Preface xxiii
List of Abbreviations xxv
Part 1 Cardiology 1 Chapter 1 Tachycardia 3Sinus tachycardia 3
Atrial fibrillation 4
Supraventricular tachycardia 4
Ventricular tachycardia 6
Diagnostic principles 6
Management 10
References 14
Chapter 2 Bradycardia 17Diagnosis 19
Management and when to refer to a specialist 21
References 22
Chapter 3 QT Interval Prolongation 23Prescribing QTc-prolonging medication 27
Diagnostic principles 28
Management 29
References 32
Chapter 4 Syncope 35Causes of syncope 35
Syncope and serious mental illness 36
Diagnostic principles 36
Diagnosis and management 38
References 39
Chapter 5 Hypertension 41Diagnostic principles 43
Diagnosis 44
Management 45
References 48
Chapter 6 Postural Hypotension 51Diagnostic principles 53
Management 54
References 58
Chapter 7 Peripheral Oedema 59Diagnostic principles 60
Management 66
References 67
Chapter 8 Myocarditis 71Diagnostic principles 71
Management 75
Clozapine-induced myocarditis 75
References 77
Chapter 9 Hypercholesterolaemia 79Diagnostic principles 80
Diagnostic criteria 81
Management 81
References 84
Chapter 10 Physical Activity 85Physical 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 93Diagnostic principles 93
Management 97
References 102
Chapter 12 Thyroid Disease 105Hypothyroidism 105
Diagnostic principles 107
Management 110
Hyperthyroidism 111
Diagnostic principles 112
Management 113
References 114
Chapter 13 Hyperprolactinaemia 117Diagnostic 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 125Monitoring 127
Prevention and treatment of weight gain 129
References 134
Part 3 Haematology 137 Chapter 15 Anaemia 139Diagnostic principles 140
Management and referral pathways 143
References 145
Chapter 16 Neutropenia 147Drug-induced neutropenia and agranulocytosis 149
Diagnostic principles 150
Management 151
References 153
Chapter 17 Thrombocytopenia 155Diagnostic principles 156
Management and when to refer 158
References 158
Chapter 18 Venous Thromboembolism and Anticoagulation 159Risk factors 159
Prophylaxis 161
Diagnosis 162
Management 164
References 168
Part 4 Gastroenterology 169 Chapter 19 Gastro-oesophageal Reflux and Peptic Ulcer Disease 171Gastro-oesophageal reflux disease 171
Peptic ulcer disease 176
References 178
Chapter 20 Gastrointestinal Bleeding 181Diagnostic principles 183
Management 185
References 188
Chapter 21 Nausea and Vomiting 191Diagnostic principles 193
Management 195
References 198
Chapter 22 Dysphagia 199Causes 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 207Diagnostic principles 207
Management 212
References 213
Chapter 24 Alcohol and Physical Health 215What 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 223Diagnostic principles 225
Management 227
References 227
Chapter 26 Dry Mouth 229Diagnostic principles 231
Management 231
References 232
Chapter 27 Hypersalivation 235Diagnostic principles 235
Management 236
References 239
Chapter 28 Constipation 241Diagnostic principles 243
Management 244
References 249
Part 5 Renal and Urology 251 Chapter 29 Urinary Retention 253Urinary retention and serious mental illness 253
Diagnostic principles 254
Management 256
References 256
Chapter 30 Urinary Incontinence 259Diagnostic principles 261
Management 262
References 264
Chapter 31 Polyuria 267Diagnostic principles 268
Management 269
References 271
Chapter 32 Sodium Derangement 273Diagnostic principles 274
Management 276
References 277
Chapter 33 Potassium Derangement 279Hyperkalaemia 279
Hypokalaemia 282
References 285
Chapter 34 Chronic Kidney Disease 287Diagnostic principles 289
Management 291
References 295
Part 6 Sexual and Reproductive Health 297 Chapter 35 Sexual Dysfunction 299Assessment of a patient with sexual dysfunction 299
Management 301
References 304
Chapter 36 Contraception 307Clinical 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 317Addressing infertility in psychiatric practice 317
Onward referral and further tests for infertility 318
Infertility treatments 318
References 318
Chapter 38 Sexually Transmitted Infection 319History 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 327Pneumonia and serious mental illness 329
Diagnostic principles 329
Management 332
References 335
Chapter 40 Influenza 337Diagnostic principles 338
Management 339
Preventing spread of influenza 341
References 342
Chapter 41 Urinary Tract Infection 343Urinary tract infection and serious mental illness 344
Diagnostic principles 344
Management 347
References 350
Chapter 42 Gastroenteritis 351Diagnostic principles 351
Management 354
References 356
Chapter 43 Viral Hepatitis 357Hepatitis B 357
Hepatitis C 361
References 364
Chapter 44 Tuberculosis 365Diagnostic principles 366
Management 369
References 371
Chapter 45 Human Immunodeficiency Virus 373Testing for HIV 374
HIV and the central nervous system 374
Antiretroviral therapy 375
References 380
Part 8 Respiratory 383 Chapter 46 Smoking Cessation 385Identifying 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 395Common 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 405Causes in the general population and people with serious mental illness 405
