PM&R and Psychiatry?

[Bleurberry]

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I'm curious if there's any room for a psychiatric sub-specialty in PM&R.
i.e. Does such a thing exist?

Thanks in advance,

 

[LTS6776]

There's not a psychiatry subspecialty within our field- although there is a rehabilition psychology subspecialty for psychologists. We certainly deal with lots of psych issues- adjustment to disability, PTSD, chronic pain syndromes- and certainly see a lot of patients with bipolar disorder and schizophrenia who have a tendency to get injured and need rehab.

 

[Bleurberry]

There's not a psychiatry subspecialty within our field- although there is a rehabilition psychology subspecialty for psychologists. We certainly deal with lots of psych issues- adjustment to disability, PTSD, chronic pain syndromes- and certainly see a lot of patients with bipolar disorder and schizophrenia who have a tendency to get injured and need rehab.

Thanks for the quick reply. That's why I was curious; I hadn't found any mention on my own, and it seems like a natural extension of the rehabilitation field. So you receive referrals, and then I guess on occasion you give a referral out to them.
Does anyone practicing feel it would be a positive step if there were a fellowship or sub-specialty in psychiatry that physiatrists could participate in, or is that spreading the butter too thin?

 

[SSdoc33]

Thanks for the quick reply. That's why I was curious; I hadn't found any mention on my own, and it seems like a natural extension of the rehabilitation field. So you receive referrals, and then I guess on occasion you give a referral out to them.
Does anyone practicing feel it would be a positive step if there were a fellowship or sub-specialty in psychiatry that physiatrists could participate in, or is that spreading the butter too thin?

no. and im not really sure what you are talking about. there are pts with psych disorders in every specialty, and PMR is no different. learning about them is important, but a separate fellowship/subspecialty will not happen

 

[masterofmonkeys]

PM&R was (a distant) 2nd on my list of things I was interested in.

Psychiatry was number 1.

I am especially interested in the psychology/psychiatry of MSK injury and rehabilitation, as anyone who's met people who are physically limited by injury and physical dysfunction (or been one themself) knows that it's a psychological minefield.

Issues of adjustment, depression, sleep trouble, obviously. But also cognitive-behavioral issues regarding commitment to intensive rehabilitation and PT. Just think about the nature of this statement:

"I feel like crap. Well, better enthusiastically and energetically bust my butt in the gym!"

Kinda an abnormal thought pattern but one that is highly important if you're going to be successful.

If you look at the people that overcome severe physical issues, they have that attitude. And I think that learning how to cultivate that attitude is exceedingly important for success.

I think that fits more as an area of psychiatry than it does PM&R though. Physiatrist tells the patient WHAT to do, psychiatrist helps them motivate themselves to actually do it. Or, physiatrist helps with alleviating pain and maximizing functionality, psychiatrist helps the patient accept the emotional and psychosocial issues of their pain and reduced function and move beyond them.

But that's just me.

 

[PMR 4 MSK]

That's a great approach. I find that those with brain injury are more likely to agree to go to a psychiatrist than a pain pt. The pain pt will say "The problem's in my back, not my head." They want the back fixed, not just to deal with it, even when we can't fix them. But they are the ones more likely to benefit from pschologic intervention.