Psychiatric Emergencies in Family Practice

1 Deluded Patients.- Delusions of jealousy.- Grandiose delusions.- Hypochondriacal delusions.- Possession of thought.- Delusions of persecution (paranoid delusions).- Delusions of reference.- Delusions of guilt, ruin and poverty.- Diagnosis.- Management.- Need for admission.- Examples.- 2 Suspicious Patients.- The sorting process.- Interviewing the suspicious patient.- Special problems with suspicious patients.- The paranoid personality.- The paranoid reaction.- Paranoid psychoses.- Litigious paranoia.- Paranoid jealousy (Othello syndrome).- Paranoid schizophrenia.- Delusional misidentification.- Paraphrenia.- Intoxications.- Drug induced delirium.- Toxic psychoses.- Primary mood disorder.- Physical illness.- Organic brain disease.- 3 Alcoholic Patients.- Acute problems in family practice.- Alcoholism and mental disorders.- Treatment of alcohol withdrawal.- Early signs of alcohol abuse.- Alcohol dependence syndrome: definition of problem drinking.- Social effects of alcohol abuse.- Physical effects of alcohol abuse.- Management of patients with drinking problems.- Alcohol — the substance and its metabolism.- 4 Hallucinated Patients.- Hallucinations in children.- Hallucinations in young adults.- Hallucinations in middle age.- Hallucinations in the elderly.- Hallucinogens.- Solvent abuse (glue sniffing).- Hallucinations from prescribed drugs.- Alcoholism.- Drug withdrawal.- Epilepsy.- Hysteria.- Manic depression.- Organic states.- Paranoid states.- Puerperal psychosis.- Schizophrenia.- Dementia.- Sensory deprivation.- 5 Depressed Patients.- The agitated patient.- Management.- The withdrawn patient.- Management.- The suicidal patient.- Management.- Presenting symptoms of depression.- Central symptoms of depression.- Peripheral symptoms of depression.- The personality.- 6 Suicide and Parasuicide.- The sorting process.- Diseases which may lead to self-harm.- Affective psychoses.- Schizophrenia.- Neurotic and personality disorders.- Acute reactions to stress.- Organic states.- Withdrawal of amphetamines or cocaine.- Situations of increased risk.- 7 Hysterical Patients.- Hysterical symptoms.- Vulnerability factors.- Types of patient.- Hysterical personality.- Amnesia.- Fugues: diagnostic features.- Multiple personality.- Stupor: diagnostic features.- Fits: diagnostic features and differential diagnosis from epilepsy.- Faints, falls and dizziness.- Motor dysfunction.- Sensory dysfunction.- Gastrointestinal presentations.- Gynaecological or genitourinary presentations.- Cardiorespiratory presentations.- Musculoskeletal presentations.- Dermatological presentations.- Psychiatric presentations.- Management.- Children and hysteria.- 8 Frightened Patients.- Fear occurring in:.- Physical illness.- Terminal illness.- Anxiety disorders.- Phobic disorders:.- Agoraphobia.- Social phobias.- Animal phobias.- Depersonalisation.- Hypochondriasis.- Obsessions.- Post-traumatic stress disorder.- Epilepsy.- Organic disorders.- Acute organic psychiatric syndromes.- Use and abuse of drugs.- 9 The Presentation and Care of the Rape Victim.- Background.- Rape trauma syndrome.- Counselling the rape victim.- Management:.- Medical.- Practical.- Psychological.- 10 Psychiatric Emergencies in Children and Adolescents.- Emotional disorders:.- Hysteria.- Acute phobic reactions.- Sleep and habit disorders.- Attempted suicide.- Wrist slashing.- Conduct disorders:.- School refusal.- Stealing.- Running away.- Illicit drug taking.- Acute psychoses and their managment.- Anorexia nervosa.- Child abuse.- Sexual problems.- Schoolgirl pregnancy.- Post-traumatic stress disorder.- Life-threatening illness and dying children.- 11 Disturbed Adolescents.- Principles of assessment.- Process of assessment.- Specific types of disturbance in adolescence.- Delinquent behaviour.- Violent behaviour.- Runaways.- Oppositional adolescents.- Anxiety and panic.- School refusal.- Depression.- Withdrawn behaviour.