic inflammatory skin disease 726–8

dermatitis artefacta 718–19

dermatological disorders affected by psychological factors 724–8

Ekbom's disease 715–17

MDP 715–17

pruritus 720–2, 724–5

psoriasis 726–7

psychogenic parasitosis 714–5

psychogenic purpura syndromes 725–6

psychological reactions 728–9

self-inflicted skin disorders 717–22

trichotillomania 722

urticarias 724–5

psychodynamic interpersonal therapy 804

psychodynamic therapy 802–3

psychogenic parasitosis 714–15

psychogenic purpura syndromes 725–6

psychological interventions

drug misuse 205–7

head/neck cancer 580–2

physical illness 795–812

principles 795–8

relational therapies 801–4

supportive techniques 798–801

psychological reactions to illness 64–81

abnormal illness behaviour 79–80

adjustment disorder 72

ageing effects 66–7

anxiety 65–6, 72–4

communication 70–1

depression 74–7

drug treatment 68–9

eating disorders 78–9

‘expert patients’ 66

factors influencing 65–72

minimizing the significance 66

nature of the illness 67

paranoid traits 66

personal factors 65–7

physical factors 69

previous psychiatric illness 71–2

psychotic reactions 77

sexual dysfunction 77–8

special procedures 68

stress 71–2

terminal illness 67

treatment environment 68

psychopharmacological treatment

psychosis

detection 95–6

HIV infection 483–4

stroke 341

psychosomatic medicine, development 7

psychotic disorders, diabetes 460–1

psychotic reactions, psychological reactions to illness 77

psychotropic drugs 764, 767–76

PTA see post-traumatic amnesia

PTSD see post-traumatic stress disorder

puerperium

antidepressant drugs 775–6

neuroleptics 785

pyramidal signs 316

questionnaires

see also information gathering skills

BDI 97

BSI 97–8

detection, psychiatric disorders 96–8

HADS 94, 97, 568

SCL-90 97–8

SF36 and SF12 98

single item screening interview 98

RA see rheumatoid arthritis

reactions to illness, psychological see psychological reactions to illness

reattribution

PMUS 856–64

techniques 801

referrals

criteria 37–8

genitourinary disorders 747–8

liaison service 27–34

palliative care 596

rates 28–33

refusal, treatment see treatment refusal

rehabilitation, nursing 114–15

relational therapies, physical illness 801–4

renal disease 506–22

adjustment difficulties 514–15

adolescents 521–2

advice sources 517

anxiety 516

depression 512–14

dialysis 507–9

family factors 511–12

healthcare limitations awareness 511

loss

mortality awareness 510–11

non-adherence 520–1

organic disorders 515–16

overview, renal medicine 506–7

pharmacotherapy 517–19

prescribing rules 518

psychiatric disorders 512–16

psychological issues 509–12

psychological themes 509

psychosocial interventions 519–20

psychotropic drugs 517

transplantation 507–9

treatment 516–20

triggers 509

uncertainty 510

repetitive strain injury

see also functional somatic syndromes

treatment 140

research 19

residential treatments, drug misuse 207–8

respiratory disorders 375–83

asthma 375–6, 379–80

breathing disorders 380–3

COPD 375–8

OSA 329, 380

restricted/unrestricted liaison service 35

reversible and selective inhibition of monoamine oxidase type A (RIMA) 773

rheumatoid arthritis (RA) 527–33

aetiological factors, psychiatric disorders 528–30

assessment, psychiatric disorders 531–2

corticosteroid-induced psychiatric syndromes 530

depression 528–9

impact, psychiatric illness 530–2

neuroticism 529–30

pain 528

prevalence, psychiatric disorders 528

social stress 529

social support 529

treatment, psychiatric disorders 531–3

treatments problems 530

RIMA see reversible and selective inhibition of monoamine oxidase type A

risk assessment

see also suicide risk assessment

attitudes 111

nursing 110–13

principles 110–11

roles

liaison psychiatry 3

MHA 48–9

nursing 102–19

SAH see subarachnoid haemorrhage

schizophrenia

legal issues 61

pregnancy 646–8

suicide 250

treatment 647–8

SCL-90 37–8 see Symptom Checklist 90

SCTF see specific common therapeutic factors

sedatives

abstinence syndrome 200

differential diagnosis 204–5

ICU 680

treatment 204–5

selective noradrenaline reuptake inhibitors (NARIs or NRIs) 770

selective serotonin reuptake inhibitors (SSRIs) 770

self-harm 245–62

see also suicide

adolescents 251, 256

aetiological models 251–3

aetiology 248–53

assessment 254–7

assessment topics 254

burn trauma 705–6

costs 261–2

defining 245

diabetes 463

drug misuse 184

epidemiology 246–7

frequent repeaters 257

general population 250–1

guidelines 257–8

hospital management 258–9

legal issues 59–61

long-term outcome 261

mentally ill 256–7

motives 255

nursing 107–10

older people 257

palliative care 607–9

problem case 822–4

psychological models 253

reasons 255

repetition risk factors 256

risk factors 250–1

services 257–8

suicide links 247–8, 255

treatment interventions 259–60

self-inflicted skin disorders 717–22

sensory signs 317–18

serotonergic syndrome 765

serotonin and noradrenaline reuptake inhibitors (SNARIs) 770–1

service, liaison see liaison service

sexual abuse, children 291–2

sexual desire disorders 659–60

sexual dysfunction 659

