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Oxford Textbook of Medicine (5 ed.)

Edited by David A. Warrell, Timothy M. Cox, John D. Firth

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Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

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Publisher:
Oxford University Press
Print Publication Date:
May 2010
Print ISBN-13:
9780199204854
Published to Oxford Medicine:
May 2012
DOI:
10.1093/med/9780199204854.001.1

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Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Psychological treatment in medical practice

Chapter:
Psychological treatment in medical practice
Author(s):

Michael Sharpe,

Simon Wessely

DOI:
10.1093/med/9780199204854.003.260602

Patients have minds as well as bodies, and medical treatment must often address both if it is to be effective.

Psychological treatments—these may be divided into general and specialist types. All medical consultations have an important and inescapable psychological effect, hence all physicians are general psychotherapists. All medical consultations have the potential for both psychological help and for harm. Helpful consultations educate the patient, reassure them, and achieve adherence to treatment. Harmful consultations leave the patient confused or with inaccurate ideas about their health, increase anxiety, and make adherence to the physician’s treatment less likely. Being able to deliver a psychologically helpful consultation is therefore a core medical skill.

Specialist psychological treatments—these also have an important role in medical practice. Referral to specialist services may be needed for patients who are distressed by their disease or its treatment, and for those who have medically unexplained symptoms (see Chapter 26.5.3). Short- and medium-term structured therapies such as cognitive behavioural therapy (CBT) are evidence-based treatments for these problems. Before the need to make a referral arises, physicians should familiarize themselves with what psychological treatments are available for their patients, how long they will have to wait to be seen, and how they will be received.

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