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دانلود کتاب Massachusetts General Hospital Comprehensive Clinical Psychiatry
دانلود کتاب روانپزشکی جامع بالینی بیمارستان عمومی ماساچوست
مشخصات کتاب
Massachusetts General Hospital Comprehensive Clinical Psychiatry
ویرایش: Second edition نویسندگان: Massachusetts General Hospital., Fava. Maurizio, Rosenbaum. Jerrold F., Stern. Theodore A., Wilens. Timothy E سری: ISBN (شابک) : 9780323328999, 032329507X ناشر: Elsevier Health Sciences سال نشر: 2016;2015 تعداد صفحات: 0 زبان: English فرمت فایل : AZW3 (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 26 مگابایت
قیمت کتاب (تومان) : 54,000
کلمات کلیدی مربوط به کتاب روانپزشکی جامع بالینی بیمارستان عمومی ماساچوست: بیماریهای روانی -- درمان ، اختلالات روانی -- درمانی ، روانپزشکی -- روش شناسی ، روانپزشکی ، روانپزشکی -- روشها ، بیماریهای روانی -- درمان ، روانپزشکی -- روش شناسی ، اختلالات روانی -- درمانی ، روانپزشکی -- روشها
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Front cover Massachusetts General Hospital Comprehensive Clinical Psychiatry Copyright page Table of Contents Preface List of Contributors Dedication Part I: Approach to the Patient Chapter 1: The Doctor–Patient Relationship Key Points Overview The Optimal Healing Environment: Patient-Centered Care Physician Practice in Patient-Centered Care Collaborating Around History-Taking Effective Clinical Interviewing Planning the Path Forward: Creating a Clinical Formulation Treatment Planning Obstacles and Difficulties in the Doctor–Patient Relationship Key References References Chapter 2: The Psychiatric Interview Key Points Overview Lessons From Attachment Theory, Narrative Medicine, and Mindful Practice The Context of the Interview: Factors Influencing the Form and Content of the Interview The Setting The Situation The Subject The Significance Establishing an Alliance and Fostering Effective Communication Building the Relationship and Therapeutic Alliance Data Collection: Behavioral Observation, the Medical and Psychiatric History, and the Mental Status Examination Behavioral Observation The Medical and Psychiatric History Presenting Problems Past Psychiatric History Past Medical History Review of Systems Family History Social and Developmental History Use of Corollary Information The Mental Status Examination Sharing Information and Preparing the Patient for Treatment The Evaluation of Children and Adolescents Difficulties and Errors in the Psychiatric Interview Dealing with Sensitive Subjects Disagreements about Assessment and Treatment Errors in Psychiatric Interviewing Key References References Chapter 3: Laboratory Tests and Diagnostic Procedures Key Points Overview A General Approach to Choosing Laboratory Tests and Diagnostic Studies Routine Screening Psychosis and Delirium Anxiety Disorders Mood Disorders Metabolic and Nutritional Neuroendocrine Disorders Immune Disorders Infectious Diseases Degenerative Disorders Substance Use Disorders Alcohol Cocaine and Stimulants Opiates Steroids Toxins Eating Disorders Drug Monitoring Mood Stabilizers Antipsychotics Antidepressants Electroencephalogram Neuroimaging Structural Neuroimaging Computed Tomography Magnetic Resonance Imaging Positron Emission Tomography and Single-Photon Emission Computed Tomography Conclusion Key References References Chapter 4: Treatment Adherence Key Points Overview Epidemiology of Adherence Clinical and Economic Impact of Non-Adherence Risk Factors for Non-Adherence Clinical Factors Mood Anxiety Psychosis Substance Misuse Patient Factors: Knowledge, Attitudes, and Beliefs Economic and Racial/Ethnic Disparities Clinical Encounters Assessing Adherence Integrating Adherence Into the Treatment Course Initial Consultation Treatment Planning Introduction to Adherence Ongoing Assessment Problem-Solving Barriers to Adherence Education Motivation Skills Logistics Future Directions Research Education Conclusion Key References References Part II: Human Development Chapter 5: Child, Adolescent, and Adult Development Key Points Overview Major Theories of Development Sigmund Freud Erik Erikson Jean Piaget Lawrence Kohlberg Attachment Theory: John Bowlby and Mary Ainsworth Brain Development Infancy (Birth to 18 Months) Temperament Motor Development in Infancy Cognitive Development in Infancy Language Development in Infancy Social and Emotional Development in Infancy Pre-school Years ( to 5 Years) Physical and Motor Development in the Pre-school Years Cognitive Development in the Pre-school Years Language Development in the Pre-school Years Social and