genitourinary disorders 742–3

psychological reactions to illness 77–8

sexual problems 221–40

aetiology, medical vs. psychological 229–30

alcohol 237

anatomy 221–2

apomorphine 239

arousal 223

assessment 223–6, 228

cancer 231–2, 551, 557

cardiovascular disorders 230

classification 222–3

cognitive approaches 240

contraceptive history 225

current sexual preferences/practices 225

current sexual relationship 224

desire 223, 659–60

diabetes 230–1

drugs, prescribed 233–5

drugs, recreational 237

family environment 225

gender reassignment 841–2

genital and reproductive organs 232–3

HIV infection 235

hormone levels 237–8

hyposexuality 341

medical conditions, other 235

medical disorders 228

medical history 225–6

medical patients 228–9

mental state examination 226

neurological disorders 231

non-medical difficulties 223

obstetric history 225

orgasm 223

pain 223

past sexual relationships 225

physical examination 226

physical treatments 238–9

physiology 221–2

prescribed drugs 233–5

presenting problems 224

prevalence 227

prostaglandin-E 239

psychological treatments 239–40

screening investigations 237–8

sexual development 224

sexual education/knowledge 225

sildenafil 238

spinal injuries 231

tadalafil 238

testosterone therapy

transexualism 235–6

treatments 238–40

SF36 and SF12 see Social Function Scales

‘shell shock’ 6

side effects, medication 69

antidepressant drugs 774–5

HIV infection 489

neuroleptics 781–5

single item screening interview 98

situation-oriented consultation 15

skills

detection, psychiatric disorders 83–6

information gathering 83–4

interviewing patients 84–5

mental state examination 86

mix 38–9

nursing 105–6

skin disorders see psychocutaneous disorders

SNARIs see serotonin and noradrenaline reuptake inhibitors

Social Function Scales (SF36 and SF12) 98

social network behaviour therapy, drug misuse 207

‘soldier's heart’ 6

solvents

differential diagnosis 205

treatment 205

somatoform/conversion disorders 357–9

see also persistent medically unexplained symptoms

aetiology 358

diagnosis 358

genitourinary disorders 740–1

history 357–8

management 358–9

problem cases 824–7

specialization beginnings

asylum psychiatrists (alienists) 5

history 5–6

nervous disorder 5–6

specific common therapeutic factors (SCTF), physical illness 796

spinal injuries, sexual problems 231

SSRIs see selective serotonin reuptake inhibitors

standard instruments, neurological disorders 313–4

Statute Law 47–8

stillbirth 652

stimulants

differential diagnosis 203–4

pharmacotherapy 196–7

symptoms 199

treatment 203–4

withdrawal 199

stomas 407–8

stress

see also post-traumatic stress disorder

cancer 552–3

depression 89

FSS 134

gastrointestinal disorders 401

ICU 679–81

physical illness 114

psychological reactions to illness 71–2

stroke 337–42

anxiety 340

behavioural changes 338–9

catastrophic reactions 341

defining 337

delirium 337

dementia 338

depression 338–9

emotionalism 340

empathy loss 342

executive function 341

hyposexuality 341

inhibition control deficit 342

OCD 341

psychosis 341

subarachnoid haemorrhage (SAH), headache 355

subspecialization, current practice variation 18

substance misuse see drug misuse

suicide 245–62

see also self-harm

adolescents 256

aetiology 248–53

Beck Suicidal Intent Scale 255

behaviour 252–3

biological aspects 252

cancer 557

defining 245

epidemiology 246

frequent repeaters 257

general population 249

HIV infection 486

ICU 681–2

older people 257

palliative care 607–9

physician assisted suicide 609–11

psychiatric disorders 249–50

risk factors 249–50

schizophrenia 250

self-harm links 247–8, 255

social characteristics 252–3

suicide prevention

drug misuse 184

nursing 107–10

strategies 248

suicide risk assessment 91, 254–7

nursing 114

physical illness 91, 114

Symptom Checklist 90 (SCL-90) 97–8

symptoms, MUS 847–64

syphilophobia 733–5

teaching 19–20

terminal illness

psychological reactions to illness 67

single item screening interview 98

TGA see transient global amnesia

tianeptine 774

tic disorders 315

GTS 353–4

PANDAS 353–4

treatment 354

topiramate 789

transient global amnesia (TGA) 332

trazodone 773

treatment refusal, legal issues 47–58

tremor 315

trends, current practice variation 14

trichotillomania 722

tricyclic antidepressants 772

twelve-step programmes, drug misuse 207–8

UK, liaison psychiatry development 10–12

ulcerative colitis 393–7

United States CL 9–10

urticarias 724–5

valproate 788

variation, current practice see current practice variation

visual field abnormalities 315–16

vitamins

alcohol 160–1, 282, 331

dementia 329

WKS 331

vulvodynia 657

vulvovaginitis 657

wakefulness, neurological disorders 309

war

First World War 6

Second World War 7–8

ways of working 17

websites

Wernicke–Korsakoff syndrome (WKS) 331–2

Wernicke's dysphasia 311–12

Wernicke's syndrome, alcohol 160–1

Wilson's disease (hepatolenticular degeneration) 324, 423–4

withdrawal

alcohol 157–60, 200–1

drug misuse 198–205

WKS see Wernicke–Korsakoff syndrome


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