Seminars in liaison psychiatry, 2nd edn

The second edition of Seminars in Liaison Psychiatry forms part of the College Seminars Series of the Royal College of Psychiatrists. For those of you who are unfamiliar, as I was, with this series, a comprehensive list of their titles can be found on the website of the Royal College of Psychiatrists; the list includes a variety of topics aimed at both accredited specialists and those in training.

This particular title is available in paperback in an attractive yellow-orange cover. Although running to 512 pages, including the appendices and index, it is a realistic size for both dipping into and a sustained read. On examining the contents, the topics covered are both comprehensive and immediately familiar to anyone working in an acute speciality. From the point of view of acute and general medicine, there are chapters entitled the ‘Psychological reaction to physical illness’, ‘Alcohol and substance abuse in the general hospital’ and one that I am sure we will all turn to early on, ‘Medically unexplained symptoms’. Further on, there are chapters entitled ‘Psycho-oncology’ and ‘Palliative care psychiatry’. The final chapter is ‘Multiple choice questions and extended matching items’. Although this is clearly intended for those specializing in psychiatry, it is a useful tool for all of us trying to reinforce our learning. As well as a comprehensive list of abbreviations, there is an extensive bibliography at the end of each chapter.

Individual chapters are clearly laid out. There is an introduction followed by major topics within the chapter, which is divided into subsidiary sections. These are demarcated by changes in font size and type, and the format is consistent throughout. As well as plain text, bullet points are used to emphasize points, which might otherwise be lost in a block of text; separate boxes highlighted in grey are used to provide summaries at intervals throughout the text.

For the general and acute physician, chapter 7, ‘Alcohol and substance abuse’, affords perhaps an easy entrée to the book and its style, because it will be a subject that will be more or less familiar. It acts as a yardstick for the rest of the book and begins with an overview of the problem, and the figures quoted regarding the scope of the problem are familiar. I might take exception to the order in which physical problems associated with alcohol abuse are quoted in Box 7.2, but this is a book on liaison psychiatry, not acute or general medicine. The chapter goes on to discuss problems encountered in opiate users, amphetamine and cocaine use, and benzodiazepine misuse and dependence. It finishes with comments relating to the adverse effects on the general health of alcohol and substance misusers.

Another chapter that caught my eye was ‘Disaster management’. The chapter begins with a review of early interventions, including their use during the First and Second World Wars, and highlights the benefits of intervening within hours of a traumatic experience. There then follows a discussion that includes evidence that debriefing can lead to more long-term problems than if no intervention is performed. Although I have limited experience of disaster management, this seemed a well-balanced chapter and anyone working on an acute medical unit should be at least apprised of the options available.

Of more general use are the chapters entitled ‘Capacity and consent’, ‘Psychological reaction to physical illness’ and ‘Medically unexplained symptoms’. Although the latter is always challenging, this chapter provides a succinct overview of the major categories of these disorders. The chapter on capacity has clear subheadings, starting with assessment, moves on to the situation when a patient lacks capacity and sets the Mental Capacity Act in context. Restraint and deprivation of liberty are discussed and there follows a section on the Bournewood case, in which specific case law is quoted. Deprivation of liberty safeguards are discussed at some length, and included is the context of acute illness. Again, the chapter is clearly laid out, with both bullet points and boxes to highlight the important points.

Thought provoking is the chapter entitled the ‘Psychological reaction to illness’. I suspect that most of us have to work within the constraints of the environment with which we are provided. The dislocation of being admitted to hospital is considered and the following section deals with depression in chronic illness, perhaps something we should all be more cognisant of.

Much thought and work has gone into each of the chapters of this well-written and well laid-out book. I would commend it to all those working in acute medical specialities, in addition to its main target audience of established and trainee liaison psychiatrists. Indeed, I would go so far as to say that it is an essential addition to the library of the acute physician.

• © 2013 Royal College of Physicians