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Book Forum: Consultation-Liaison Psychiatry   |    
The American Psychiatric Publishing Textbook of Consultation-Liaison Psychiatry: Psychiatry in the Medically Ill, 2nd ed.
STEVEN S. SHARFSTEIN, M.D.
Am J Psychiatry 2002;159:1796-1796. doi:10.1176/appi.ajp.159.10.1796
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Baltimore, Md.

Edited by Michael G. Wise, M.D., and James R. Rundell, M.D. Washington, D.C., American Psychiatric Publishing, 2002, 1,160 pp., $175.00.

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The heft of this textbook is based on the intellectual weightiness of the more than 100 contributors who bring together a tradition of psychosomatic medicine with the practical science of modern consultation-liaison psychiatry. Nothing challenges the biopsychosocial skills of a psychiatrist more than working in a complex medical/surgical environment, making a psychiatric diagnosis in a medically ill patient, and communicating with other physicians and other medical staff. This textbook brings together the theory and practice of consultation-liaison psychiatry, which underscores efforts of consultation-liaison psychiatrists to attain added qualification status for the practice of psychiatry in the context of the medically ill.

Many 19th-century medical books asserted that an individual could not be simultaneously medically ill and insane because the human body would not be able to sustain the combination. Now we know that complex psychiatric and medical comorbidities are major culprits in the relentless cost escalation of medical care, and the cost-effectiveness of consultation-liaison psychiatric interventions has been demonstrated time and again. The chapter by Hall et al. in this book on the cost-effectiveness of the consultation-liaison service is both an excellent summary of the research and a practical guide for the psychiatrist in asserting the value of psychiatric care and advocating for adequate reimbursement and support in the general medical setting.

The book is divided into four parts: General Principles, Psychiatric Disorders in General Hospital Patients, Clinical Consultation-Liaison Settings, and Treatment. Unlike a concise guide one can carry around in one’s pocket while traveling the wards and intensive care units, this book nicely fits on the office shelf for more in-depth reading and understanding when time permits.

For those of us who love both medicine and psychiatry, consultation-liaison has been a great, exciting experience. For me, 20 years ago at the National Institutes of Health, doing this work was extremely interesting and stimulating in a complex research environment with patients who suffered from complex medical illness. Being helpful to patients, families, and consulting physicians while knowing that you would see the patient only once or twice required a special set of skills and was rewarding in its own right. I did not have available a textbook such as this opus of Wise and Rundell; this superb compilation of what we have learned in the last quarter-century would have been of great benefit.

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