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Teaching a Neuromedical-Contextual Approach to Psychosomatic Medicine

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Abstract

The practice of psychosomatic medicine in the general hospital setting can be challenging, particularly for the inexperienced trainee. Guidance for how to approach a psychiatric consultation can be nonspecific or lacking altogether. In response, we offer a pedagogical model that emphasizes patient-specific neurological, medical, and contextual variables. A stepwise, “ABC” approach to psychiatric consultation is elaborated, beginning with collection of critical history (“Admission, Background, Consultation Question”), followed by both patient encounter (“Appearance, Behavior, Context”) and actual patient examination (“Arousal, Brain/Body, Cognitive Assessment”), ultimately informing any given case formulation. Multiple clinical vignettes illustrate this approach and are offered for educational purposes in dissemination to trainees.

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Disclosures

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Cleveland Clinic Foundation, Cleveland, OH, USA

    Xavier F. Jimenez

  2. Harvard Medical School, Boston, MA, USA

    Pierre N. Azzam

  3. University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Priya Gopalan

Authors
  1. Xavier F. Jimenez
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  2. Pierre N. Azzam
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  3. Priya Gopalan
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Correspondence to Xavier F. Jimenez.

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Jimenez, X.F., Azzam, P.N. & Gopalan, P. Teaching a Neuromedical-Contextual Approach to Psychosomatic Medicine. Acad Psychiatry 39, 204–211 (2015). https://doi.org/10.1007/s40596-014-0193-9

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  • DOI: https://doi.org/10.1007/s40596-014-0193-9

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