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The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry

The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry

Authors
Publisher John Wiley and Sons Ltd
Year 29/10/2020
Pages 752
Version paperback
Readership level Professional and scholarly
Language English
ISBN 9781119554202
Categories Psychiatry
$61.65 (with VAT)
274.05 PLN / €58.76 / £51.01
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Book description

Learn to improve your assessment, investigation, and management of physical health conditions in people with severe mental illness


The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry offers psychiatric and general practitioners an evidence-based and practical guide for the appropriate assessment, investigation, and management of common physical health conditions seen in people with severe mental illness. Written by a renowned team of respected experts in medicine, surgery, pharmacy, dietetics, physiotherapy, and psychiatry, the book bridges the gap between psychiatric and physical health services for the severely mentally ill.


The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry also provides practitioners with expert guidance on making effective referrals to other medical and surgical subspecialties, telling readers what information subspecialties would expect to receive. Its use will improve the quality of clinical care received by mentally ill patients and, by promoting a holistic approach to treatment that considers both body and mind, will enhance the therapeutic relationship between patient and practitioner.


The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry covers the following:





Guidance on assessment and management of well over a hundred different medical and surgical presentations commonly seen in people with serious mental illness

Management of physical health emergencies in a psychiatric setting

Evidence-based approaches to management of physical side effects of psychiatric medications

Advice on approaches to promote a healthy lifestyle in people with serious mental illness, such as smoking cessation and changes to diet and physical activity



Perfect for both psychiatrists and general practitioners who wish to improve the quality of care they provide to people with serious mental illness, The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry will be of use to anyone setting out to navigate the divide between the treatment of psychiatric and physical health conditions.

