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Book Review

Clinical Manual of Psychosomatic Medicine: A Guide to Consultation-Liaison Psychiatry, 2nd ed

Catherine Chiles, MD

Published: May 15, 2013

Clinical Manual of Psychosomatic Medicine: A Guide to Consultation-Liaison Psychiatry, 2nd ed

by Kemuel L. Philbrick, MD; James R. Rundell, MD; Pamela J. Netzel, MD; and James L. Levenson, MD. American Psychiatric Publishing, Inc, Arlington, Virginia, 2012, 542 pages, $68.00 (paper).

As a follow-up to the 2005 manual by Wise and Rundell,1 this second edition pulls out all the stops and has all the requisite bells and whistles!

This edition evokes the term comprehensive while maintaining its utility as a "handbook." The second edition pays tribute to the educational legacy of Michael G. Wise for a series of concise guides2 that are the earlier generations of these clinical manuals. The new text is wholly restructured with the patient, the practitioner, and the student of Psychosomatic Medicine in mind. Prior chapters are reworked into a brand new schema of 4 domains: General Considerations, Syndromes, Treatments, and Unique Issues in Psychosomatic Medicine Settings.

The introductory General Considerations section includes health care systems issues extant in "Effective Psychiatric Consultation" and "Medicolegal Issues"; the latter chapter has been brought to the fore of the text and updated, giving it the proper weight of highly utilized information (eg, guardianship, capacity, restraint) in consultation settings. The chapter "Mental Status and Cognitive Examination" includes clinical diagnostic pearls; it outlines adjunctive methods of obtaining data such as screening tools as well as the pertinent bedside neurologic examination. "Personality and Response to Illness" affirms the importance of recognizing pervasive personality patterns in patient illness that often prompt consultation or challenge consultants. Suicidality is given special consideration in the subsequent chapter for its extreme and important aspects of human suffering in the consultation setting.

In the Syndromes section, the major diagnostic categories are given full attention in practical detail, including relevant epidemiology, pathogenesis, and approach to treatment in the medically ill. In 190 pages, these chapters cover the breadth and depth of clinical issues that arise in consultation: "Anxiety," "Delirium," "Dementia," "Eating Disorders," "Mood Disorders," "Sleep Disorders," "Somatoform and Related Disorders," and "Substance-Related Disorders."

In the Treatments section, an overview of biological considerations, such as adverse drug-drug interactions and neuroleptic malignant and serotonin syndromes, is followed by a chapter on psychosocial aspects of patient care. Patient considerations range from decisions related to spirituality to the very practical domain of finances during diminished patient autonomy. Potentially sensitive patient concerns are probed with an array of sample questions. This section neatly frames the active use of the biopsychosocial paradigm in psychosomatic medicine settings.

The first edition of the manual included a last chapter of various special topics (30 pages); in the new edition, this section has been deeply transformed into over 200 pages of in-depth reviews of important areas of subspecialized focus, such as HIV psychiatry, oncology, and bariatric surgery. New topics that have become part of modern clinical practice, such as disaster psychiatry in "Disaster and Terrorism Casualties," are given due consideration in this expanded section. "Gastroenterology," "Dermatology," "Endocrinology," "Rehabilitation Medicine," and many other chapters address the special concerns confronting the liaison psychiatrist as well as the general consultant.

In this expanded and rejuvenated second edition, the authors’ clinical wisdom is supported by the evidence base that has burgeoned in psychosomatic medicine since the previous edition was published. This handy book has grown in size and depth during the same timeframe in which the recognized subspecialty of psychosomatic medicine has matured in its scope and mission. Whether used as a quick reference or as a good read from start to finish, the Clinical Manual of Psychosomatic Medicine: A Guide to Consultation-Liaison Psychiatry, Second Edition, will enhance your clinical practice and elevate your knowledge.


1. Wise MG, Rundell JR. Clinical Manual of Psychosomatic Medicine: A Guide to Consultation-Liaison Psychiatry. 1st ed. Arlington, VA: American Psychiatric Publishing, Inc; 2005.

2. Wise MG, Rundell JR. Concise Guide to Consultation Psychiatry, 3rd ed.Washington, DC: American Psychiatric Publishing, Inc; 2002.

Catherine Chiles, MD

Author affiliation: Yale University School of Medicine, New Haven, Connecticut.

Potential conflicts of interest: None reported.

Volume: 74

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