For this edition, two of the three editors, Professor Sir Simon Wessely and Dr Gareth Owen, are new, and they have been largely responsible for reviewing the entire text and bringing it up to date throughout. Once more, we have drawn upon the clinical experience of colleagues associated with the Maudsley Hospital. For this edition, we want to give special thanks to Drs John Moriarty, Larry Rifkin, Sarah Bernard, Marco Picchioni, Marta Di Forti, Jacqueline Phillips Owen, and Alex Thomson. We also want to thank Drs Sean Cross, Mike Kelleher, Ricardo Sainz Fuertes, Livia Martucci, Lisa Conlan, and Asanga Fernando. Thomas Hindmarch read the proofs on his medical elective and gave useful advice on language for upcoming doctors. Although this book is primarily aimed at psychiatrists in training, we hope it will be useful to any clinician interested in psychiatry. We have preserved the form of the Handbook and many of the changes to the content are fairly minor. The book is now reduced to ten chapters with revisions and updates mainly to chapters on the psychosocial assessment of adults, neuropsychiatric assessment, special problems, and treatment. Much has changed in mental health law since the last edition and we have produced a new chapter on this. As before, responsibility for the final text rests entirely with ourselves as editors.
The comprehensive psychiatric interview The psychiatric interview has many features in common with the medical interview. The main goals are to elicit the necessary information to make sense of the presenting problems, to determine whether you are able to make a diagnosis, and to try and understand the origins of the presenting problems in a particular individual (the ‘formulation’). Like the rest of medicine, most of the information required for a diagnosis comes from the history rather than the examination or any investigations. However, there is another feature of the psychiatric assessment which, although important in other specialities, is more explicit in psychiatry, i.e. using the interview in obtaining a trusting relationship with the patient. Rapport can determine the information obtained at interview, set the stage for a future relationship with the patient, and is likely to effect engagement and compliance with any future treatment. This is particularly important when the patient may not feel that s/he has a problem either because of a psychotic illness or where s/he has considerable ambivalence about their desire for help such as with an eating disorder or substance abuse. Lastly, the psychiatric interview can have value both as a psychotherapeutic and psychoeducational intervention.