Lippincott’s Primary Care Psychiatry

edited by Robert M. McCarron, DO; Glen L. Xiong, MD; and James A. Bourgeois, OD, MD. In book series: Primary Care Series. Lippincott Williams & Wilkins, Baltimore, MD, 2009, 272 pages, $85.00 (hardcover with online access and office chart).

More than half of all psychiatric care delivered in this country is provided by primary care practitioners (PCPs). In fact, PCPs write well over 80% of all antidepressant prescriptions, and the number is likely to increase over the next decade. Unfortunately, most PCPs have little formal training in accurate diagnosis and effective treatment of those who have severe mental illness.

The University of California, Davis, is nationally known for work in the area of primary care psychiatric training. It is one of 2 programs in the country to have 2 “dual training” residency programs, in psychiatry and medicine as well as psychiatry and family medicine. The Medicine and Psychiatry faculty has recently published Lippincott’s Primary Care Psychiatry as part of the Primary Care Series. Included with the book is access to a companion Web site (psychiatryforpcp.com). The Web site includes fully searchable text and patient handouts for various psychiatric disorders.

The text reviews the basics of psychiatric disorders for practicing primary care physicians, covering the highlights of clinical presentation, differential diagnosis, relevant laboratory data, treatment, and advice on referring to a psychiatrist. The introductory chapter provides practical tips for the primary care psychiatric interview and introduces the AMPS Screening tool, which is used to quickly screen for the most common psychiatric disorders (anxiety, mood, psychosis, and substance use disorders).

The chapters in this well-edited text cover commonly encountered disorders and follow a consistent format throughout. They are structured using the following sections: Introductory Case; Clinical Highlights; Clinical Significance; Diagnosis; Differential Diagnosis, including “Not to Be Missed” points; Biopsychosocial Treatment, including “When to Refer”; Practice Pointers case studies; ICD-9 codes, and Practical Resources. Lippincott’s Primary Care Psychiatry includes chapters on depression, anxiety, psychosis, substance use disorders, eating disorders, personality disorders, and unexplained physical symptoms. Other chapters focus on topics including geriatric psychiatry, sleep disorders, suicide and violence risk assessment, and cultural considerations.

This well-organized book clearly presents a large volume of information in easily understood parts. Case vignettes keep the material engaging. Because of their dual training and practice at this clinical interface, the authors have unique insight into the needs of primary care practitioners. This book will be useful to family practitioners, internists, nurse practitioners, physician assistants, and mental health practitioners to understand, diagnose, and effectively treat the most common psychiatric problems seen in the primary care office setting.

William M. Regan, MD, JD

Bill.Regan@tn.gov

Author affiliation: Middle Tennessee Mental Health Institute, Nashville. Potential conflicts of interest: None reported.