Review of the book entitled Prática psiquiátrica no hospital geral: interconsulta e emergência

BOOK REVIEW

Review of the book entitled Prática psiquiátrica no hospital geral: interconsulta e emergência

Gibsi Maria Possapp Rocha

Psychiatrist, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

^{Correspondence}

Neury José Botega (org.)

Porto Alegre, Artmed, 2006, 572 p.

The book "Prática psiquiátrica no hospital geral: interconsulta e emergência" [Psychiatric practice in the general hospital: consultation-liaison and emergency] is a major contribution for professionals in the mental health area, and not only for psychiatrists who work with consultation-liaison in general hospitals. The need for a second edition in such a short period of time is self-explanatory. Residency training programs in our academic community have "adopted" it as a textbook. The author's involvement in graduation activities and scientific meetings with the psychiatric community in the state of Rio Grande do Sul is a reflection of his comprehensive scientific work focused on this theme.

It has been written with the spirit of a clinician and professor, based on his years of experience in those areas. Dr. Neury Botega is a professor of medical psychology and has organized the Consultation-Liaison Service at Hospital de Clínicas of UNICAMP in 1986. Since then, its internship has been a major part of the residency program in psychiatry. Dr. Botega has been teaching and researching in this area; more recently, he has focused on suicidal behavior.

The book goes beyond aspects concerning a general hospital, thus allowing an up-to-date understanding of different clinical situations. Consultation-liaison is seen as "a process conditioned by forces that modulate the triad physician-patient-specialist."

The second edition has almost 100 extra pages, due to an update in several topics and three new chapters: "Alcohol addiction: basic concepts," "Eating disorders" and "Research in general hospitals: first steps."

Dr. Botega, besides being the organizer, has also written seven chapters and is the co-author of nine out of the 35 chapters that form this new edition. He has counted on the contribution of 44 widely known professionals in the area, who have helped him create this up-to-date, didactical book, which is of great use for professionals in the mental health area.

The first chapter makes a historical review of general hospital psychiatric units worldwide, reaching South America and Brazil. It gives an overview on the development of consultation-liaison all over the world and in our country, as well as of trends in general hospital psychiatry.

Before dealing with patient assessment in chapter 11, the following nine chapters comprehend several aspects of the disease, hospitalization, family, psychiatric consultation-liaison, physician-physician relationship, and mental health of health professionals. In this last chapter, several aspects regarding the physician are discussed: sociological factors, his vulnerabilities, preventive work that should be started during college and residency, discussion groups and others. Chapter 9 describes, in a didactical and complete manner, the training of professionals in psychiatric consultation-liaison and what is needed to structure a consultation-liaison service.

Chapter 11, which is about patient assessment, gives us an idea of Dr. Botega's experience when he discusses the art and technique required for a better knowledge of the affective dynamics involving patient, physician and staff responsible for the treatment. He also describes important aspects, such as neurological examination performed by the psychiatrist and use of standardized scales and their applications.

The subsequent nine chapters are about organic conditions and specific psychiatric diseases, comprehending conceptual, etiologic, semiological and management aspects, maintaining the focus on consultation-liaison.

The following seven chapters refer to special situations, such as pregnancy, AIDS, pain, organ failure and transplantation, ICU patients and suicidal patients, including one chapter about death, whose reading should be mandatory for any psychiatrist or mental health worker, even those who do not work in consultation-liaison.

Each chapter about different disorders and clinical situations includes updated information about handling several conditions. Besides this information, the book includes five chapters about different therapeutic interventions, two about psychotropics, from the perspective of drug interactions, adverse effects and intoxications, one about psychological treatments and two about group treatments.

The chapter about consultation-liaison in child psychiatry has a quite comprehensive review about getting sick; specific situations such as abuse, cancer and Münchausen's syndrome by proxy; technical aspects of consultation-liaison in children; treatment modalities; and the role of psychiatrists in teaching other professionals.

In the chapter about ethical and legal issues, Dr. Botega provides us with all his knowledge based on his practice as a consultation-liaison psychiatrist and professor, approaching the relationship with other professionals and care concerning the suffering of patients and staff. Situations that are rarely discussed in the literature are described, such as hunger strike, ability to look after a baby, among others.

The last chapter is about research in general hospitals. In a practical and synthetic manner, it brings 13 pages of information able to guide psychiatrists to delimit their research object and make methodological choices with an understanding of the several stages involved and inherent difficulties.

To conclude, I would like to say that its reading is easy, didactical and enlightening. Despite its title, it is a book that is not restricted to the hospital environment, but comprehends several issues for health professionals, and not only for consultation-liaison psychiatrists.

Publication Dates

• Publication in this collection
  16 Nov 2006
• Date of issue
  Aug 2006