A Case-Based Approach to Emergency Psychiatry

Working in an emergency department as a psychiatrist or mental health clinician requires an ability to gain a patient's rapport, establish a differential diagnosis, assess risk and make disposition decisions in a fast-paced and potentially chaotic setting. Patients may be medically ill, agitated, intoxicated, or suicidal, and resources for treatment may be difficult to access. A Case-Based Approach to Emergency Psychiatry provides the emergency department clinician with vivid and complex cases, discussed by psychiatrists who work daily in the emergency setting, that illustrate basic principles of assessment, diagnosis and treatment. These challenging and complex cases are based on the years of experience of the authors combined with current evidence-based practices and discussion. Risk assessment, psychosis, mood disorder, substance abuse, ethics, forensic issues, and personality disorders are discussed, along with child and adolescent, geriatric, and developmental disabilities. Special attention is also paid to alternatives to inpatient care, short-term crisis intervention, and the interface between medical and psychiatric illnesses. The case-based format allows the authors to link aspects of the clinical presentation to discussion and literature review in a memorable and compelling format. Anxiety, Trauma And Hoarding / Katherine Maloy -- Mood Disorders : Clinical Examples And Risk Assessment / Jennifer Goldman -- Evaluating Suicide Risk In Psychotic Disorders / Katherine Maloy And Yona Silverman -- Evaluating Violence Risk In Psychotic Disorders / Abigail L. Dahan And Jessica Woodman -- Medical And Neurologic Syndromes / Jonathan Howard, Miriam Zincke, Anthony Dark, Bem Atim -- Substance Abuse : Intoxication And Withdrawal / Joe Kwon, Emily Deringer, Luke Archibald -- Evaluating The Geriatric Patient / Dennis Popeo -- Borderline And Narcissistic Personality Disorders / Wiktoria Bielska, Jillian Copeland. Psychiatric Emergencies In Children And Adolescents / Ruth Gerson, Fadi Haddad -- Developmental And Autism Spectrum Disorders In Adults / Katherine Maloy -- Ethical And Legal Issues / Amit Rajparia -- Forensic Issues / Jennifer A. Mathur, Wiktoria Bielska, Rebecca Lewis, Bipin Subedi -- Short-term Crisis Intervention And Mobile Crisis Evaluation / Adria N. Adams, Camilla Lyons, Madeleine O'brien -- Somatization And Consulting To The Medical Emergency Department / Lindsay Gurin -- Psychodynamic Issues In Psychiatric Emergency Evaluation / Daniel J. Zimmerman -- Use Of Language Interpretation / Bipin Subedi, Katherine Maloy -- The Homeless Patient / Katherine Maloy. Edited By Katherine Maloy. Includes Bibliographical References And Index. Working in an emergency department as a psychiatrist or mental health clinician requires an ability to gain a patient's rapport, establish a differential diagnosis, assess risk and make disposition decisions in a fast-paced and potentially chaotic setting. Patients may be medically ill, agitated, intoxicated, or suicidal, and resources for treatment may be difficult to access. __A Case-Based Approach to Emergency Psychiatry__ provides the emergency department clinician with vivid and complex cases, discussed by psychiatrists who work daily in the emergency setting, that illustrate basic principles of assessment, diagnosis and treatment. These challenging and complex cases are based on the years of experience of the authors combined with current evidence-based practices and discussion. Risk assessment, psychosis, mood disorder, substance abuse, ethics, forensic issues, and personality disorders are discussed, along with child and adolescent, geriatric, and developmental disabilities. Special attention is also paid to alternatives to inpatient care, short-term crisis intervention, and the interface between medical and psychiatric illnesses. The case-based format allows the authors to link aspects of the clinical presentation to discussion and literature review in a memorable and compelling format. Content: Anxiety, trauma and hoarding / Katherine Maloy -- Mood disorders : clinical examples and risk assessment / Jennifer Goldman -- Evaluating suicide risk in psychotic disorders / Katherine Maloy and Yona Silverman -- Evaluating violence risk in psychotic disorders / Abigail L. Dahan and Jessica Woodman -- Medical and neurologic syndromes / Jonathan Howard, Miriam Zincke, Anthony Dark, Bem Atim -- Substance abuse : intoxication and withdrawal / Joe Kwon, Emily Deringer, Luke Archibald -- Evaluating the geriatric patient / Dennis Popeo -- Borderline and narcissistic personality disorders / Wiktoria Bielska, Jillian Copeland -- Psychiatric emergencies in children and adolescents / Ruth Gerson, Fadi Haddad -- Developmental and autism spectrum disorders in adults / Katherine Maloy -- Ethical and legal issues / Amit Rajparia -- Forensic issues / Jennifer A. Mathur, Wiktoria Bielska, Rebecca Lewis, Bipin Subedi -- Short-term crisis intervention and mobile crisis evaluation / Adria N. Adams, Camilla Lyons, Madeleine O'Brien -- Somatization and consulting to the medical emergency department / Lindsay Gurin -- Psychodynamic issues in psychiatric emergency evaluation / Daniel J. Zimmerman -- Use of language interpretation / Bipin Subedi, Katherine Maloy -- The homeless patient / Katherine Maloy. Cover 1 A Case-​Based Approach to Emergency Psychiatry 4 Copyright 5 Contents 6 Contributors 8 Introduction 12 1. Anxiety, Trauma, and Hoarding 14 2. Mood Disorders: Clinical Examples and Risk Assessment 30 3. Assessing Suicide Risk in Psychosis 44 4. Assessing Risk of Violence in Psychosis 52 5. Altered Mental Status and Neurologic Syndromes 62 6. Substance Abuse: Intoxication and Withdrawal 83 7. Evaluating the Geriatric Patient 101 8. Personality Disorders as a Psychiatric Emergency 107 9. Evaluating and Treating Children with Psychiatric Complaints in the Emergency Department 123 10. Developmental Disability and Autism Spectrum Disorders in Adults 132 11. Ethical Issues in Emergency Psychiatry 138 12. Evaluating and Treating the Forensic Patient 150 13. Interim Crisis Services: Short-​Term Treatment and Mobile Crisis Teams 163 14. Somatic Symptom Disorders and the Emergency Psychiatrist 176 15. Psychodynamic Aspects of Emergency Psychiatry 189 16. Use of Interpreters in Emergency Psychiatric Evaluation 200 17. Evaluating and Treating the Homeless Patient 207 Index 216 Working in an emergency department as a psychiatrist or mental health clinician requires an ability to gain a patient's rapport, establish a differential diagnosis, assess risk, and make disposition decisions in a fast-paced and potentially chaotic setting. A Case-Based Approach to Emergency Psychiatry, written by psychiatrists who work daily in the emergency setting, will assist the emergency department clinician in learning these skills through vivid, complex cases that illustrate basic principles of assessment, diagnosis, and treatment