In consulting with anxious medical patients, the psychiatrist needs to
consider the possibility of organic disease, differentiate anxiety an
d depression, and ascertain whether comorbid conditions are present. G
uidelines for differential diagnosis are presented. With the anxious p
atient, treatment goals are to establish rapport, help the patient mob
ilize intellectual defenses, and enhance self-esteem. Many anxious med
ical patients will benefit from benzodiazepines, selective serotonin r
euptake inhibitors, or doxepin. The therapeutic potential of the consu
ltation is increased by the psychiatrist's meeting with the nursing st
aff and by a humanistic approach to the patient.