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Clinical Manual of Palliative Care Psychiatry


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Table of Contents

ForewordIntroductionPART I: Background and ContextChapter 1. Palliative Care 101Chapter 2. Psychiatry in Palliative CarePART II: Core Clinical ApplicationsChapter 3. Depression Chapter 4. AnxietyChapter 5. Delirium PART III: Other Common Psychiatric ConditionsChapter 6. Dementia (Major Neurocognitive Disorder)Chapter 7. InsomniaChapter 8. Substance Use Disorders PART IV: InterventionsChapter 9. Psychotherapy Chapter 10. Pain Management and Psychopharmacology PART V: Pediatric PatientsChapter 11. Children and Adolescents Index

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With the imperative that psychiatry fully embrace its role among other medical specialties in the management of complex illness, the psychiatric literature is enhanced by timely publications which enhance models of multispecialty care. Drs. Fairman, Hirst, and Irwin have produced a tightly organized, succinct, pragmatic, and current clinical handbook on palliative care psychiatry that is an important contribution to the field. Effectively bridging the relevant areas of psychosomatic medicine and geriatric psychiatry, they show how the consultation psychiatrist is a critical member of the multispecialty and multidisciplinary teams treating patients in a palliative care model. Their chapters cover the critical areas of clinical palliative care psychiatry practice, with especially thoughtfully written chapters on delirium, dementia, insomnia, pain management, substance use disorders, psychotherapy, and the palliative care of children. Their use of tables and figures to illustrate their approach to palliative care patients is especially well done. This book will be of great value to psychosomatic medicine and geriatric psychiatrists, but is equally highly recommended for the general psychiatrist and child and adolescent psychiatrist who will need to care for critically and terminally ill patients as well. James A. Bourgeois, O.D., M.D., Clinical Professor and Vice Chair, Clinical Affairs, Department of Psychiatry/Langley Porter Psychiatric Institute, University of California, San Francisco Comprehensive! Concise! Practical! Packed with useful information. The guide I have been waiting for to assist psychiatric residents, psychosocial oncology teams and oncologists in the practice of primary palliative care. Added bonuses are the additional resources and tables at the back of each chapter. This manual is a must read for every clinician dealing with advanced illness and end of life issues. Mary Helen Davis M.D., DFAPA, Integrative Psychiatry, Behavioral Oncology and Palliative Care Consultant, Associate Clinical Professor of Psychiatry at University of Louisville School of Medicine. Well-referenced, easy-to-use, and clinically practical, the Clinical Manual of Palliative Care Psychiatry skillfully addresses some of the most challenging aspects of palliative medicine. This book should be in every hospice and palliative medicine physician's library, as well as every psychiatrist who cares for this important patient population. Drs. Fairman, Hirst, and Irwin are leading experts in palliative care psychiatry, and I am thrilled that they have shared their wisdom with us to the benefit of all our patients. Holly Yang, M.D., MSHPEd HMDC FAAHPM FACP, Scripps Health, San Diego, California This is a clearly written and evidence-based book on psychiatry in palliative care. Reading this book will go a long way to helping specialist palliative care clinicians feel comfortable dealing with psychiatric illnesses. A must read! Robert Arnold, M.D., Leo H. Criep, Chair in Patient Care, Chief Medical Officer, UPMC Palliative and Supportive Institute, University of Pittsburgh Psychiatry is a very valuable but underutilized resource in oncology, palliative care, geriatrics, and long-term care. The frequency of serious psychological concerns is quite high in those with advanced illness and this book is a unique resource that addresses all aspects of suffering and effective treatment. This comprehensive resource on how psychiatry can enhance palliative care should be required reading for all professionals working with the seriously ill and dying. Dr. Stephen R. Connor, Senior Fellow to Worldwide Hospice Palliative Care Alliance The Clinical Manual of Palliative Care Psychiatry is a concise and clearly written handbook that will be useful to both psychiatric physicians, advanced practice nurses, and other professionals working at the bedside of patients with serious illness. Intuitively organized, its brief and helpful chapters provide the newcomer with critical overviews, and the more experienced clinician with a framework to be sure he/she has hit all the marks. Fairman, Hirst, and Irwin have done a commendable job of condensing the most up-to-date evidence into a pocket-type guide that should inform and improve clinical care for years to come. Thomas B. Strouse, M.D., FAPM, DFAPA, Maddie Katz Professor of Palliative Care Research and Education, Vice-Chair for Clinical Affairs, UCLA David Geffen School of Medicine Department of Psychiatry Drs. Fairman, Hirst, and Irwin's new book, Clinical Manual of Palliative Care Psychiatry, is a critically important contribution to this evolving specialty known as palliative care psychiatry. The eleven chapters are comprehensive yet concise with excellent tables; several chapters are devoted to specific psychiatric complications which practitioners regularly encounter in their clinical work with patients with life-limiting illnesses. Consultation-liaison psychiatry services will find this volume essential for both trainees and senior clinicians who are caring for patients at the end of life. Jon A. Levenson, M.D., Associate Professor of Psychiatry Columbia University Medical Center, Attending Psychiatrist, Division of Consultation-Liaison Psychiatry, Director, Undergraduate Med Education

About the Author

Nathan Fairman, M.D., M.P.H., is Assistant Clinical Professor in the Department of Psychiatry and Behavioral Sciences at the University of California Davis School of Medicine in Sacramento, California. Jeremy M. Hirst, M.D., is Associate Clinical Professor in the Department of Psychiatry, Associate Director of Palliative Care Psychiatry, and Associate Director of Patient and Family Support Services at the Moores Cancer Center, University of California San Diego School of Medicine, in La Jolla, California. Scott A. Irwin, M.D., Ph.D., is Associate Professor of Psychiatry and Director of Supportive Care Services at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, in Los Angeles, California.


The content of the Clinical Manual is extraordinarily expert, well structured, and well presented. The clearly written text, figures, and tables all provide critically important information to the psychiatric and palliative care clinician enabling her/him to rapidly enhance her/his knowledge, clinical judgment, and clinical care delivery.

-Deane L. Wolcott, M.D., DLFAPA, FAPM, FAPOS, Director, Oncology Supportive Care Services, Samuel Oschin Comprehensive Cancer Institute, Cedars- Sinai Medical Center, Los Angeles, CA

The Clinical Manual of Palliative Care Psychiatry expertly distills the essential knowledge and wisdom of this growing field in psychiatry. It identifies some of the most critical implicit aspects of working with seriously ill patients and makes them explicit and accessible. This book will be very useful to both psychiatry and palliative care clinicians.

-William F. Pirl, M.D., MPH, FAPM, FAPOS, Director, Center for Psychiatric Oncology and Behavioral Sciences, Massachusetts General Hospital Cancer Center, Associate Professor of Psychiatry, Harvard Medical School, Past-President, American Psychosocial Oncology Society

Clinical Manual of Palliative Care Psychiatry is an important and welcome addition to the growing literature on an aspect of palliative care medicine that is at once a subspecialty and at the same time so universally applicable as to constitute a core competency. This is a very approachable clinical text. Readers will find well-written chapters concluding with key points, practical tables, and figures very useful to those new to the field.

-Alan D. Valentine, M.D., Chair, Department of Psychiatry, The University of Texas MD Anderson Cancer Center

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