Cambridge Textbook of Effective Treatments in Psychiatry

Cover Page......Page 0
About the Book......Page 3
Title Page......Page 4
ISBN 052184228X......Page 5
Contents (with page links)......Page 6
Contributors......Page 10
Preface......Page 19
Part I Introduction......Page 21
Introduction......Page 22
Validity of psychiatric diagnoses......Page 23
Aetiology......Page 24
The current state of psychiatric diagnoses......Page 25
Matching diagnosis, syndrome and treatment......Page 27
Models of treatment for mental disorder......Page 28
Choosing treatments from diagnosis: the example of mood disorders......Page 29
References......Page 33
Presentism......Page 35
Periodicity and incommensurability......Page 36
'Treatment resistance’ and 'treatment effectiveness’......Page 37
Chronicity and psychiatry......Page 38
Linking chronicity and treatment resistance......Page 39
Mental bothers derangements and their treatments......Page 40
The convulsive therapies......Page 46
Nineteenth century materia medica......Page 43
'Psychopharmacology’......Page 45
The early use of an electric stimulus......Page 47
France......Page 48
Great Britain......Page 49
The origins of psychosurgery......Page 50
Psychosurgery in Britain during the late nineteenth century......Page 51
Burckhardt......Page 53
Moniz......Page 54
References......Page 56
Part II Summary of treatment modalities in psychiatric disorders......Page 64
General remarks......Page 66
The gold standard: double-blind, placebo-controlled, randomized controlled trial......Page 67
Use of placebos in psychopharmacologic trial......Page 68
Interpretation of the psychopharmacology literature......Page 69
Comments on meta-analyses of large databases......Page 70
A limited review of evidence for antidepressants in various clinical populations and presentations......Page 71
Relative efficacy of older versus newer antidepressants......Page 72
Depression in schizophrenic patients......Page 73
Conclusions......Page 74
References......Page 75
Introduction......Page 76
Randomized controlled studies......Page 77
Effect on suicide risk......Page 78
Catatonia/neuroleptic malignant syndrome (NMS)......Page 79
Continuation ECT in mood disorders......Page 80
Laboratory and ECT-related EEG parameters......Page 81
Hypothalamic-pituitary axes functioning and the dexamethasone suppression test......Page 82
Electroconvulsive therapy versus transcranial magnetic stimulation (also see Chapter 4)......Page 83
Recent studies in ECT and schizophrenia......Page 84
Delirium......Page 87
ECT in children and adolescents......Page 85
Geriatric patients......Page 86
Common side effects and their tolerability......Page 88
Other cognitive functions......Page 89
Brain structural, metabolic and neurochemical effects......Page 90
Conclusions and recommendations......Page 91
References......Page 92
Lessons from ECT and the rationale for focal brain stimulation......Page 102
Transcranial magnetic stimulation (TMS) and magnetic seizure therapy (MST)......Page 103
Major depression......Page 104
Schizophrenia......Page 105
Post-traumatic stress disorder......Page 106
Evidence for the effectiveness of MST in major depression......Page 107
Major depression......Page 108
Transcranial direct current stimulation......Page 109
Conclusions......Page 110
References......Page 111
Psychodynamic therapies......Page 117
Behavioral and cognitive-behavioral therapies......Page 118
Historical overview......Page 119
Common factors in psychotherapy......Page 123
Patient/client factors in therapy outcome......Page 124
Therapist factors in therapy outcome......Page 125
The role of the therapeutic alliance......Page 126
Process research......Page 127
The length of therapy......Page 128
Conclusions......Page 129
References......Page 130
Introduction......Page 135
Self-help materials......Page 136
Interventions for health professionals......Page 137
Direct educational intervention......Page 138
Educational interventions as part of organized care pathways......Page 139
Conclusions......Page 140
Bipolar disorders......Page 141
Family education......Page 142
Interventions for the general public......Page 143
Case management......Page 144
Obsessive-compulsive disorder......Page 145
Final thought: patients as educators......Page 146
References......Page 148
Legislation regarding herbal and nonherbal dietary supplements......Page 151
Background......Page 152
Uses......Page 153
Active components......Page 154
Uses......Page 155
Uses......Page 157
Background......Page 158
Uses......Page 159