The Maudsley Practice Guidelines for Physical Health Conditions in Psychiatry

Table of contents

TABLE OF CONTENTS



Preface xxi





List of abbreviations xxiii











Part 1 Cardiology 1











Chapter 1 Tachycardia 3





Sinus tachycardia 3





Atrial fibrillation 4





Supraventricular tachycardia 4





Ventricular tachycardia 6





Diagnostic principles 6





Management 10





References 14











Chapter 2 Bradycardia 17





Diagnosis 19





Management and when to refer to a specialist 21





References 22











Chapter 3 QT Interval Prolongation 23





Prescribing QTc?prolonging medication 27





Diagnostic principles 28





Management 29





References 32











Chapter 4 Syncope 35





Causes of syncope 35





Syncope and serious mental illness 36





Diagnostic principles 36





Diagnosis and management 38





References 39











Chapter 5 Hypertension 41





Diagnostic principles 43





Diagnosis 44





Management 45





References 48











Chapter 6 Postural Hypotension 51





Diagnostic principles 53





Management 54





References 58











Chapter 7 Peripheral Oedema 59





Diagnostic principles 60





Management 66





References 67











Chapter 8 Myocarditis 71





Diagnostic principles 71





Management 75





Clozapine?induced myocarditis 75





References 77











Chapter 9 Hypercholesterolaemia 79





Diagnostic principles 80





Diagnostic criteria 81





Management 81





References 84











Chapter 10 Physical Activity 85





Physical activity and serious mental illness 85





How much physical activity and exercise should people be doing? 86





Practical tips 87





Messages to include in discussions with patients 87





References 88











Part 2 Endocrinology 91











Chapter 11 Diabetes Mellitus 93





Diagnostic principles 93





Management 97





References 102











Chapter 12 Thyroid Disease 105





Hypothyroidism 105





Diagnostic principles 107





Management 110





Hyperthyroidism 111





Diagnostic principles 112





Management 113





References 114











Chapter 13 Hyperprolactinaemia 117





Diagnostic principles 119





Management and when to refer to a specialist 121





Hyperprolactinaemia and osteoporosis risk in serious mental illness 122





Hyperprolactinaemia and cancer risk 123





References 123











Chapter 14 Obesity 125





Monitoring 127





Prevention and treatment of weight gain 129





References 134











Part 3 Haematology 137











Chapter 15 Anaemia 139





Diagnostic principles 140





Management and referral pathways 143





References 145











Chapter 16 Neutropenia 147





Drug?induced neutropenia and agranulocytosis 149





Diagnostic principles 150





Management 151





References 153











Chapter 17 Thrombocytopenia 155





Diagnostic principles 156





Management and when to refer 158





References 158











Chapter 18 Venous Thromboembolism and Anticoagulation 159





Risk factors 159





Prophylaxis 161





Diagnosis 162





Management 164





References 168











Part 4 Gastroenterology 169











Chapter 19 Gastro?oesophageal Reflux and Peptic Ulcer Disease 171





Gastro?oesophageal reflux disease 171





Peptic ulcer disease 176





References 178











Chapter 20 Gastrointestinal Bleeding 181





Diagnostic principles 183





Management 185





References 188











Chapter 21 Nausea and Vomiting 191





Diagnostic principles 193





Management 195





References 198











Chapter 22 Dysphagia 199





Causes of dysphagia in the general population 199





Diagnostic principles 200





Management 203





Oesophageal cancer in psychiatric populations 203





Dysphagia in the elderly 204





References 204











Chapter 23 Deranged Liver Function Tests 207





Diagnostic principles 207





Management 212





References 213











Chapter 24 Alcohol and Physical Health 215





What is harmful use? 215





Physical complications of alcohol use 216





Approach to the patient with suspected alcohol misuse 217





Management 220





References 222











Chapter 25 Unintentional Weight Loss 223





Diagnostic principles 225





Management 227





References 227











Chapter 26 Dry Mouth 229





Diagnostic principles 231





Management 231





References 232











Chapter 27 Hypersalivation 235





Diagnostic principles 235





Management 236





References 239











Chapter 28 Constipation 241





Diagnostic principles 243





Management 244





References 249











Part 5 Renal and Urology 251











Chapter 29 Urinary Retention 253





Urinary retention and serious mental illness 253





Diagnostic principles 254





Management 256





References 256











Chapter 30 Urinary Incontinence 259





Diagnostic principles 261





Management 262





References 264











Chapter 31 Polyuria 267





Diagnostic principles 268





Management 269





References 271











Chapter 32 Sodium Derangement 273





Diagnostic principles 274





Management 276





References 277











Chapter 33 Potassium Derangement 279





Hyperkalaemia 279





Hypokalaemia 282





References 285











Chapter 34 Chronic Kidney Disease 287





Diagnostic principles 289





Management 291





References 295











Part 6 Sexual and Reproductive Health 297











Chapter 35 Sexual Dysfunction 299





Assessment of a patient with sexual dysfunction 299





Management 301





References 304











Chapter 36 Contraception 307





Clinical approach 308





Contraceptive options 308





Ethical and legal considerations 312





When to refer 313





Special considerations in patients with serious mental illness 313





References 314











Chapter 37 Infertility 317





Addressing infertility in psychiatric practice 317





Onward referral and further tests for infertility 318





Infertility treatments 318





References 318











Chapter 38 Sexually Transmitted Infection 319





History 319





STI testing in psychiatry 320





Determining urgency of clinical action/referral 321





Referral to sexual health services 322





References 324











Part 7 Infectious Diseases 325











Chapter 39 Pneumonia 327





Pneumonia and serious mental illness 329





Diagnostic principles 329





Management 332





References 335











Chapter 40 Influenza 337





Diagnostic principles 338





Management 339





Preventing spread of influenza 341





References 342











Chapter 41 Urinary Tract Infection 343





Urinary tract infection and serious mental illness 344





Diagnostic principles 344





Management 347





References 350











Chapter 42 Gastroenteritis 251





Diagnostic principles 251





Management 254





References 256











Chapter 43 Viral Hepatitis 357





Hepatitis B 357





Hepatitis C 361





References 364











Chapter 44 Tuberculosis 365





Diagnostic principles 366





Management 369





References 371











Chapter 45 Human Immunodeficiency Virus 373





Testing for HIV 374





HIV and the central nervous system 374





Antiretroviral therapy 375





References 380











Part 8 Respiratory 383











Chapter 46 Smoking Cessation 385





Identifying those who want to stop smoking and degree





of nicotine dependence 385





Approaches to smoking cessation 387





References 392