Emotional Development in the Pre-school Years Moral Development in the Pre-school Years Gender Identity School-age Years (5 to 12 Years) Language Development in the School-age Years Motor Development in the School-age Years Cognitive Development in the School-age Years Social and Emotional Development in the School-age Years Moral Development in the School-age Years Adolescence (12 to 20 Years) Physical Development during Adolescence Cognitive Development during Adolescence Social and Emotional Development during Adolescence Moral Development during Adolescence Sexual Development during Adolescence Adult Development Young Adulthood Middle to Late Adulthood Late Adulthood and Senescence Key References References Part III: Psychological and Neuropsychological Testing Chapter 6: Diagnostic Rating Scales and Psychiatric Instruments Key Points Overview General Considerations in the Selection of Diagnostic Rating Scales General Diagnostic Instruments Scales for Mood Disorders Scales for Psychotic Disorders Scales for Anxiety Disorders Scales for Substance Abuse Disorders Scales for Cognitive Disorders Conclusion Key References Suggested Reading Chapter 7: Understanding and Applying Psychological Assessment Key Points Overview Psychometrics: the Science of Test Development Basic Psychometric Assumptions: Reliability and Validity Definition of a Psychological Test Major Categories of Psychological Tests Intelligence Tests Objective (Self-Report) Tests of Personality and Psychopathology The Minnesota Multiphasic Personality Inventory–2 The Millon Clinical Multiaxial Inventory–III The Personality Assessment Inventory Objective Tests and the DSM-5 Performance-Based Tests of Personality The Rorschach Inkblot Method Thematic Apperception Test Projective Drawings The Assessment Consultation Process and Report Obtaining the Assessment Consultation Using Psychological Assessment to Enhance Care Understanding the Assessment Report Key References References Chapter 8: Neuropsychological Assessment Key Points Introduction Dimensions of Behavior Assessed Intellectual Function Attention Frontal/executive Functions Memory Language Visuoperceptual, Visuospatial, and Visuoconstructional Functioning Emotional Functions Sensory-perceptual and Motor Functions BRIEF Neuropsychological Screening Measures Conclusion Acknowledgments Key References References Part IV: The Psychotherapies Chapter 9: Coping with Medical Illness and Psychotherapy of the Medically Ill Key Points Background History Clinical and Research Challenges Practical Pointers References Chapter 10: An Overview of the Psychotherapies Key Points Background Psychodynamic Psychotherapy Cognitive-Behavioral Therapy Supportive Psychotherapy Brief Psychotherapy Psychiatric Medication with Psychotherapy Interpersonal Psychotherapy Dialectical Behavior Therapy Group Therapy Couples Therapy Integrative Psychotherapy Innovative Directions of Psychotherapy Research Child and Adolescent Psychotherapy Emotional, Cognitive, and Neurodevelopmental Issues for Children and Adolescents Child and Adolescent Psychodynamic Psychotherapy Manual-Driven Therapies and Behavioral Therapies Systems-Based Care Conclusion Key References References Chapter 11: Brief Psychotherapy: An Overview Key Points Overview History of Brief Psychotherapy Modern Brief Psychotherapies Psychodynamic Short-term Therapies Cognitive-Behavioral Brief Therapies Interpersonal Therapy Eclectic Therapies The Essential Features of Brief Therapy The Initial Evaluation Patient Selection Exclusion Criteria Inclusion Criteria Developing a Focus Completing the Initial Evaluation and Setting Goals The Brief Therapy Mind-set Being an Active Therapist Phases of Planned Brief Therapy Post-treatment Contact KEY References Suggested Reading Chapter 12: Couples Therapy Key Points Overview Seminal Ideas in Couples Therapy Identification of Dysfunctional Relational Patterns Mate Choice and the Contribution of One’s Family of Origin Communication Intimacy and Control Life Cycle Context and Transition Points Conducting a Couples Therapy Evaluation The First Session with Both Members of the Couple The Two Individual Meetings Alcohol and Substance Abuse Previous Therapy History of Mental Illness Sexual Abuse Medical Problems Intimate Partner Violence The Fourth Meeting with Both Members of the Couple: Wrap-up and Recommendations Couples Therapy Techniques Cognition as the Focus of Change Affect as the Focus of Change Behavior as the Focus of Change Conclusion Key References References Chapter 13: Family Therapy