- Anorexia nervosa.- Parasuicide.- Psychotic disturbance.- Sexual deviations and problems:.- Exhibitionism.- Transvestitism.- Transsexualism.- Sexual abuse of adolescents.- High-risk families.- 12A The Bereaved Adult.- Anticipation.- Impact.- Normal grief.- Determinants of outcome.- Counselling in early bereavement.- Counselling in later bereavement.- 12B The Bereaved Child.- Preparation and explanation.- Substitute care.- Should children visit a dying parent in hospital?.- Should children go to the funeral?.- Therapeutic intervention.- Other and special bereavements: loss of sibling, grandparents, neighbours, friends, teachers, pets.- Violent death.- Divorce, separation, loss of limb or bodily function.- Services available to the bereaved child and family.- 13 Vulnerable Students.- Emergency presentation.- Acute reactive “unhappiness” or “depression”.- Work panic and examination stress.- Colleague referrals.- Relationship break-up.- The morning after.- The manipulative episode.- The manic episode.- The diabetic.- General matters.- Social.- Emotional.- Medical.- Academic — dynamics of success and failure.- Needs.- Curiosity.- Understanding.- Transfer.- Maturity.- Test out.- Degree.- Grants.- Medical status.- Confidentiality.- Occupational hazards of being a student.- The problem area.- The role of listening in treatment.- 14 Dangerous Patients.- Sorting process.- Violence in the community.- Family violence:.- Morbid jealousy.- Baby battering.- Wife battering.- Granny bashing.- Familial homicide:.- The depressive murderer.- Parents who kill their children.- 15 Demented Patients.- Causes of dementia.- Clinical features.- End results.- Diagnosis.- An abbreviated mental test.- Depression and dementia.- The Diogenes syndrome.- Parkinsonism and dementia.- Management:.- Specific and symptomatic.- Prognosis.- 16 Problems Arising after Therapeutic Abortion.- Common presenting symptoms.- Timing of presentation.- Approach to the interview.- Factors causing symptoms.- Overt reasons for the unwanted pregnancy.- Covert reasons for the unwanted pregnancy.- Categories of patients.- Counselling.- Repeated abortion.- 17 Puerperal Emergencies.- Acute mental illness in the mother.- Puerperal psychosis.- Puerperal and post-natal depression.- Threats to the safety of the newborn.- Incompetent mothering.- Irritable mothers.- Delayed maternal attachment.- Rejection of the baby.- Obsession of infanticide.- Child abuse.- Infanticide.- 18 Emergencies Arising from the Non-Medical Consumption of Drugs.- Definitions.- Types of emergency.- Classification by pharmacological action.- Classification by style of use.- Overdoses and their management:.- Opioids.- Sedative/tranquilliser drugs.- Volatile inhalants.- Stimulants.- Psychedelic drugs.- Acute adverse reactions and their management:.- Opioids.- Sedative/tranquilliser drugs.- Psychedelic drugs.- Stimulants.- Drug withdrawal emergencies and their management:.- Sedative/tranquilliser drugs.- Opiates.- Stimulants.- Complications of drug misuse:.- Syringe transmitted infections.- Local infection trauma.- Pregnancy and drug addiction:.- Management.- Counselling on drug problems.- 19 Excited Patients.- The sorting process.- New excitement.- Recurrent excitement.- Assessment.- Management:.- Psychological.- Pharmacological.- Forensic considerations.- 20 Confused Patients.- The distinction between delirium and uncomplicated dementia.- Symptoms and signs of delirium.- The causes of delirium.- Delirium in children and adults.- Delirium in the elderly.- Mental Status Testing.- Other causes of “confusion”.- Investigations.- Management.- 21 Moody Patients.- The sorting process.- Lifelong moodiness:.- Diurnal variation.- Hysterical personality.- Psychopathic personality.- Cyclothymic personality.- Recent moodiness.- Psychiatric illness:.- Depressive illness.- Mania.- Schizophrenia.- Physical illness:.- Cerebral lesions.- Endocrine disorders.- Hormones.- Drugs.- Life rhythms.