Abstract
Renal personnel are trained and equipped to deal with medical emergencies but have little training in the management of acute behavioral, cognitive, and emotional changes. The disoriented, combative, noncompliant, or paranoid patient presents a host of problems. The main focus of this discussion is the recognition that acute alterations of personality and mentation often herald an organic cerebral disturbance. Patients with chronic renal disorders are particularly susceptible to a variety of severe physiological disturbances and subsequent cerebral disorders (Table 1). Typically, emergency psychiatric consultation is requested following an abrupt change in the patient’s behavior. At the University of Chicago hospitals, as high as 50% of all emergency psychiatric consults were ultimately found to be related to patients with organic cerebral disorders. This indicates that there is both a difficulty in recognizing organic causes of confusion and delirium and an inexperience in managing such disturbances. This combination of factors places the renal liaison psychiatrist in an important role due to his training in evaluating mental status, his ability to understand the interpersonal concerns between staff and patient, and his understanding of abnormal behavior.
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Selected Bibliography
Benjamin, S., and Sherwin, I. Organic brain syndromes: An empirical study and critical review. American Journal of Psychiatry, 1978, 135(1), 13–21.
Benson, D. F., and Blumer, D. (Eds.), Psychiatric aspects of neurological disease. New York: Grune and Stratton, 1975.
Bond, T. Recognition of acute manic delirium. Archives of General Psychiatry, 1980, 37, 553–554.
Charatan, F. B. Acute confusion and the elderly. Hospital Physician, 1975, 12, 8–10.
Fauman, M. A. Treatment of the agitated patient with an organic brain disorder. Journal of the American Medical Association, 1978, 240, 380–382.
Hall, R. C., Physical illness manifesting as psychiatric disease. Archives of General Psychiatry, 1980, 37, 989–995.
Kimball, C. P. Liaison psychiatry. Psychiatric Clinics of North America, 1979, 2(2), 201–210.
Koppitz, E. M. Psychological evaluation of children’s figure drawing. New York: Grune and Stratton, 1968.
Krakowski, A. J. Liaison psychiatry in North America. Bibliotheca Psychiatrica, 1979, 159, 4–14.
Lezak, M. A. Neuropsychological assessment. New York: Oxford University Press, 1976.
Lishman, W. A. Organic psychiatry. In The psychological consequences of cerebral disorder. Oxford: Blackwell Scientific Publications, 1978.
mcFie, J. Assessment of organic intellectual impairment. New York: Academic Press, 1975.
Peterson, H. W. and Martin, M. J. Organic disease presenting as a psychiatric syndrome. Postgraduate Medicine, 1973, 54, 78–82.
Plum, F., and Posner, J. B. The diagnosis of stupor and coma. 3rd Ed. Philadelphia: F. A. Davis Company, 1980.
Schrier, R. W. (Ed.), Renal and electrolyte disorders. Boston: Little, Brown and Company, 1976.
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© 1983 Springer Science+Business Media New York
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Famularo, R.A., Kimball, C.P. (1983). Liaison Psychiatry Considerations in Renal Hemodialysis Patients with Acute Organic Cerebral Disorders. In: Levy, N.B., Mattern, W., Freedman, A.M. (eds) Psychonephrology 2. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-6669-8_6
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DOI: https://doi.org/10.1007/978-1-4899-6669-8_6
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