Psychiatric disorders are common in general medical practice. This handbook is a practical guide intended for all health care professionals frequently required to treat patients with acute psychiatric disorders. An accessible and authoritative guide to the immediate management of the full range of psychiatric problems presented in emergency departments, it is arranged by symptoms rather than diagnoses. The authors offer the reader a systematic guide through assessment and diagnosis, immediate investigations and management, and treatment as far as transferal to specialist departments. They cover assessment and management of the emergency, and guide the reader, in a step-by-step synthesis, to the point at which the patient is stabilized and consideration can be given to the planning of definitive treatment. The authors include an introductory section on eliciting and recording the psychiatric history of a patient and then consider--in alphabetical order--the management of common psychiatric presentations. A final section looks at legal matters, including the use of common law and the Mental Health Act and liaison with other statutory agencies, in particular the police and social services.
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History taking and the mental state examination
General principles of psychiatric management
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abnormalities Accident and Emergency acute confusional admission to hospital aggression alcohol allows amnestic antipsychotic anxiety anxiolytics appropriate assessment associated avoid Benzodiazepines casualty department causes characterized chronic clinical common considered deliberate self-harm delirium tremens delusional beliefs delusions depressed patients depressive illness diagnosis diazepines difficult disease disorganization syndrome disorientation distress disturbance doctor drug misuse effects Emergency department example fugue hallucinations haviour hypomania important individual insight interview intoxication involved manic patient ment mental disorder Mental Health Act mental illness mental state examination mood Munchausen syndrome Neuroleptic nursing occur particularly perception physical examination physical illness Postnatal depression potentially practitioner present problems professionals psychiatric disorders psychiatric emergencies psychiatric services psychiatrist psychological psychotic illness puerperal psychosis Recognition Immediate management referral regarding relatively result risk of suicide schizophrenia Section self-harm significant somatic staff stupor suicidal behaviour suicidal thoughts symptoms and signs thiamine tion treatment Typically underlying usually violence Wernicke's encephalopathy