Mood_Disorders_PIPC

Mood_Disorders_PIPC - PIPC Psychiatry In Primary Care MOOD...

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PIPC ® P sychiatry I n P rimary C are MOOD DISORDERS Robert K. Schneider, MD Departments of Psychiatry, Internal Medicine and Family Practice The Medical College of Virginia at the Virginia Commonwealth University Richmond, Virginia
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PIPC ® Goals Effectively recognize, diagnose and treat mental illness in primary care Bring the psychiatry skills and knowledge base of the primary care physician on par with other medical specialty knowledge bases
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Outline PIPC 1 Introduction PIPC ® Interview MAPS-O ® Mood Disorders Suicide
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Outline PIPC 2 Anxiety Disorders PIPC 3 Neurotransmitters The 3 Phases and the 5Rs Medications Cases and Discussion
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“de facto mental health system” Regier,1978 54% of people with mental illness who seek treatment are exclusively seen in the “general medical sector” 25% of patients in primary care setting have a diagnosable mental illness
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Why Now? Great scientific evidence Genetic basis for disease Twin studies and Human Genome Project Neuroscience Research CT to MRI to PET to SPECT scanning Neurotransmitter basic science Somatic Therapies Psychiatric Medication Explosion (“SSRI Surge”) Economic pressures (Managed Care)
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PIPC ® Interview
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PIPC Interview Organized by “organ system” approach Hypothesis driven interview Makes psychiatric knowledge assessable Demonstrates holes in knowledge base for PCP Creates a foundation for evidence to be applied
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Data Gathering: Hypothesis Driven Interview Notice cues from patient pattern recognition Develop differential diagnosis Collect target symptoms Ask further questions to rule in or rule out
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Example: Chest Pain Target symptoms Chest pain, Shortness of Breath Differential diagnosis Cardiac (ischemic, valvular, cardiomyopathy) GI (esophageal spasm, PUD) Pulmonary (COPD, pleuresy, pneumonia) Musculoskeletal (intercostal spasm, rib fx) Further questions Age, onset, associated symptoms, etc…. .
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Mood_Disorders_PIPC - PIPC Psychiatry In Primary Care MOOD...

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