Chapter 47 Chronic Obstructive Pulmonary Disease 395





Common causes of COPD in the general population and patients





with serious mental illness 395





The asthma-COPD overlap 396





Diagnostic principles 397





Management 400





References 403











Chapter 48 Asthma 405





Causes in the general population and people with serious





mental illness 405





Diagnostic principles 406





Management 409





References 412











Chapter 49 Obstructive Sleep Apnoea 413





Diagnostic principles 414





Management 415





References 416











Part 9 Neurology 419











Chapter 50 Delirium 421





Diagnostic principles421





Management 426





References 429











Chapter 51 Autoimmune Encephalitis 431





Autoimmune disease mechanisms 431





Clinical approach 432





Management 437





References 439











Chapter 52 Catatonia 441





Diagnostic principles 442





Management 444





References 448











Chapter 53 Seizure Disorders 451





Acute seizure 452





Psychiatric comorbidity in people with epilepsy 455





Psychiatric side effects of antiepileptic drugs 457





Psychiatric drug therapy in people with epilepsy 457





Psychogenic non?epileptic seizures 458





Epilepsy surgery 459





Epilepsy and learning disability 459





References 459











Chapter 54 Headache 461





Diagnostic principles 463





Management 466





References 468











Chapter 55 Disorders of Sleep and Circadian Rhythm 471





Definitions of common sleep disorders in psychiatric





populations 471





Diagnostic principles 474





Management 476





References 477











Chapter 56 Extrapyramidal Side Effects 479





Clinical approach 480





Management 482





References 483











Chapter 57 Tardive Dyskinesia 485





Clinical approach 486





Management 487





References 489











Chapter 58 Tremor 491





Clinical approach 491





Management 494





References 496











Part 10 Rheumatology and Musculoskeletal Health 497











Chapter 59 Low Back Pain 499





Diagnostic principles 500





Management 502





References 503











Chapter 60 Arthritis 505





Clinical approach 510





Management 512





References 512











Part 11 Ophthalmology 515











Chapter 61 Eye Disease 517





Clinical approach to a patient with visual disturbance or





orbital/periorbital disorders 517





Disorders of the eyelids 522





Disorders of the conjunctiva 526





Disorders of the cornea 529





References 533











Part 12 Obstetrics and Gynaecology 535











Chapter 62 Pregnancy 537





The pre?conception period 538





During pregnancy 539





Psychiatric medication in pregnancy 543





Postpartum psychosis 547





Electroconvulsive therapy in pregnancy 547





References 548











Chapter 63 Menopause 551





Physiology and symptoms of perimenopause 551





Clinical approach 552





Treatment 553





References 556











Part 13 Dermatology 559











Chapter 64 General Dermatology 561





Infectious skin disease 561





Non?infectious skin disease 564





References 566











Chapter 65 Psychodermatology 569





Psychiatric disorders with skin manifestations 569





Psychophysiological conditions 571





Secondary psychological disorders 571





Cutaneous sensory disorders 572





References 572











Part 14 Electroconvulsive Therapy 573











Chapter 66 Electroconvulsive Therapy 575





Indications and contraindications 575





The ECT procedure 576





Physiological effects of ECT 576





Pre?ECT assessment 578





Safety of ECT 579





ECT prescribing 579





Guidance for the doctor administering ECT 579





Side effects of ECT 580





Special patient groups 581





References 581











Part 15 Emergencies 583











Chapter 67 Chest pain 585





Diagnostic principles 586





Management 590





Information to provide in a 'chest pain' referral to medical services 591





References 591











Chapter 68 Acute Shortness of Breath 593





Diagnostic principles 593





Management 595





References 596











Chapter 69 Acute Coronary Syndrome 597





Diagnostic principles 598





Management 602





References 603











Chapter 70 Arrhythmia 605





Tachycardia 605





Bradycardia 605





Reference 608











Chapter 71 Hypertensive Crisis 609





Diagnostic principles 609





Management 610





References 611











Chapter 72 Sepsis 613





When to think sepsis 613





Septic shock 614





Management 614





Post?sepsis syndrome 615





References 616











Chapter 73 Acute Kidney Injury 617





Categorisation of acute kidney injury 617





Diagnostic principles 620





Management 622





Psychiatric medication and acute kidney injury 622





References 623











Chapter 74 Diabetic Emergencies 625





Hypoglycaemia 625





Diabetic ketoacidosis 626





Hyperosmolar hyperglycaemic state 627





References 627











Chapter 75 Acute Upper Gastrointestinal Bleeding 629





Signs of acute upper gastrointestinal bleeding 629





Waiting for transfer 629





Handing over to the acute medical team 630











Chapter 76 Status Epilepticus 631











Chapter 77 Anaphylaxis 633





Management 633





References 636











Chapter 78 Reduced Consciousness and Coma 637





Clinical approach 637





References 640











Chapter 79 Thyroid Emergencies 641





Hypothyroid crisis/myxoedema coma 641





Hyperthyroid crisis/thyroid storm 642





References 643











Chapter 80 Head Injury 645





Clinical approach 645





Types of intracranial haemorrhage 649





References 650











Chapter 81 Acute Meningitis and Infective Encephalitis 651





Meningitis 651





Infective encephalitis 653





References 655











Chapter 82 Stroke and Transient Ischaemic Attack 657





Stroke 657





Diagnostic principles 658





Management 659





Transient Ischaemic Attack 660





Diagnostic principles 660





Management 661





References 661











Chapter 83 Overdose 663





General principles 663





Information gathering 664





Emergency assessment and management 664





Specific scenarios 667





Management of a person who refuses admission to hospital





after an overdose 670





References 670











Chapter 84 Acute Dystonia 673





Diagnostic principles 673





Management 675





References 677











Chapter 85 Neuroleptic Malignant Syndrome 679





Diagnostic principles 679





Management 680





References 681











Chapter 86 Serotonin Syndrome 683





Diagnostic principles 683





Management 684





References 685











Chapter 87 Emergencies in Obstetrics and Gynaecology 687





Maternal collapse 689





Pre?eclampsia 689





Major obstetric haemorrhage 691





Amniotic fluid embolism 691





Ectopic pregnancy 691





Miscarriage 693





Hyperemesis gravidarum 694





Ovarian cyst accidents 695





Pelvic inflammatory disease 697





References 697











Chapter 88 The Acute Abdomen 699





History 699





Causes of the acute abdomen based on pain location 702





Examination 705





Investigations 706





Onward referral 706





References 707











Chapter 89 The ABCDE Approach 709





First steps 709





Airway (A) 710





Breathing (B) 711





Circulation (C) 711





Disability (D) 711





Exposure (E) 712





References 712

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