Consultation-liaison (C-L) psychiatry, which focuses on the psychiatric care of patients in medical-surgical settings, has evolved into an increasingly recognized subspecialty. The Academy of Psychosomatic Medicine, using consultants and a database created from 49 extant C-L fellowship programs, has specified goals and standards for C-L fellowship training. These standards include organizational issues, clinical skills, a didactic curriculum, research training, and evaluation issues. The important contributions of C-L psychiatry to medical education are emphasized.

Education↗

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A type of disability neurosis: the Humpty Dumpty syndrome.

Eight selected male patients with disability neurosis are presented. Past histories were remarkably similar in that they indicated childhood deprivation, premature independence and early excessive responsibility. It is hypothesized that these men reacted to injury or illness with a crumblin of previous defenses against massive dependency wishes and that their symptoms are perpetuated by ambivalent relationships with employers and physicians. Treatment needs to be prophylactic before the symptoms become so entrenched as to be refractory to therapeutic intervention.

Adult↗