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Medical Complications of Psychiatric Illness

Claire Pomeroy, M.D., James E. Mitchell, M.D., James L. Roerig, Pharm.D., B.C.P.P., and Scott J. Crow, M.D.

  • ISBN 978-0-88048-807-5
  • Item #8807

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Psychiatric patients have an increased rate of morbidity and mortality due to physical illnesses. Distressingly, psychiatrists fail to recognize these comorbid medical illnesses in nearly half of all cases. All too often, the physical illness may be causing or exacerbating the psychiatric symptoms. Furthermore, the psychiatric condition itself and iatrogenic complications of medication or other treatments can result in serious medical pathology.

Until now, most psychiatrists have deferred the general medical care of their patients to other practitioners. Yet because psychiatrists are uniquely positioned to provide health care that bridges somatic and mental conditions, they are increasingly being called on to ensure that their patients also receive adequate medical care.

This breakthrough text responds to that call to action from a perspective unique in the literature: It focuses on the medical complications of psychiatric illnesses, rather than the more typical psychiatric complications of medical illnesses.

This concise yet comprehensive book is intended for practitioners who treat adult medical patients. It is divided into two main sections:

  • Health Care of Psychiatric Patients, organized by recommendations for routine medical management and reproductive health, focuses on the general health care maintenance of psychiatric patients with medical illnesses. Also discussed are the unique reproductive health needs of psychiatric patients, who are often at increased risk of coercive or abusive sexual relationships, rape and other sexual assaults, unplanned pregnancy, pregnancy complications, and sexually transmitted diseases.
  • Psychiatric Disorders, organized by diagnostic groupings, focuses on those psychiatric disorders—affective, anxiety, and somatoform disorders and dementia; schizophrenia and other psychotic disorders; Munchausen's syndrome and other factitious disorders; self-injurious behavior; eating disorders; and alcohol and drug abuse—that most clearly can have medical complications.

Using extensive notes and tables throughout, these distinguished contributors have created far more than just another compendium of medical illnesses that can present with psychiatric symptoms. Here you'll find a practical, detailed roadmap that will be welcomed not only by students, residents, and clinicians working with adult psychiatric patients who develop medical complications, but also by practitioners who manage psychiatric patients in a general medical practice.


  • Contributors
  • Introduction
  • Part I: Health Care of Psychiatric Patients
  • Chapter 1. Routine Medical Evaluation and Health Maintenance
  • Chapter 2. Reproductive Health
  • Part II: Psychiatric Disorders
  • Chapter 3. Affective, Anxiety, and Somatoform Disorders and Dementia
  • Chapter 4. Schizophrenia and Other Psychotic Disorders
  • Chapter 5. Munchausen's Syndrome and Other Factitious Disorders
  • Chapter 6. Self-Injurious Behavior
  • Chapter 7. Eating Disorders
  • Chapter 8. Alcohol and Drug Abuse
  • Index

About the Authors

Claire Pomeroy, M.D., M.B.A., is Professor and Chief of Infectious Diseases in the Department of Internal Medicine at the University of Kentucky College of Medicine. She also serves as Associate Dean for Research and Informatics and Associate Chief of Staff at that institution. Her research interests focus on host immune function in disease, including alterations observed in patients with anorexia nervosa and other eating disorders. Dr. Pomeroy is the author of more than 100 articles and book chapters.

James E. Mitchell, M.D., completed his undergraduate studies at Indiana University and his medical education at Northwestern University in Chicago. He took his residency training at the University of Minnesota, and following a period of private practice, joined the faculty there, rising to the level of Professor and Director of Adult Psychiatry. In 1996, he moved to Fargo, North Dakota, where he assumed the Presidency of the Neuropsychiatric Research Institute and the Chairmanship of the Department of Neuroscience at the University of North Dakota School of Medical and Health Sciences. He is known primarily for his research in the area of eating disorders.

James L. Roerig, Pharm.D., B.C.P.P., is an Associate Professor of Psychiatry in the Department of Neuroscience at the University of North Dakota School of Medicine and Health Sciences, and is a Research Scientist at the Neuropsychiatric Research Institute in Fargo, North Dakota.

Scott Crow, M.D., is Associate Professor of Psychiatry and Director of the Eating Disorders Clinic at the University of Minnesota, and is currently President of the Minnesota Psychiatric Society.

