Main description:

This eagerly awaited volume occupies an important place in the series Critical Issues in Psychiatry. Most mental health professionals are quite at home with ordinary day-to-day crises of clinical practice but relatively unprepared for the true psychiatric emergency. Such emergencies are too infrequent for most of us to experience a real sense of competence. On the other hand, emergency room psychiatrists as well as residents and other trainees have long wished for a truly comprehensive textbook that would cover the spectrum of emergency psychiatry. This book is just such a definitive and comprehensive volume for the specialist, while at the same time a clear, succinct, and comprehensive reference for the clinician. of emergency care, The authors consistently present a systematic model emphasizing the interconnection between the process of emergency interven tion and the specific features of clinical crisis. They are true to the principle that one's system of care should be built on priorities. It is immediately apparent that these are highly experienced clinicians as well as teachers. It is difficult to imagine a clinical situation that is not addressed by this book. It includes chapters on triage, assessment, and treatment planning; emer gencies associated with all the various psychopathologies; age groups from childhood to old age; the emergency management of violent and suicidal pa tients as well as rape and disaster victims; emergencies secondary to substance abuse and prescribed medications; psychotherapeutic and psychopharmacol ogic intervention; as well as the relevant legal, social, and community issues in emergency care.

Contents:

I. Emergency Care: An Overview.- I. The Concept of Emergency Care.- 1. Introduction.- 2. Emergency Psychiatry: A Systematic Approach.- 3. Emergency Psychiatry: The Process.- 4. Special Clinical Applications.- 5. Conclusion.- References.- II. The Process of Emergency Care.- 2. The First Few Minutes: Identifying and Managing Life-Threatening Emergencies.- 1. Introduction.- 2. Initial Assessment and Psychological Management.- 3. Determination of the Problem.- 4. Physical Management.- 5. Pharmacologic Management.- 6. Medical Management.- 7. Conclusion.- References.- 3. Legal Issues in a Psychiatric Emergency Setting.- 1. Introduction.- 2. Autonomy, Privacy, and Informed Consent.- 3. Informed Consent.- 4. Substitute Consent.- 5. Written versus Oral Consent.- 6. Emergencies.- 7. Confidentiality.- 8. Special Mental Health Laws.- 9. Dangerousness.- 10. The Management of Dangerousness.- 11. Least Restrictive Alternative.- 12. Right to Treatment.- 13. Right to Refuse Treatment.- 14. Legal Liability.- 15. Standards of Care.- 16. Suicide.- 17. The Hardest Part.- Notes.- 4. General Principles of Pharmacologic Management in the Emergency Setting.- 1. Introduction.- 2. Evaluating the Patient and Choosing Medication.- 3. Applying General Principles of Drug Use to the Emergency Setting.- 4. Forming a Relationship with the Patient.- 5. Conclusion.- References.- 5. The Therapeutic Stance.- III. Patients and Clinical Syndromes 1: Potentially Life-Threatening.- 6. Emergency Management of Potentially Violent Patients.- 1. Introduction.- 2. General Assessment Issues.- 3. Assessing and Managing the Potentially Violent Patient.- 4. Treatment Options.- 5. Disposition.- 6. Conclusion.- References.- 7. Emergency Care of Suicidal Patients.- 1. Introduction.- 2. Clinical Checklist for Assessment.- 3. Management.- 4. Treatment Planning.- 5. Conclusion.- Appendix: The Rating Scales.- References.- IV. Patients and Clinical Syndromes 2: Medication-Related/Toxic Origins.- 8. Alcohol Use and Abuse.- 1. Introduction.- 2. Definitions.- 3. Pharmacology.- 4. Acute Intoxication.- 5. Sequelae of Chronic Intoxication.- 6. Alcohol Withdrawal.- 7. General Approach to Treatment Planning.- 8. Conclusion.- 9. Drug Use and Abuse.- 1. Abuse of Opiate Drugs.