When Psychological Problems Mask Medical Disorders

Second Edition
A Guide for Psychotherapists

James Morrison

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247 Pages
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Widely regarded as a standard clinical resource, this book helps practitioners think outside the mental health box and recognize when a client may need a medical evaluation. Part I provides an accessible overview of symptoms that can be observed in a standard mental status examination and may point to medical illness. Engaging case vignettes and interviewing pointers help readers hone their diagnostic skills. Part II presents concise facts—including basic medical information and physical and mental symptoms—on more than 60 diseases and syndromes. An easy-to-read chart in Part III cross-tabulates all of the disorders and symptoms for quick reference and comparison.

New to This Edition Winner (First Place)—American Journal of Nursing Book of the Year Award, Psychiatric and Mental Health Nursing Category

“James Morrison's book is a gem. He addresses common medical illnesses that produce psychological symptoms in a refreshing manner, making the book an excellent review text for fellow psychiatrists and nonphysician psychotherapists....His occasionally tongue-in-cheek style makes for pleasant readability without minimizing the importance of his message....Tables...are laid out in easily readable form and useful for quick cross-referencing....This is book worth its weight in gold: it is eminently readable and can save some lives and bring improvement to many others.”

Journal of the American Medical Association (on the first edition)

“At once a primer on the collaboration of psychotherapist and physician and a useful reference book for this purpose. Although it is intended for psychotherapists with limited medical training, it may also be useful to primary care physicians and other medical clinicians who may be the first contact for patients who present with psychiatric symptoms.”

Psychiatric Services (on the first edition)

“This factual, current, and well-written guide is necessary reading for all clinicians who desire to sharpen their diagnostic skills. Morrison addresses the problems presented by psychiatric patients who may suffer from medical disorders, helping the clinician make sense of symptom presentations that are often confusing and on occasion mysterious and baffling. With tables, lists, and detailed explanations, this book establishes order and method in the examination of the complex patient. This second edition carries on the quality of the first, but is greatly enhanced by more information, new insights and clinical revelations, and a pragmatic interpretation of the latest findings.”

—Rodrigo A. Muñoz, MD, Department of Psychiatry, University of California, San Diego; past president, American Psychiatric Association

“The ability to differentiate medical and psychological sources of psychological symptoms is a core competency in case formulation and treatment planning. Morrison's succinct book helps clinicians with this critical task better than any other. The book is cross-indexed so information is rapidly available. It is replete with case examples and interesting historical references, and benefits from Morrison's wit and humor. An outstanding contribution.”

—Tracy D. Eells, PhD, Department of Psychiatry and Behavioral Sciences, University of Louisville

“The second edition of this authoritative work covers a topic that is far too often ignored in the training and practice of mental health practitioners. The book is comprehensive, well organized, and easy to read. Morrison’s engaging style and inclusion of numerous summary tables make the book particularly accessible. This is an essential resource that should be on every clinician’s bookshelf or e-reader.”

—Martin M. Antony, PhD, ABPP, Department of Psychology, Ryerson University, Canada

“I used the first edition for many years to train doctoral students in clinical psychology, and found it to greatly enhance their training. I have no doubt that the second edition also will be extremely popular among students. The text is compelling and easy to read. It helps students and busy professionals quickly explore alternative diagnoses to avoid misdiagnosing medical disorders as psychological illnesses.”

—Leslie A. Robinson, PhD, Director, Clinical Health Track; Director, Center for Health Promotion and Evaluation, Department of Psychology, University of Memphis

“Although most therapists are not medical specialists, we do not treat disembodied persons. Morrison alerts us to the most common mental symptoms that might be due to physical disorders, and heightens our diagnostic acumen. His efficient presentation, using both narrative and tables, can alert us to problems we might not have asked about and make treatment more comprehensive and effective. This updated second edition—written in the intelligent, experienced, and modest voice we have come to expect from Morrison—is a foundational resource for all therapists.”

—Edward L. Zuckerman, PhD, author of Clinician's Thesaurus

Table of Contents


I. A Review of Symptoms

The Need for Evaluation

Observing the Mental Status

Appearance and Behavior

Mood (Affect)


Content of Thought

Intellectual Resources

Insight and Judgment

Personality Change

Diagnostic Principles

II. 66 Disorders

Adrenal Insufficiency


Altitude Sickness

Amyotrophic Lateral Sclerosis

Antidiuretic Hormone, Inappropriate Secretion

Brain Abscess

Brain Tumor


Carcinoid Syndrome

Cardiac Arrhythmias

Celiac Disease

Cerebrovascular Accident (Stroke)

Chronic Obstructive Lung Disease

Congestive Heart Failure


Cushing's Syndrome

Diabetes Mellitus



Heavy-Metal Toxicity

Herpes Encephalitis


Huntington's Disease


Hypertensive Encephalopathy




Kidney Failure

Klinefelter's Syndrome

Liver Failure

Lyme Disease

Ménière's Syndrome


Metachromatic Leukodystrophy


Mitral Valve Prolapse

Multiple Sclerosis

Myasthenia Gravis

Neurocutaneous Disorders

Normal-Pressure Hydrocephalus


Parkinson's Disease


Pernicious Anemia



Polycystic Ovary Syndrome


Postoperative Delirium

Premenstrual Syndrome

Prion Disease

Progressive Supranuclear Palsy

Protein Energy Malnutrition

Pulmonary Thromboembolism

Rheumatoid Arthritis

Sensory Deficit

Sickle-Cell Disease

Sleep Apnea

Substance Intoxication and Withdrawal


Systemic Infection

Systemic Lupus Erythematosus

Thiamine Deficiency

Traumatic Brain Injury

Wilson's Disease

III. Symptom Summaries

About the Author

James Morrison, MD, is Affiliate Professor of Psychiatry at Oregon Health and Science University in Portland. He has extensive experience in both the private and public sectors. With his acclaimed practical books—including DSM-5 Made Easy; Diagnosis Made Easier, Second Edition; The First Interview, Fourth Edition; Interviewing Children and Adolescents, Second Edition; and When Psychological Problems Mask Medical Disorders, Second Edition; and The Mental Health Clinician's Workbook—Dr. Morrison has guided hundreds of thousands of mental health professionals and students through the complexities of clinical evaluation and diagnosis.


Psychiatrists, clinical psychologists, clinical social workers, psychiatric nurses, and counselors working with adults; graduate students and residents.

Course Use

Serves as a text in graduate-level courses that deal with psychiatric diagnosis.
Previous editions published by Guilford:

First Edition, © 1997
ISBN: 9781572305397
New to this edition: