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Liaison Psychiatry

This document discusses the identification and treatment of psychiatric morbidity in medically ill patients. It covers how medical illnesses and drugs can cause psychiatric symptoms like depression, anxiety, and psychosis. It also describes how psychiatric disorders can present with physical symptoms that are not due to organic pathology. The management principles involve considering how the illness may threaten life or cause disability, recognizing potential psychiatric disorders, addressing treatment side effects and prognosis uncertainty, and facilitating expression of illness meaning to develop a therapeutic alliance.

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195 views5 pages

Liaison Psychiatry

This document discusses the identification and treatment of psychiatric morbidity in medically ill patients. It covers how medical illnesses and drugs can cause psychiatric symptoms like depression, anxiety, and psychosis. It also describes how psychiatric disorders can present with physical symptoms that are not due to organic pathology. The management principles involve considering how the illness may threaten life or cause disability, recognizing potential psychiatric disorders, addressing treatment side effects and prognosis uncertainty, and facilitating expression of illness meaning to develop a therapeutic alliance.

Uploaded by

api-3703352
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Liaison psychiatry

Identification & treatment


of psychiatric morbidity
in medically ill patients
Medical illnesses causing
psychiatric symptoms
Endocrine Metabolic
Hyperthyroidism: anxiety, paranoid Hypoglycaemia: anxiety,
psychosis confusional state
Hypothyroidism: depression, Vitamin deficiency: depression,
dementia, psychosis dementia
Cushing’s syndrome: depression, Neoplastic
psychosis Pancreas & lung: depression
Phaeochromocytoma: anxiety Brain: personality change,
Infections psychosis
HIV: anxiety, depression, delirium, Nervous system
dementia Parkinson's disease: depression,
Viral infections: depression dementia
Multiple sclerosis: anxiety,
euphoria, depression
Drug induced psychological
problems
Depression Anxiety
• Antihypertensives • Amphetamines
• Anticancer • Sympathomimetics
• Anti diabetics • Caffeine
• Hormones • Organophosphates
• Analgesics • Sulphonamides
• H1 receptor antagonists • Penicillin
• Mercury & arsenic
Psychosis
Delirium • Hallucinogens,
• Anticholinergics • Appetite suppressants
• Digoxin • Corticosteroids
• Cimetidine • Anticholinergics
Psychiatric disorders presenting
with physical symptoms
Somatisation disorder: Somatoform pain disorder:
• Multiple somatic complaints • Continuous, dull, diffuse,
• Seek immediate relief • Aggravated by stress,
Hypochondriasis: • Relieved with tranquilisers
• Preoccupation with bodily ill- Anxiety disorder:
health • Fear of heart attack
• Seek investigations & • Autonomic dysfunction
reassurances Masked depression
Dysmorphophobia: • Multiple somatic symptoms
• Preoccupation with body • Biological symptoms of depression
disfigurement
• Medical shopping
Dissociative disorder:
• Physical symptoms without
organic pathology
• Stress related
Management
(Principles)
Consider Recognise psychiatric disorder
Illness • Feeling state
• Threat to life • Worried about health
• Duration • Sleep
• Disability • On medication for nerves
• History of psychiatric disorder
Treatment
• • Problems at home/work
Side effects
• • Observe behaviour
Uncertainty of outcome
Patient reaction Management
• • Meaning of the illness
Anxiety
• • Facilitate expression
Denial
• • Address patient concern
Depression
• • Reassure
Non compliance
• • Develop therapeutic alliance
Social circumstances
• Ensure follow up

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