By Phillip R. Slavney MD, Orest Hurko MD
This concise quantity advises basic care physicians on the way to realize, review, and deal with universal psychiatric and neurologic proceedings in sufferers with scientific sickness. sufferers with those difficulties was once mentioned experts, yet lower than the present procedure of overall healthiness care they're more and more being evaluated and handled via internists and kin practitioners.
The ebook includes twelve problem-focused chapters, every one written via a expert college member of the Johns Hopkins collage tuition of medication who's skilled in consulting with fundamental care physicians. the issues mentioned are unhappiness, anxiety, forgetfulness, unrealistic issues approximately healthiness, suicidal options, alcoholism and drug dependence, weak point, numbness, again ache, complications, dizziness, and tremor. Screening reviews for psychiatric and neurologic issues also are defined and defined.
The booklet is designed to function either an creation and a handy reference. The authors emphasize bettering conversation with sufferers approximately problems with analysis and treatment.
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Extra info for The primary care physician's guide to common psychiatric and neurologic problems : advice on evaluation and treatment from Johns Hopkins
If a patient has had only one episode, a case can be made for slow tapering of the antidepressant after a year of treatment, with careful monitoring for relapse. After a second episode, the physician may advise patients to remain on antidepressants indeﬁnitely. Summary Major depression is a common, often severe, and potentially life-threatening syndrome. Typical features include persistent sadness, excessive selfdoubt, diminished mental and physical energy, disturbed sleep and appetite, decreased capacity to experience pleasure, and wishes for death or suicidal ideas.
The answer is likely to reveal why the patient has actually come for help. Once this information is obtained, the goals of treatment from the patient’s point of view are clariﬁed. ” Here, the emphasis is not only on speciﬁc attempts to solve the problem, but also on how the patient’s functioning has been affected by it. This brief psychosocial assessment ends with an expression of empathy by the physician or nurse. Patients need to be reassured that their problems will be taken seriously. , “That must be very difﬁcult”) acknowledges the patient’s complaints and communicates an understanding of the situation.
This latter condition is deﬁned as fear of situations in which help might not be available. As a result of agoraphobia, individuals with panic disorder may become housebound or leave their homes only in the company of another person. Agoraphobia without a history of panic disorder is rare. Nervousness ■ 39 A third of patients with panic disorder have a concurrent major depression, and two-thirds have a lifetime risk of that disorder. Some patients with panic disorder abuse alcohol in an attempt to diminish their symptoms, while others inadvertently provoke attacks by using cocaine or amphetamines.