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Process of Psychiatric Consultation in the Medical Setting
Elena Friedman, M.D.; Philip R. Muskin, M.D.
FOCUS 2013;11:441-449. doi:10.1176/appi.focus.11.4.441
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Author Information and CME Disclosure

Elena Friedman, M.D., Assistant Professor of Psychiatry, Weill Cornell Medical College/New York Presbyterian Hospital

Philip R. Muskin, M.D., Professor of Clinical Psychiatry, Columbia University; Chief: Consultation-Liaison Psychiatry at Columbia University Medical Center/New York Presbyterian Hospital

The authors report no competing interests.

Address correspondence to: Philip R. Muskin, M.D., Chief, Consultation-Liaison Psychiatry, Columbia University Medical Center/New York Presbyterian Hospital, 622 West 168th St., Mailbox #427, New York, NY 10032; e-mail: prm1@columbia.edu


Psychiatric consultation in the general hospital differs greatly from consultation in psychiatric clinics or private offices due to the nature of the patients’ medical illnesses and the physical setting of the hospital. This review highlights these differences and describes the process of the in-hospital psychiatric consultation. We examine specialized patient populations and important consultation scenarios, as well as ways in which patients and physicians cope with medical illness. We address bedside recommendations for clinicians and examine some of the controversies in consultation-liaison psychiatry.

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CME Activity

Add a subscription to complete this activity and earn CME credit.
Sample questions:
Who coined the term “psychosomatic medicine?”

See Friedman and Muskin; Clinical Context, History, p 441
Research demonstrates that concordance rates with consultation recommendations primarily depend upon which of the following factors?

See Friedman and Muskin; Treatment Strategies and Evidence, p 443
In treating an agitated delirious patient with a pre-existing dementia in the ICU, which of the following factors influences the choice of an antipsychotic medication?

See Friedman and Muskin; Agitated Patient, p 445
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