ABC of Psychological Medicine (ABC Series) by Richard Mayou, Michael Sharpe, Alan Carson

By Richard Mayou, Michael Sharpe, Alan Carson

This booklet presents either the proof and the information to allow medical professionals to enhance their overview and administration of the mental and behavioural features of the commonest difficulties featuring quite often treatment.

It summarises the new study facts and gives logic information on how mental and psychiatric points of affliction could be addressed in the scientific session.

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It may involve hospital attendance but also unpleasant surgery, radiotherapy, or chemotherapy. Side effects include hair loss and disfigurement. Patients worry about whether treatment is working and are likely to become distressed at times of apparent treatment failure. End of treatment—At the end of apparently successful treatment some patients can experience “rebound” distress associated with the fear that the cancer might recur or spread. The ending of a prolonged relationship with the cancer service staff can lead to a sense of loss and vulnerability.

22 Assessment of chronic multiple functional somatic symptoms x Elicit a history of the current complaints, paying special attention to recent life events x Find out what the patient has been told by other doctors (as well as friends, relatives, and alternative practitioners). Does this accord with the medical findings? ” Management strategy for patients with chronic multiple functional somatic symptoms x Try to be proactive rather than reactive—Arrange to see patients at regular, fixed intervals, rather than allowing them to dictate timing and frequency of visits x During appointments, aim to broaden the agenda with patients— This involves establishing a problem list and allowing patients to discuss relevant psychosocial problems x Stop or reduce unnecessary drugs x Try to minimise patients’ contacts with other specialists or practitioners—This will reduce iatrogenic harm and make containment easier if only one or two practitioners are involved x Try to co-opt a relative as a therapeutic ally to implement your management goals x Reduce your expectation of cure and instead aim for containment and damage limitation x Encourage patients (and yourself) to think in terms of coping and not curing Explanations to the patient Present patient’s problems as a summary with an invitation to comment: “So let me see if I’ve understood you properly: you have had a lot of pain in your abdomen, with bloating and distension for the past four years.

These often occur when those involved in treatment are working under considerable pressure. Clear procedures for training and support of staff are essential. For those working in large emergency services the provision of regular specialist support is advisable. Types of trauma The pattern of consequences varies with the type of trauma experienced. All services that see trauma emergencies need management plans for psychological as well as medical care. This includes planning for major events in which there are many victims and for the much commoner road traffic and other incidents in which there are often several victims, some of whom may be severely injured and who may well be related or know one another.

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