Diagnostic principles 406
Management 409
References 412
Chapter 49 Obstructive Sleep Apnoea 413Diagnostic principles 414
Management 415
References 416
Part 9 Neurology 419 Chapter 50 Delirium 421Management 426
References 429
Chapter 51 Autoimmune Encephalitis 431Autoimmune disease mechanisms 431
Clinical approach 432
Management 437
References 439
Chapter 52 Catatonia 441Diagnostic principles 442
Management 444
References 448
Chapter 53 Seizure Disorders 451Acute 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 461Diagnostic principles 463
Management 466
References 468
Chapter 55 Disorders of Sleep and Circadian Rhythm 471Definitions of common sleep disorders in psychiatric populations 471
Diagnostic principles 474
Management 476
References 477
Chapter 56 Extrapyramidal Side Effects 479Clinical approach 480
Management 482
References 483
Chapter 57 Tardive Dyskinesia 485Clinical approach 486
Management 487
References 489
Chapter 58 Tremor 491Clinical approach 491
Management 494
References 496
Part 10 Rheumatology and Musculoskeletal Health 497 Chapter 59 Low Back Pain 499Diagnostic principles 500
Management 502
References 503
Chapter 60 Arthritis 505Clinical approach 510
Management 512
References 512
Part 11 Ophthalmology 515 Chapter 61 Eye Disease 517Clinical 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 537The 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 551Physiology and symptoms of perimenopause 551
Clinical approach 552
Treatment 553
References 556
Part 13 Dermatology 559 Chapter 64 General Dermatology 561Infectious skin disease 561
Non-infectious skin disease 564
References 566
Chapter 65 Psychodermatology 569Psychiatric 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 575Indications 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 585Diagnostic principles 586
Management 590
Information to provide in a 'chest pain' referral to medical services 591
References 591
Chapter 68 Acute Shortness of Breath 593Diagnostic principles 593
Management 595
References 596
Chapter 69 Acute Coronary Syndrome 597Diagnostic principles 598
Management 602
References 603
Chapter 70 Arrhythmia 605Tachycardia 605
Bradycardia 605
Reference 608
Chapter 71 Hypertensive Crisis 609Diagnostic principles 609
Management 610
References 611
Chapter 72 Sepsis 613When to think sepsis 613
Septic shock 614
Management 614
Post-sepsis syndrome 615
References 616
Chapter 73 Acute Kidney Injury 617Categorisation of acute kidney injury 617
Diagnostic principles 620
Management 622
Psychiatric medication and acute kidney injury 622
References 623
Chapter 74 Diabetic Emergencies 625Hypoglycaemia 625
Diabetic ketoacidosis 626
Hyperosmolar hyperglycaemic state 627
References 627
Chapter 75 Acute Upper Gastrointestinal Bleeding 629Signs of acute upper gastrointestinal bleeding 629
Waiting for transfer 629
Handing over to the acute medical team 630
Chapter 76 Status Epilepticus 631Management 633
References 636
Chapter 78 Reduced Consciousness and Coma 637Clinical approach 637
References 640
Chapter 79 Thyroid Emergencies 641Hypothyroid crisis/myxoedema coma 641
Hyperthyroid crisis/thyroid storm 642
References 643
Chapter 80 Head Injury 645Clinical approach 645
Types of intracranial haemorrhage 649
References 650
Chapter 81 Acute Meningitis and Infective Encephalitis 651Meningitis 651
Infective encephalitis 653
References 655
Chapter 82 Stroke and Transient Ischaemic Attack 657Stroke 657
Diagnostic principles 658
Management 659
Transient Ischaemic Attack 660
Diagnostic principles 660
Management 661
References 661
Chapter 83 Overdose 663General 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 673Diagnostic principles 673
Management 675
References 677
Chapter 85 Neuroleptic Malignant Syndrome 679Diagnostic principles 679
Management 680
References 681
Chapter 86 Serotonin Syndrome 683Diagnostic principles 683
Management 684
References 685
Chapter 87 Emergencies in Obstetrics and Gynaecology 687Maternal 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 699History 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 709First steps 709
Airway (A) 711
Breathing (B) 711
Circulation (C) 711
Disability (D) 711
Exposure (E) 712
References 712
Index 713
David M. Taylor, BSc, MSc, PhD, FCMHP, FFRPS, FRPharmS, FRCP (Edin), is Director of Pharmacy and Pathology at the Maudsley Hospital; Professor of Psychopharmacology at King's College, London, UK. Fiona Gaughran, MD, FRCP(I), FRCP (Lon), FRCP (Edin), FRCPsych, FHEA, is Director of Research and Development at South London and Maudsley NHS Foundation Trust, where she is Lead Consultant for the National Psychosis Service; Reader in Psychopharmacology and Physical Health at King's College, London, UK. Toby Pillinger, MA (Oxon), BM BCh, MRCP, PhD, is an Academic Clinical fellow at the Institute of Psychiatry, Psychology and Neuroscience, King's College, London; South London and Maudsley NHS Foundation Trust, London, UK.
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