Consultation-Liaison Psychiatry and Beyond
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1 Consultation-Liaison Psychiatry 1990 and Beyond
2 Consultation-Liaison Psychiatry 1990 and Beyond Edited by University of California, San Francisco Fresllo, California SPRINGER SCIENCE+BUSINESS MEDIA, LLC
3 Library of Congress Cata1oging-in-Pub1 ication Data Consu1tatlon-1 iaison psychlatry 1990 and beyond! edlted by Hoy1e Leigh. p. cm. Inc1udes updated presentatl0ns at a workshop he1d May 1992 ln ~ashlngton, O.C. Inc 1 udes b 1 b 11 ograph 1 ca 1 references and 1 ndex. ISBN ISBN (ebook) DOI / Consu1tatl0n-liaison psych1atry. 1. Lelgh, Hoyle, [DNLM, 1. Psychlatry--trends--congresses. 2. Referral and Consu I tat 1 on--ut 1 Il zat 1 on--congresses. 3. Referra I and Consultatlon--trends--congresses. ~M 64 C RC455.2.C65C dc20 DNLM/DLC for Llbrary of Congress CIP Proceedings of a workshop on Changes in Consultation-Liaison Psychiatry, held May 1992, in Washingtion, D.C. ISBN Springer Springer Science+Business Media New York Originally published by Plenum Press, New York in 1994 Softcover reprint of the hardcover 1 st edition 1994 AII rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher
4 FOR VINNIE AND ALEXANDER
5 PREFACE The essential role of the psychiatrist as consultant and educator of primary care physicians is increasing in importance as the American health care system faces fundamental restructuring. In a recent workshop during the annual meeting of the American Psychiatric Association, a number of prominent consultation-liaison psychiatrists reviewed major developments in consultation-liaison psychiatry during the past decade and looked toward the future. This book is based on these presentations, but it is not simply a proceedings book. A number of additional experts have contributed important chapters, and all the chapters based on the presentations are expanded and updated. Thus, this book reviews the current state of consultation-liaison psychiatry and anticipates future challenges. It also informs the reader about the state-of-the-art knowledge and skills in consultation-liaison psychiatry as of This book should be a valuable up-to-date overview/refresher for both consultationliaison psychiatrists and general psychiatrists who wish to update and formulate his/her consultant role. It should be especially valuable for psychiatric residents for whom the role as consultant to primary physicians assumes increasing importance, and for primary physicians and medical students who are interested in learning about commonly encountered complex biopsychosocial problems of their patients and integrating these dimensions in patient care. I am grateful to Mary Safford and Eileen Bermingham of Plenum for their help with the preparation and production of this book. I am also thankful to Anita Shaw for her secretarial help., M.D. Fresno, California vii
6 CONTENTS INTRODUCTION: Consultation-Liaison Psychiatry on the Threshold of a New Century Legal and Ethical Changes in Consultation Psychiatry... 7 Lowell Tong and Craig VanDyke Chronic Pain Jon Streltzer and Byron Eliashof Chronic Pain and Addiction Jon Streltzer Psychiatric Consultation with Chemically Dependent Patients Stephen R. Griffith The Dementia Syndrome in Consultation Psychiatry Robert Hanowell Psychotherapy Solutions in the Medical Setting Stuart J. Eisendrath Physical Factors affecting Psychiatric Condition: A Proposal for a Future DSM Training in Medical Psychiatry Scott Ahles Consultation-Liaison in Child Psychiatry: Continuity and Change in the Past Decade David A. Fox Consultation-Liaison The Hawaii Experience Jon Streltzer Consultation-Liaison Funding: Issues for Service and Training James J. Strain, George Fulop, and Jeffrey S. Hammer ix
7 Computerization and Consultation-Liaison Psychiatry in the 1990's Seth M. Powsner A Computerized Database System for Psychiatric and Consultation Records Databasing in CLP Psychiatry Jeffrey S. Hammer and James J. Strain Contributors Index x
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