Side effects, formulations and pharmacokinetics......Page 160
Principles of homeopathy......Page 161
How does homeopathy work?......Page 162
Traditional Chinese medicine......Page 163
The neurophysiological mechanisms of acupuncture......Page 164
Acupuncture and its clinical applications......Page 165
Insomnia......Page 166
Acupuncture and smoking withdrawal......Page 167
Conclusion......Page 168
Addendum: referral to a CAM practitioner......Page 169
Acknowledgments......Page 170
References......Page 171
Introduction......Page 176
Hospital and community services......Page 177
Assertive community treatment......Page 178
Day hospitals......Page 181
Rehabilitation and employment......Page 182
Feedback of outcomes of care......Page 183
Problems of interpretation......Page 184
Summary......Page 185
References......Page 186
Part III Specific treatments......Page 190
Organic disorders......Page 192
Introduction......Page 194
Typical antipsychotics......Page 195
Olanzapine......Page 196
Risperidone......Page 197
Benzodiazepines......Page 198
Other medications......Page 199
The American College of Critical Care Medicine Clinical Practice Guidelines for the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult......Page 200
Non-pharmacological interventions......Page 201
Guidelines......Page 202
References......Page 203
Introduction......Page 206
Antipsychotics......Page 207
Antidepressants......Page 208
Benzodiazepines......Page 209
Non-pharmacological management of non-cognitive symptoms of dementia......Page 210
Dementia and impaired psychological well-being......Page 211
Reminiscence therapy......Page 212
Validation therapy......Page 213
Combined/non-specific approaches to treatment......Page 214
Disruptive vocalizations......Page 216
Aggression......Page 217
Sleep and sundowning......Page 218
Introduction......Page 219
Antipsychotics......Page 220
Psychostimulants......Page 221
Dopaminergic drugs......Page 222
Conclusion......Page 223
References......Page 225
Introduction......Page 236
Alzheimer’s disease......Page 237
Head-to-head comparisons of cholinesterase inhibitors for Alzheimer’s disease......Page 242
Donepezil......Page 243
Galantamine......Page 244
Dementia with Lewy Bodies......Page 245
Donepezil......Page 246
Rivastigmine......Page 247
Galantamine......Page 248
Summary......Page 249
Conclusion......Page 251
Estrogen......Page 252
Selegiline......Page 253
Non-steroidal anti-inflammatory drugs (NSAIDs)......Page 254
Reality orientation therapy......Page 255
References......Page 257
Psychosis in neurological disease......Page 263
Atypical antipsychotics......Page 264
Treating psychosis in Parkinson’s disease......Page 266
Conclusions......Page 268
Pharmacological treatment of depression......Page 269
Depression following stroke......Page 270
Depression in Parkinson’s disease......Page 271
Conclusions......Page 274
References......Page 276
Alcohol......Page 282
Introduction......Page 284
Introduction......Page 285
Evidence......Page 286
Emergency departments......Page 287
Predictors of success......Page 288
Introduction......Page 289
Introduction......Page 290
Evidence......Page 291
Introduction......Page 292
Introduction......Page 293
Summary......Page 294
Evidence......Page 295
Evidence......Page 296
Summary......Page 297
Introduction......Page 298
Conclusions......Page 299
References......Page 300
Harmful use of alcohol......Page 308
Disulfiram......Page 309
Contraindications, warnings and interactions......Page 310
Evidence......Page 311
Summary......Page 312
Evidence......Page 313
Evidence......Page 314
Topiramate......Page 315
Evidence......Page 316
Evidence......Page 317
Introduction......Page 318
Evidence......Page 319
Dose......Page 320
Evidence......Page 322
Adjunctive treatments......Page 323
Recommended second-line treatment in official national guidelines......Page 324
References......Page 325
General advice and information......Page 333
Bibliotherapy......Page 334
Other groups and other interventions......Page 335
Summary......Page 336
References......Page 337
Introduction......Page 339
Evidence......Page 341
Summary......Page 342
Introduction......Page 343
Evidence......Page 345
Introduction......Page 347
Modified TCs......Page 348
Evidence......Page 349
A note on the COMBINE study......Page 350
Naltrexone......Page 351
Disulfiram......Page 352
Summary......Page 353
References......Page 354
Introduction......Page 359
Evidence......Page 360
Biofeedback......Page 362
Meditation......Page 363
Evidence......Page 364
Conclusions......Page 366
