CONSULTING WITH ANXIOUS MEDICAL PATIENTS .2. DIAGNOSTIC AND THERAPEUTIC CONSIDERATIONS

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.