title: Teaching a neuromedical-contextual approach to psychosomatic medicine.
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.
authors.affiliation: Cleveland Clinic Foundation, Cleveland, OH, USA, jimenex2@ccf.org.
authors.forename: Xavier F
authors.initials: XF
authors.lastname: Jimenez
authors.forename: Pierre N
authors.initials: PN
authors.lastname: Azzam
authors.forename: Priya
authors.initials: P
authors.lastname: Gopalan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006769:Hospitals, General / Q000379:methods; D006801:Humans; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D017145:Models, Educational; D010343:Patient Admission; D011570:Psychiatry / Q000193:education / Q000379:methods; D011580:Psychological Techniques / Q000193:education*; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011611:Psychosomatic Medicine / Q000193:education / Q000379:methods; D012017:Referral and Consultation; D013663:Teaching