References......Page 367
Drug misuse......Page 370
Introduction......Page 372
Cessation of drug use......Page 373
Improving interpersonal functioning and enhancing social support......Page 374
Psychological therapies and opioid dependence......Page 375
Psychological therapies and cocaine dependence......Page 378
Psychological therapies and amphetamine and methamphetamine dependence......Page 380
Psychological therapies and cannabis dependence......Page 381
Summary and conclusions......Page 383
References......Page 384
Introduction......Page 388
Treatment for stimulant use disorder......Page 389
Dopamine agonists (amantadine, bromocriptine)......Page 390
Baclofen......Page 391
Behavioral therapies......Page 392
Acupuncture......Page 393
Summary and conclusions......Page 394
References......Page 396
Epidemiology......Page 400
Clinical features of opioid dependence......Page 401
Evidence-based treatments for opioid dependence......Page 402
Methadone in medically assisted withdrawal......Page 403
Antagonists in medically assisted withdrawal......Page 404
Opioid antagonist treatment (treatment of dependence)......Page 405
Conclusions......Page 413
References......Page 415
Manifestations of anxiety and of sedative-hypnotic abstinence syndromes......Page 421
Epidemiology......Page 422
Pharmacological treatments......Page 423
Z-drugs......Page 424
Psychological treatments......Page 425
Minimal interventions......Page 426
Summary and Conclusions......Page 427
References......Page 428
Introduction......Page 432
Cannabis withdrawal......Page 433
Treatment for cannabis dependence......Page 434
Summary and conclusions......Page 437
References......Page 438
Introduction......Page 441
National guidelines......Page 442
Nicotine replacement therapies (NRTs)......Page 444
Sustained release bupropion......Page 447
Other non-nicotine pharmacotherapies......Page 449
Behavioural therapy......Page 451
Alternative treatments......Page 452
Conclusions......Page 453
References......Page 455
Introduction......Page 461
Assessment and diagnosis of dual diagnosis......Page 462
Treatment models with emphasis on integrated care......Page 463
General clinical interventions......Page 464
Motivational interviewing......Page 465
Major depression and dysthymia......Page 466
Bipolar disorder......Page 467
Panic disorder......Page 468
Personality disorders......Page 469
Schizophrenia......Page 470
Summary and conclusions......Page 471
References......Page 473
Schizophrenia......Page 478
Phases of treatment......Page 480
Typical vs. atypical antipsychotics......Page 481
Tolerability and efficacy as interacting factors......Page 482
Antipsychotics and relapse prevention......Page 483
Treatment resistant schizophrenia......Page 484
Conclusions......Page 485
References......Page 486
Introduction......Page 488
Historical points......Page 489
Family interventions......Page 490
Cognitive therapy......Page 492
Cognitive remediation or cognitive rehabilitation......Page 493
Social skills training......Page 494
Vocational rehabilitation......Page 495
Conclusions......Page 496
References......Page 497
Mood disorders......Page 500
Decision to treat......Page 502
Interactions......Page 503
Dosing and side effect management......Page 504
Substitution......Page 505
Maintenance......Page 506
Acute treatment – depression......Page 507
Maintenance......Page 509
References......Page 511
Electroconvulsive therapy (ECT)......Page 517
Transcranial magnetic stimulation (TMS)......Page 520
Vagal nerve stimulation (VNS)......Page 521
Deep brain stimulation (DBS)......Page 522
References......Page 523
Cognitive therapy......Page 526
Treatment of depression collaborative research program (TDCRP)......Page 527
Studies of cognitive therapy following the TDCRP......Page 528
Probably efficacious treatments......Page 530
Conclusions......Page 531
References......Page 533
Light therapy......Page 535
Omega-3 supplementation......Page 536
Exercise therapy......Page 537
Androgens......Page 538
Conclusions......Page 539
References......Page 540
Anxiety and neurotic disorders......Page 544
Assessment......Page 546
General principles of treatment......Page 548
Benzodiazepines and cyclopyrrolones......Page 549
Long-term treatment......Page 550
Second-line drug treatments......Page 551
Pharmacological treatments in somatoform disorders......Page 552
Self-help......Page 553
When and when not to treat......Page 554
Conclusions......Page 555
References......Page 556
Clinical features......Page 561
Risk factors......Page 562
