Inpatient psychiatry

Blog Post by Michael Casher, MD, Director, Psychiatry Adult Inpatient Program, Clinical Assistant Professor, Department of Psychiatry, University of Michigan Medical School

Inpatient psychiatry may yet join consultation psychiatry (psychosomatic medicine) as a subspecialty within American psychiatry in the future.  There is a growing movement within many branches of medicine for “hospitalists”, physicians who spend the majority of their time taking care of hospitalized patients.  This is especially common now in the U.S. in the fields of internal medicine, pediatrics, and neurology, but there are now beginning to be a number of psychiatric hospitalists as well, including many in academic centers.  Inpatient psychiatry encompasses treatment of virtually all of the serious/severe mental disorders.  In our experience on a university-based psychiatric unit, we see quite a few patients with mood disorders and psychotic disorders, as well as borderline PD patients in crisis.  We also frequently take care of geropsychiatric patients with depression or dementia-related agitation.

Dr Bess and I are among this group of academic hospitalists and our book Manual of Inpatient Psychiatry represents our accumulated viewpoint on the best current practice of inpatient psychiatry.  Inpatient psychiatry is an exciting area of our field and as pointed out in our previous blog posting, is a great place to teach psychiatry to medical students and more advanced trainees.  We are already aware of several residency programs that have adopted our book for their trainees.  Our own residents and students find its format comfortable, especially because it fits into their labcoat pockets (a feature that was very important to us when we first proposed the manual to Cambridge.

I must point out that while it was difficult work to complete our book, it was very gratifying to work collaboratively with my co-author and to mesh our points of view to come up with a common “voice” for our book, which I believe is one of its strengths.

Michael Casher is a co- author of Manual of Inpatient Psychiatry, published by Cambridge University Press

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2 Responses to Inpatient psychiatry

  1. James J. Amos, MD says:

    I like the premise, organization, and portability of the book based on the advertisement. I passed along a hyperlink to the web page to our chief residents. I didn’t see a chapter on medical-psychiatry units (or Complexity Intervention Units as Dr. Roger Kathol, MD prefers we call them). Maybe the authors would consider calling me or colleagues here at The University of Iowa to discuss collaborating on the inclusion of such a chapter in the next edition? Many thanks for this contribution to trainee education!

    • Michael Casher MD says:

      Dr Amos,

      Thanks for the nice comments. Have also enjoyed reading your postings. Our hospital/psych dept does not have a med-psych unit, and consequently Dr Bess and I did not view ourselves as sufficiently well-versed in all the complicated issues associated with this sort of program to include a separate chapter. Nonetheless, I believe we do pay a lot of attention to organic issues/medical comorbidities throughout the book. We treat some medically complicated patients but I would imagine the medical capacity of your Complexity Intervention Unit well exceeds what we attempt to handle.

      Interestingly, I have heard from a Professor Sar in Istanbul(!) who thinks the next edition should include a chapt on dissociation, an area he has written about extensively. If our book makes it to a second edition, we will definitely need to enlist some help from others such as you and your colleagues to make our manual even more comprehensive.

      Michael

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