Massachusetts General Hospital Handbook of General Hospital Psychiatry. Edition No. 8

Table of Contents

1 Approach to Psychiatric Consultations in the General Hospital
2 the Doctor-patient Relationship
3 the Psychiatric Interview
4 Limbic Music
5 Functional Neuroanatomy and the Neurologic Examination
6 Psychological and Neuropsychological Assessment in the Medical Setting
7 Diagnostic Rating Scales, Procedures, and Laboratory Tests
8 Mood Disorders: Depression and Bipolar Disorder
9 Delirium
10 Patients With Neurocognitive Disorders
11 Patients With Psychosis
12 Pharmacotherapy of Anxiety Disorders
13 Substance Use Disorders
14 Somatic Symptom and Related Disorders and Functional Somatic Syndromes
15 Factitious Disorders and Malingering
16 Eating Disorders
17 Pain
18 Neuropsychiatric Conditions: Seizures, Headaches, Stroke Syndromes, and Traumatic Brain Injuries
19 Patients With Abnormal Movements
20 Infectious or Inflammatory Europsychiatric Impairment
21 Catatonia, Neuroleptic Malignant Syndrome, and Serotonin Syndrome
22 Patients With Disordered Sleep
23 Sexual Disorders and Sexual Dysfunction
24 the Psychiatric Management of Patients With Cardiac Disease
25 Patients With Kidney Disease
26 Patients With Gastrointestinal Disease
27 Organ Failure and Transplantation
28 Hiv Infection and Aids
29 COVID-19 Infection
30 Patients With Cancer
31 Pulmonary Disease
32 Burns, Trauma, and Intensive Care Unit Treatment
33 Patients With Genetic Syndromes
34 Coping With Medical Illness and Psychotherapy of the Medically Ill
35 Resilience, Wellness, and Coping With the Rigors of Psychiatric Practice
36 Device Neuromodulation and Brain Stimulation Therapies
37 Psychopharmacology in the Medical Setting
38 Psychiatric Consultation to Children and Adolescents
39 Chronic Disease and Unhealthy Lifestyle Behaviors: Behavioral Management
40 Complementary Medicine and Natural Medications
41 Difficult Patients
42 Care of the Patient With Thoughts of Suicide
43 Emergency Psychiatry
44 Geriatric Psychiatry
45 Care at the End of Life
46 Psychiatric Illness During Pregnancy and the Postpartum Period
47 Culture and Psychiatry
48 Legal Aspects of Psychiatric Consultation
49 Approaches to Collaborative Care and Behavioral Health Integration
50 Community Psychiatry
51 Global Psychiatry and Mental Healthcare Delivery
52 Care of LGBTQIA+ Patients
53 Building Interdisciplinary Collaborations Across Healthcare Settings
54 Management of a Psychiatric Consultation Service

Authors

Theodore A. Stern Psychiatrist and Chief Emeritus, Avery D. Weisman Psychiatry Consultation Service, Director, Thomas P. Hackett Center for Scholarship in Psychosomatic Medicine, Massachusetts General Hospital, Boston, MA, USA, Ned H. Cassem Professor of Psychiatry in the Field, Psychosomatic Medicine/Consultation, Harvard Medical School, Boston, MA, USA.

Dr. Theodore A. Stern is the Ned H. Cassem Professor of Psychiatry in the field of Psychosomatic Medicine/Consultation at Harvard Medical School (HMS), Chief Emeritus of The Avery D. Weisman, Psychiatry Consultation Service, and Director of the Thomas P. Hackett Center for Scholarship in Psychosomatic Medicine at the Massachusetts General Hospital (MGH). Dr. Stern has co-authored more than 550 peer-reviewed journal articles and book chapters, and he has edited or authored more than 60 books (including the MGH Handbook of General Hospital Psychiatry, the MGH Psychiatry Update and Board Preparation, Learning About Psychopharmacology, Facing Overweight and Obesity, Facing Pelvic Pain, Facing Memory Loss and Dementia, Facing Serious Mental Illness, and the MGH Study Guide for Psychiatry Exams). Dr. Stern is a Past-President of the Academy of Consultation-Liaison Psychiatry (ACLP) and is the Editor-in-Chief Emeritus of its journal, Psychosomatics (now called Journal of the Academy of Consultation-Liaison Psychiatry). He has won the coveted "Best Teacher Award� from the graduating residents at the MGH/McLean Hospital Psychiatric Residency Training Program, the Cynthia N. Kettyle Teaching Award from the HMS Department of Psychiatry, the MGH Department of Psychiatry's Award for Exceptional Mentorship in the Clinical Realm, a Lifetime Achievement Award from the Society of Liaison Psychiatry, and the Thomas P. Hackett Award from the ACLP (its highest honor).

