Primary Care Psychiatry: Evidence-Based Diagnosis, Psychopharmacology, and Behavioral Health Management for Depression, Anxiety, Substance Use, and Psychiatric Emergencies in the Primary Care Setting

More than half of all mental health care in the world is delivered not by psychiatrists but by primary care providers. Every day, in examination rooms and brief follow-up appointments, family physicians, internists, nurse practitioners, and physician assistants face patients with depression, anxiety, bipolar disorder, psychosis, trauma, substance use disorders, and suicidal crises. Most of those patients will never see a specialist. This textbook was written to equip every primary care provider with the knowledge, tools, and clinical frameworks to meet that responsibility with confidence. Primary Care Psychiatry is a comprehensive, evidence-based clinical reference covering the full spectrum of behavioral health conditions encountered in primary care practice. It is written for primary care physicians, family medicine and internal medicine residents, nurse practitioners, physician assistants, and any clinician who manages psychiatric conditions outside of a specialty psychiatric setting. The book opens with four foundational chapters covering the global burden of mental illness in primary care, the psychiatric assessment adapted for time-limited primary care visits including validated screening tools from the PHQ-9 through the Columbia Suicide Severity Rating Scale, collaborative and integrated care models including the evidence base for the Collaborative Care Model and stepped-care frameworks, and cultural competency, health equity, and the social determinants of mental health. Section II covers every major psychiatric disorder encountered in primary care across twelve dedicated chapters. Coverage includes major depressive disorder and persistent depressive disorder with complete pharmacotherapy guidance, treatment-resistant depression and augmentation strategies including esketamine and TMS referral pathways, generalized anxiety disorder, panic disorder, and social anxiety disorder with benzodiazepine prescribing guidance, OCD and related disorders, PTSD and trauma-informed care, bipolar disorder with complete mood stabilizer prescribing and monitoring protocols, psychotic disorders and antipsychotic management, neurocognitive disorders including MCI, dementia subtypes, and delirium, alcohol use disorder with SBIRT and pharmacotherapy, opioid use disorder with buprenorphine induction protocols and harm reduction, personality disorders, and somatic symptom and functional disorders. Section III addresses special populations including medical-psychiatric comorbidity, child and adolescent mental health and ADHD management, geriatric psychiatry and the Beers Criteria, perinatal mental health including pharmacotherapy in pregnancy and breastfeeding, and LGBTQ+ mental health with affirming care frameworks. Section IV covers psychiatric emergencies in primary care, suicide and violence risk assessment, and complete psychopharmacology references for antidepressants, anxiolytics, mood stabilizers, and antipsychotics. The final section covers brief psychotherapies deliverable in primary care, sleep disorders, eating disorders, lifestyle psychiatry, and digital mental health. Every chapter opens with a real-world clinical scenario, includes validated screening tools, evidence-based treatment algorithms, clinical pearls, pharmacology summary tables, and a Primary Care Reality box addressing what is genuinely achievable in a time-limited primary care visit. Back matter includes a complete psychiatric medication quick reference, reproducible screening tools, psychopharmacology monitoring protocols, a billing and coding guide, and crisis resource directories. This textbook is designed to serve as both a learning resource for trainees and a long-term clinical reference for practicing primary care providers.