By Richard Mayou, Michael Sharpe, Alan Carson
This booklet presents either the facts and the assistance to let medical professionals to enhance their overview and administration of the mental and behavioural facets of the most typical difficulties proposing typically therapy. It summarises the hot examine facts and gives logic tips on how mental and psychiatric points of affliction will be addressed in the clinical session.
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Extra info for ABC of Psychological Medicine (ABC Series)
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.
Discussion, empathy, reassurance, and practical help are essential. Antidepressants have been shown to be effective in patients with cancer in randomised trials, although surprisingly few trials have been conducted. If in doubt about what drug to choose or about possible interactions with cancer treatment, it is important to check with a pharmacist. Specialist psychological intervention, such as formal cognitive-behavioural therapy, may also be required to treat persistent depression or anxiety.
Htm) Specialist treatments x x x x x x x Antidepressant drugs Effective drug treatment of pain, nausea, and other symptoms Problem solving discussion Cognitive-behavioural treatment of psychological complications Joint and family interviews to encourage discussion and planning Group support and treatment Cognitive-behavioural methods to help cope with chemotherapy and other unpleasant treatments Referral decisions x What specialist expertise in psycho-oncology is available at my local cancer centre or unit?