Cognitive-behavioural therapy (CBT)......Page 563
Selective serotonin reuptake inhibitors (SSRIs)......Page 564
Comparative and combination treatments......Page 565
Treatment delivery challenges......Page 566
Conclusions......Page 567
References......Page 568
Specific phobia (SP)......Page 572
Agoraphobia......Page 573
Exposure-based treatments......Page 574
Psychotherapeutic treatment of blood-injection-injury phobias......Page 575
Psychosocial treatment: agoraphobia......Page 576
Treatment delivery challenges......Page 577
Summary and guidelines......Page 578
References......Page 579
Introduction......Page 582
Monoamine oxidase inhibitors (MAOIS)......Page 583
Psychological treatments......Page 584
Exposure therapy......Page 585
Comparative efficacy of pharmacological and psychological interventions......Page 586
Conclusions......Page 587
References......Page 589
Introduction......Page 593
NICE guidelines......Page 595
Efficacy of selective serotonin reuptake inhibitors (SSRIs)......Page 596
Summary and comment on the US guidelines for OCD......Page 597
Behaviour therapy including ERP......Page 598
Clomipramine......Page 599
Selective serotonin reuptake inhibitors......Page 600
Combined psychological and pharmacological treatment in OCD......Page 601
Conclusions......Page 602
References......Page 603
Introduction: differences in classification of stress disorders......Page 607
Adjustment disorder......Page 608
Trials of clinical interventions......Page 609
Psychosocial treatment......Page 610
Pharmacotherapy......Page 611
Serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs)......Page 612
Monoamine oxidase inhibitors (MAOIs)......Page 613
Benzodiazepines......Page 614
Antipsychotics......Page 615
Clinical issues in pharmacotherapy......Page 616
Exposure therapies......Page 618
EMDR (formerly known as Eye Movement Desensitization and Reprocessing)......Page 619
Skills training in affective and interpersonal regulation followed by exposurea phase-based treatment for PTSD related to childhood abuse......Page 620
Therapeutic themes that become a focus of exploration and reframing......Page 621
Mechanisms of therapeutic efficacy in PTSD: psychosocial vs. pharmacologic treatments......Page 622
Treatment Guidelines recommendations......Page 623
References......Page 624
Eating disorders......Page 630
The use of medication in the management of anorexia nervosa......Page 632
Patients with high medical risk......Page 633
The use of medication in the management of bulimia nervosa......Page 634
Guideline recommendation......Page 635
New approaches......Page 636
Clinical approaches......Page 637
Conclusions......Page 638
References......Page 639
Intensive feeding......Page 641
Exercise......Page 642
Electroconvulsive therapy......Page 643
Conclusions......Page 644
References......Page 645
Classification and clinical features of eating disorders......Page 647
Specialist settings......Page 648
Outpatient: adults......Page 649
Specialist settings......Page 650
Summary......Page 651
Conclusions......Page 652
References......Page 653
Introduction......Page 656
Psychoeducation for family members of patients with eating disorders......Page 657
Negative effects of education/information about eating disorders......Page 658
Conclusions......Page 659
References......Page 660
NCCAM......Page 661
Meditation......Page 662
Herbalism/homeopathy......Page 663
Conclusions......Page 664
References......Page 665
Inpatient treatment of eating disorders......Page 666
Duration of inpatient care......Page 667
Outcome studies of day care programmes......Page 668
Direct comparison between inpatient, day patient and outpatient care......Page 670
Differences in UK and US guidance on inpatient and day care treatments for eating disorders......Page 671
References......Page 672
Personality disorders......Page 676
Introduction......Page 678
Meta-analyses......Page 679
Psychological treatment......Page 680
Dynamic psychotherapy......Page 681
Cognitive therapy......Page 683
Dialectical behaviour therapy (DBT)......Page 684
Therapeutic community treatments......Page 685
Newer antidepressants......Page 686
Atypical antipsychotics......Page 687
Mood stabilizers......Page 688
Psychosocial interventions......Page 689
Avoidant personality disorder......Page 690
Mixed personality disorders......Page 691
Limitations using BPD as an example......Page 692
Conclusions......Page 693
References......Page 695
Introduction......Page 701
Anger management......Page 702
Cognitive-behavioural therapy......Page 703
