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Biomedical subjects

D R Lipsitt

Publications and source records attributed to D R Lipsitt.

At least 19 recordsLinked to original sources
PubMed1996

Primary care of the somatizing patient: a collaborative model.

Somatizing patients can be frustrating to treat, and their lengthy diagnostic workups represent a huge drain on health care resources. Cure of somatoform disorders is elusive; however, cost-effective, compassionate management is possible through collaboration between primary care physicians and psychiatrists or behavioral health care groups.

Diagnostic Errors↗
PubMed1991

Can we really teach psychosomatic medicine? A review of successes and failures.

Medicine, it seems, is lately in a state of perpetual crisis. Some would attribute the problem, at least in part, to the enduring heritage of Descartes, who imprinted dualistic notions of a separation of mind and body upon medical education and practice. The perspective of psychosomatic medicine has long been hailed as the remedy for flaws in the way medicine has been taught and practiced for at least five decades. If medicine as a humanistic endeavor is to take account of the whole individual, it must encompass biological, social and psychological dimensions of the person. Many attempts at curriculum reform and postgraduate education have had variable success in countering the dualism of medicine. This presentation will discuss the challenge, the problems and the future of psychosomatic teaching, with illustrations from a variety of educational experiments.

Curriculum↗
PubMed1987

Pain in the neck, face, and head. Role of the consultation-liaison psychiatrist.

The special nature of pain in the face, head, and neck is not emphasized in the psychiatric literature on chronic pain. Although chronic pain of all types and locations share many features the psychological and symbolic significance of the head in the development of self-esteem, body image, and interpersonal relationships often confers special characteristics of pain on this area. As psychiatric consultation is not likely to be requested for patients with head, face, and neck pain in the absence of blatant "psychiatric" problems, it behooves the psychiatrist to exercise his liaison functions to enhance patient care in the inpatient setting and to help physicians recognize the utility of early psychiatric assessment on an outpatient basis with patients not yet requiring hospitalization. A collegial relationship with internists, dentists, neurologists, and surgeons facilitates the psychiatrist's role as a "team participant," often more effective in providing brief diagnostic, therapeutic, and management recommendations for patients who are usually not psychologically-minded and reluctant to pursue ongoing psychiatric treatment. However, the consultation-liaison psychiatrist can play an important role in expanding his colleagues' awareness of the multiple meanings of pain and the accompanying illness behavior, provide pedagogic help in the interviewing or history-taking process, offer suggestions about psychopharmacologic and other drug treatment, and serve as a resource for appropriate referral to sources of a variety of chronic pain treatments, including biofeedback, acupuncture, and family consultation. To fulfill both his consultative and liaison functions, it is incumbent upon the psychiatrist to be knowledgeable as well about nonpsychiatric aspects of pain of the head, face, and neck. We must acknowledge also how much we yet do not know: for example, why the psyche "chooses" a locus of pain in the body; how an external (or internal) stimulus is converted via cognitive, neuroendocrine, enzymatic, and other pathways to a somatic representation; the biochemistry of pain reduction by naturally occurring and synthetic drugs; and what characteristics distinguish the continuously creative individual who sustains persistent pain with barely an utterance from another who may "cave in" to seemingly trivial distress that results in total invalidism.

Adult↗
PubMed1981

The family in consultation--liaison psychiatry.

This article calls attention to an underemphasized aspect of consultation-liaison psychiatry: the importance of the family in the management of illness response. Recent trends in family dynamics have focused primarily on family therapy and less on the critical role family members play in the "coloration," course, and outcome of acute episodes of illness. Case vignettes illustrate examples of intervention by liaison team members in the care of hospitalized medical-surgical patients. The authors suggest that a typology of family response to illness and hospitalization would offer a useful framework for diagnosis, evaluation, and management of the psychosocial aspects of illness. A coordinated approach by liaison team members is important to ensure comprehensive treatment.

Aged↗