This is a wonderful book that every psychiatrist should have on their shelf. This book will help psychiatrists obtain the best medical care for their patients by helping them know what disorders to look for, what other doctors to consult, and what tests to order.—Michelle Field-Chez, M.D.,, Doody's Health Science Book Review Journal, 8/1/2003

Medical complications of psychiatric disorders may be overlooked by either the psychiatrist or the internist. This book provides a remedy by covering the symptoms and signs of medical disorders associated with the most common psychiatric syndromes. It is an excellent source of important information for both the psychiatrist and the internist.—Stewart Agras, M.D., Professor of Psychiatry, Stanford University School of Medicine, Stanford, California

This book will be of great value to practicing psychiatrists in that it addresses a topic of considerable clinical importance; namely, the general medical management of patients with psychiatric disorders. In these days of early specialization it is particularly important to have a comprehensive and up-to-date resource of this type. The authors are to be congratulated on their successful treatment of a neglected topic.—Christopher G. Fairburn, M.D., Professor of Psychiatry, Oxford University, Oxfordshire, United Kingdom

This is an excellent and comprehensive overview of medical complications of psychiatric illness. This volume should be on the bookshelf of every practicing psychiatrist.—Walter H. Kaye, M.D., Professor of Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania

The authors have put together an impressive book on psychiatric illness in the context of the wide medical field. Did you know that diabetes mellitus is more frequent and asthma and hayfever less frequent in schizophrenics? The book presents in detail medical complications of affective and anxiety disorders, schizophrenia and other psychotic disorders, eating disorders, and alcohol and drug abuse. It provides substantial information on medical complications of these psychiatric illnesses. While it supplies thoroughly researched and detailed information, it also gives an excellent overview. The book is a substantial contribution to the field and it should be of interest not only to psychiatrists but also to any medical doctor.—Manfred M. Fichter, M.D., Professor of Psychiatry, University of Munich and Roseneck Hospital, Centre for Behavioral Medicine, Munich, Germany

This handbook presents an essential source of up-to-date information on medical complications of psychiatric disorders. Practicing psychiatrists and other mental health care professionals will find this book invaluable. The authors authoritatively cover both general health care issues of psychiatric patients and medical consequences of specific mental disorders.—Professor Hans W. Hoek, M.D., Parnassia, The Hague Psychiatric Institute, The Netherlands

Psychiatry is part of medicine. In fact many would say the most interesting and rewarding part. Psychiatric illnesses are like other illnesses and require doctors for their optimal management. The physical and medical complications of psychiatric illnesses which often manifest are among the reasons for this. Professor Mitchell's book Medical Complications of Psychiatric Illness is very timely. He is a distinguished clinician and academic well-known for his compassionate way of dealing with patients, and his great erudition. Amongst his major interests are the eating disorders, and they are particularly good examples of psychiatric illness to which medical manifestations are strongly linked. I recommend Professor Mitchell's new book particularly to psychiatrists, but also to family physicians, internists, and medical students.—Pierre Beumont, A.M., Professor of Psychological Medicine, University of Sydney, Sydney, Australia

Those who do not practice consultation-liaison psychiatry regularly will likely find this text to be an effective tool with which they may better assess and treat their patients, exactly as the authors of the book intended. The consultation-liaison psychiatrist may utilize this text as a teaching tool, whether he is teaching residents, students, or internists. The tremendous scope of medical illness in psychiatric patients makes it difficult to cover any one illness in detail, but this text serves as a useful jumping-off point to further explore the specifics of a particular illness from the exhaustive list of references the authors have provided.—Autumn Ning, M.D.,, Psychosomatics, 8/1/2003

Overall, Medical Complications of Psychiatric Illness is a useful contribution to the literature because it highlights the importance of health maintenance as well as the identification and the management of medical problems in psychiatric patients. The book is well written, well referenced, and concise. It is a practical resource for practicing psychiatrists, and it would also be useful for psychiatry residents, medical students, and other mental health staff. In addition, there is sufficient value for primary care physicians and/or hospital physicians who care for psychiatric patients.—Donald M. Hilty, M.D., and Thomas S. Nesbitt, M.D., American Journal of Psychiatry, 8/1/2003

Medical Complications of Psychiatric Illness is an important book. It is the first to systematically address the medical comorbidity of patients with psychiatric illness, a critical component of comprehensive care for this vulnerable population. The book is a very useful practical guide for the medical care of psychiatric patients. It is concise and easy to read, and both psychiatrists and primary care providers will be able to use it as a quick reference.—Lydia Chwastiak, M.D., M.P.H., Psychiatric Services, 8/1/2003

This is a small, reasonably priced volume that should be in the libraries of all physicians.—Thomas N. Wise, M.D.,, The Journal of Nervous and Mental Disease, 8/1/2003

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