Antipsychotic drugs......Page 704
Mood stabilizers......Page 705
References......Page 706
Sexual and gender identity disorders......Page 710
Introduction......Page 712
Classification of sexual dysfunction......Page 713
Male sexual dysfunction......Page 714
Drug treatments......Page 715
Psychological treatments......Page 717
Retarded ejaculation and anorgasmia......Page 718
Female sexual dysfunction......Page 719
Psychological approaches......Page 720
Drug treatments......Page 721
Transexualism in men and women......Page 722
Concluding remarks......Page 723
References......Page 725
Introduction......Page 729
Treatment......Page 731
Conclusions......Page 733
References......Page 734
Child psychiatry......Page 738
Family, school and other networks......Page 740
General issues concerning the evidence base for psychological treatments of children and adolescents......Page 741
Cognitive-behaviour therapy (CBT)......Page 742
Family and systemic therapy......Page 743
Parent training......Page 744
Interpersonal therapy (IPT)......Page 745
Social skills groups and problem-solving skills training......Page 746
References......Page 748
Ethics and psychotropic drug prescribing......Page 752
Brain......Page 753
Drug distribution and metabolism......Page 755
References......Page 756
Small group therapy in school settings......Page 760
Multi-systemic therapy......Page 761
Inpatient treatment......Page 762
Complementary and alternative medicine......Page 763
References......Page 764
Interventions for attachment insecurity......Page 767
Psychosocial support and counselling for caregivers......Page 768
Provision of 'normal’ caregiving as a non-specific intervention......Page 769
Summary......Page 770
References......Page 771
Background......Page 774
Feeding disorder of infancy or early childhood (including DSM-IV-TR 307.59 and ICD-10 F98.2: Infant feeding disorder of non-organic origin)......Page 775
Feeding difficulties and/or mismanagement (feeding problem not otherwise specified) (ICD-10 R63)......Page 777
Pica (DSM-IV-TR 307.52); pica of infancy and childhood (ICD-10 F98.3)......Page 780
Critical evaluation and opinion of feeding disorders interventions......Page 782
Sleep onset association disorder......Page 783
Limit-setting sleep disorder......Page 786
Critical evaluation and opinion of sleep disorders treatment......Page 787
References......Page 789
'Miracle cures’......Page 794
Pharmacological interventions......Page 795
Behavioural programmes for pre-school children......Page 796
Understanding the research based evidence for effective approaches to intervention......Page 797
References......Page 798
Introduction......Page 801
Introduction......Page 802
First-line agents – stimulants......Page 803
Precautions and side effects with stimulants......Page 804
Tricyclic antidepressants......Page 805
Alpha-agonists......Page 806
Combination of a stimulant and non-stimulant......Page 807
Behaviour therapy and cognitive-behavioural therapy......Page 808
Combined treatments......Page 809
Conclusions......Page 810
References......Page 811
Introduction......Page 815
Family interventions......Page 816
Psychopharmacology......Page 818
Conclusions......Page 821
References......Page 823
Introduction......Page 827
SSRIs......Page 828
Bipolar disorder......Page 829
Cognitive-behavioural therapy (CBT)......Page 830
Interpersonal therapy (IPT)......Page 831
Summary......Page 832
Conclusions......Page 833
References......Page 834
Schizophrenia......Page 838
Early intervention......Page 840
Family therapy......Page 843
Conclusions......Page 844
References......Page 845
Introduction......Page 849
Pharmacotherapy......Page 850
Psychopharmacology......Page 851
Psychopharmacology......Page 852
Psychopharmacology......Page 853
Conclusions......Page 855
References......Page 856
Introduction......Page 860
Psychodynamic psychotherapy......Page 861
Motivation interviewing and enhancement......Page 862
Family therapy interventions......Page 864
Medical concerns and management......Page 865
Amenorrhea......Page 866
Practice guidelines for treatment......Page 867
References......Page 869
Appendix I: Summary of specific drugs having evidence of effectiveness in mental disorders......Page 874
Further Reading......Page 884
Appendix II: Key to effectiveness tables......Page 886
A......Page 888
B......Page 892
C......Page 895
D......Page 899
E......Page 902
G......Page 904
H......Page 905
L......Page 906
M......Page 907
O......Page 909
P......Page 911
R......Page 914
S......Page 915
T......Page 918
Y,Z......Page 919