- 2. Abuse of Central Nervous System (CNS) Depressants.- 3. Abuse of CNS Stimulants/Amphetamines.- 4. Abuse of CNS Stimulants/Cocaine.- 5. Abuse of Hallucinogens.- 6. Phencyclidine (PCP) Abuse.- 7. Marijuana Use and Abuse.- 8. Inhalant Abuse.- 9. Summary.- 10. Emergency Presentations Related to Psychiatric Medication.- 1. Introduction.- 2. Lithium Toxicity.- 3. Extrapyramidal Effects.- 4. Anticholinergic Syndromes.- 5. Conclusion.- References.- V. Patients and Clinical Syndromes 3: Behavioral, Cognitive, and Affective Disturbances.- 11. Acute Psychoses.- 1. Overview.- 2. Triage.- 3. Assessment.- 4. Differential Diagnosis.- 5. Management.- 6. Patient-Evaluator Interaction.- 7. Treatment Planning.- References.- 12. Presentation of Depression in an Emergency Setting.- 1. Introduction.- 2. Assessment.- 3. Management and Disposition.- 4. Clinical Applications.- 5. Summary.- Selected Reading.- 13. Emergency Care of Anxious Patients.- 1. Introduction.- 2. Assessment.- 3. Treatment.- 4. Conclusion.- References.- VI. Patients and Clinical Syndromes 4: Victims of Situational Crises.- 14. Psychological Management of Disaster Victims.- 1. Introduction.- 2. Psychological Reactions to Disasters.- 3. Assessment.- 4. Management.- 5. Conclusion.- References.- 15. Emergency Care of Rape Victims.- 1. Introduction.- 2. Definitions.- 3. Popular Myths versus the Facts.- 4. The Rape Crisis.- 5. Management.- 6. Conclusion.- References.- 16. Emergency Care of Battered Women.- 1. Introduction.- 2. Definitions.- 3. Background.- 4. The Victims, Their Families, and the Abusers.- 5. The Emergency Presentation.- 6. Assessment and Management of Identified Victims.- 7. Conclusion.- References.- 17. Child Abuse and Neglect.- 1. Introduction.- 2. Dynamics of Child Abuse and Neglect.- 3. Legal Issues.- 4. Evaluation and Intervention.- 5. Follow-Up.- 6. Summary.- VII. Patients and Clinical Syndromes 5: Special Populations.- 18. Psychiatric Emergencies in Children and Adolescents.- 1. Introduction.- 2. Description of Childhood Psychiatric Emergencies.- 3. General Considerations.- 4. The Emergency Intervention.- 5. Classification of Psychiatric Emergencies in Childhood and Adolescence.- 6. The Specific Syndromes.- 7. Suicidal Behaviors in Children and Adolescents.- 8. Homicidal Behaviors in Children and Adolescents.- 9. Firesetting.- 10. Runaway Children and Adolescents.- 11. School Refusal.- 12. Other Problems.- 13. Conclusion.- References.- 19. Elderly Psychiatric Emergency Patients.- 1. Introduction.- 2. Overview.- 3. Working with the Geriatric Patient.- 4. Assessment, Management, and Treatment.- 5. Clinical Presentations.- 6. Conclusion.- References.- VIII. Special Settings, Circumstances, and Approaches.- 20. Managing Emergencies in the Practice of Psychotherapy.- 1. Introduction.- 2. Types of Genuine Emergencies.- 3. Pseudoemergencies.- 4. Management.- 5. Conclusion.- Postscript.- 21. General Hospital Psychiatric Emergency Services.- 1. Introduction.- 2. Organization of Services.- 3. Staffing Patterns.- 4. Conclusion.- References.- 22. Psychiatric Emergency Care in Resource-Poor Areas.- 1. Introduction.- 2. The Intervention.- 3. Conclusion.- 23. Psychiatric Home Visiting Services.- 1. Introduction.- 2. Function, Composition, and Structure.- 3. Intervention Techniques.- 4. Conclusion.- 24. The Telephone in Psychiatric Emergencies.- 1. Introduction.- 2. Hotlines.- 3. Crisis Centers and Other Emergency Facilities.- 4. Personnel.- 5. The Emergency Call.- 6. Conclusion.- References.- 25. Role of Family and Networks in Emergency Psychotherapy.- 1. Introduction.- 2. Who Are the Significant Others?.- 3. Assessment.- 4. Management.- 5. Conclusion.- References.- 26. Crisis Groups.- 1. Introduction.- 2. Why a Group?.- 3. Review of the Literature.- 4. Patient Evaluation and Selection.- 5. The Open Group in General.- 6. Technical Aspects.- 7. Treatment Outcome.- 8. Summary.- References.