Scott R. Beach Psychiatrist, Department of Psychiatry, Massachusetts General Hospital; Associate Professor, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. Since 2016, Dr. Scott R. Beach has been the director of the Infectious Disease Consultation Service at MGH, providing psychiatric care in the co-located HIV clinic. Areas of clinical expertise include QT prolongation with psychiatric medications, catatonia and related syndromes, and patients who deceive providers. Dr. Beach's research focuses on collaborative care models in patients with heart disease, positive emotions and their predictive value following acute coronary syndromes, and QT prolongation with antidepressants. He is also principal investigator of a pilot study investigating neuroimaging and gene expression in patients with catatonia. He has been a co-investigator on grants from the NIH and the American Foundation for Suicide Prevention. Dr. Beach is the author of over 20 book chapters and 30 peer-reviewed articles. Felicia A. Smith Associate Chief, Department of Psychiatry, Chief, MGH Division of Psychiatry and Medicine, Massachusetts General Hospital; Assistant Professor, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. Dr. Felicia A. Smith was previously a co-editor on this title and has been selected again by Dr. Stern to collaborate on the revision. She is a graduate of the MGH/McLean Adult Psychiatry Residency Program. Following graduation, she remained on staff and, in 2008, was named director of the Acute Psychiatry Service at MGH. It was in this role that she grew her strong interest in medical education, as it allowed her to help guide psychiatric residents, psychology interns and medical students. She previously held the role of program director for the Adult Psychiatry Residency Program. Oliver Freudenreich Co-Director, MGH Psychosis Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital; Professor of Clinical Psychiatry, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. Dr. Oliver Freudenreich's academic interest lies in the area of optimal psychopharmacological treatment for schizophrenia, including the development of innovative treatments and management of treatment-resistant psychosis. In addition to his clinical and clinical trial expertise in schizophrenia, Dr. Freudenreich provides psychiatric consultations for medically complex patients with serious mental illness and for diagnostically difficult cases with psychosis. He has published extensively in his areas of interest and has written a handbook on psychotic disorders (2e published in 2020). Dr. Freudenreich teaches and speaks on a regular basis at international and national meetings. Recent awards include the MGH Department of Psychiatry Clinical Excellence Award and the 2022 Outstanding Psychiatrist Award for the Public Sector from the Massachusetts Psychiatric Society. Ana-Maria Vranceanu Director, Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital; David T. Rovee PhD and Joanne V. Rovee Endowed Chair in Psychiatry, Professor of Psychology, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. Dr. Ana-Maria Vranceanu is the former Director of Behavioral Health Integration for the Behavioral Medicine Service and has developed multidisciplinary collaborations with medical practices within MGH including The Neuroscience Intensive Care Unit, The Neurofibromatosis Clinic, The Pain Clinic, The Mild Closed Head Injury Clinic, the Massachusetts Eye and Ear Infirmary and the Department of Orthopedic Surgery. She is an expert in developing in-person and live video skills interventions integrated within medical practices, to preserve health, promote recovery after surgery or injury and optimize management of chronic illness. She has served as Principal Investigator on more than 15 foundation or federally funded research grants. She has over 150 publications and has edited the "MGH Book of Behavioral Medicine." Dr. Vranceanu has a particular interest in mentoring interns, postdocs, medical residents and junior faculty members, and has been awarded the Dorothy W. Cantor Leadership for Women in Psychology fellowship from the American Psychological Association. Maurizio Fava Psychiatrist-in-Chief, Department of Psychiatry, Vice Chair, Executive Committee on Research, Massachusetts General Hospital, Boston, MA, USA, Executive Director, Clinical Trials Network & Institute (CTNI), Massachusetts General Hospital, Boston, MA, USA, Associate Dean for Clinical & Translational Research & Slater Family Professor of Psychiatry, Harvard Medical School, Boston, MA, USA. Dr. Maurizio Fava is Chair of the Department of Psychiatry at the Massachusetts General Hospital (MGH). Dr. Fava obtained his MD from University of Padova School of Medicine (residency in endocrinology); he completed residency training in psychiatry at the MGH. He founded and was director of the hospital's Depression Clinical and Research Program (DCRP) from 1990 to 2014. In 2007, he founded and is now Executive Director of the MGH Clinical Trials Network and Institute (CTNI), the first academic CRO specialized in planning and coordination of multi-center clinical trials in psychiatry. Under Dr. Fava's direction, the DCRP became one of the most highly regarded depression programs in the country, a model for academic programs that link, in a bi-directional fashion, clinical and research work. His prominence in the field is reflected in his role as the co-principal investigator of STAR*D, the largest research study ever conducted in the area of depression, and of the RAPID Network, the NIMH-funded series of studies of novel, rapidly acting antidepressant therapies. Dr. Fava is a world leader in the field of depression. He has authored or co-authored more than 900 original articles published in medical journals with international circulation, edited eight books, and has been successful in obtaining funding as principal or co-principal investigator from both the National Institutes of Health and other sources for a total of more than $150 million.