Key Points Overview Case Vignette Psychodynamic Family Therapy The Theory The Practice The Proponents The Metaphor Experiential Family Therapy The Theory The Practice The Proponents The Metaphor Structural Family Therapy The Theory The Practice The Proponents The Metaphor Strategic Family Therapy The Theory The Practice The Proponents The Metaphor Systemic Family Therapy The Theory The Practice The Proponents The Metaphor Narrative Family Therapy The Theory The Practice The Proponents The Metaphor Behavioral Family Therapy The Theory The Practice The Proponents The Metaphor Psychoeducational Family Therapy The Theory The Practice The Proponents The Metaphor The Maudsley Model: an Example of Theory Integration Conclusion Key References References Chapter 14: Group Psychotherapy Key Points Overview Creating a Group Clinical Vignette Creation and Goals of a Psychodynamic Group Who Should be Treated in Group Therapy? Combined Therapies Legal and Ethical Considerations in Group Therapy Research, Outcome, and Evaluation Consultation and Supervision for Group Therapy KEY References Suggested Reading Chapter 15: Hypnosis Key Points Overview Historical Background Anton Mesmer and Mesmerism Early Applications of Hypnosis in Medical Practice Hypnosis in Psychiatric Practice Current Research and Theory Theoretical Perspectives on the Hypnotic State Effects on Physiological Function Measurement of Hypnotic Susceptibility Measurement of Hypnotic Depth Functional Neuroanatomy of Hypnosis Genetic and Molecular Basis of Hypnosis Evidence for the Efficacy of Hypnosis Clinical Indications for Hypnosis Customary Clinical Use Pain Management Surgical Care Medical and Dermatological Uses Contraindications for Using Hypnosis Potential Complications of Hypnosis Hypnosis and Performance Enhancement Training in Hypnotherapy The Cochrane Collaborative The Society for Clinical and Experimental Hypnosis The American Society of Clinical Hypnosis Conclusion Current Controversies and Future Considerations Key References References Chapter 16: Cognitive-behavioral Therapy, Behavioral Therapy, and Cognitive Therapy Key Points Overview Behavioral Therapy, Cognitive Therapy, and Cognitive-Behavioral Therapy Putting Behavioral Therapy and Cognitive Therapy Together Basic Principles of Cognitive-behavioral Therapy The Basic Practice of Cognitive-behavioral Therapy The Practice of Cognitive-behavioral Therapy: The Case of Panic Disorder The Efficacy of Cognitive-Behavioral Therapy Adult Unipolar Depression Adolescent Unipolar Depression Bipolar Disorder Generalized Anxiety Disorder Panic Disorder Social Anxiety Disorder Obsessive-Compulsive Disorder Post-traumatic Stress Disorder Schizophrenia Eating Disorders Substance Dependence Other Psychological Conditions The Effectiveness of Cognitive-behavioral Therapy Combining Cognitive-Behavioral Therapy with Medication Recent Developments and Future Directions Conclusion Key References References Part V: Psychiatric Diagnoses and Conditions Chapter 17: The DSM-5: A System for Psychiatric Diagnosis Key Points DSM-5 in Context: an Evolving Diagnostic System The Process of Change for DSM-5 The Three-Section Structure of DSM-5 Section I Section II Section III Diagnostic Criteria Changes Neurodevelopmental Disorders Schizophrenia Spectrum and other Psychotic Disorders Bipolar and Related Disorders Depressive Disorders Anxiety Disorders Obsessive-compulsive and Related Disorders Trauma- and Stressor-related Disorders Somatic Symptom and Related Disorders Eating Disorders Gender Dysphoria Disruptive, Impulse Control, and Conduct Disorders Substance-related and Addictive Disorders Neurocognitive Disorders Critiques and Limitations of DSM-5 Psychodynamic Approaches Behavioral Approaches Family/Systems Theory Conclusion Key References References Part VI: Disorders of Cognition Chapter 18: Delirium Key Points Overview Diagnosis Differential Diagnosis Examination of the Patient Specific Management Strategies for Delirium Drug Treatment Delirium in Specific Diseases Conclusions Key References References Chapter 19: Dementia Key Points Overview Epidemiology of Dementia The Role of Age of Onset Evaluation of the Patient with Suspected Dementia Alzheimer’s Disease Brief Description Epidemiology of Alzheimer’s Disease Pathophysiology Genetics of Alzheimer’s Disease Clinical Features and Diagnosis Differential Diagnosis Treatments Supportive and Long-term Care Prognosis Dementia with Lewy Bodies Definition Epidemiology and Risk Factors Pathophysiology Clinical Features and Diagnosis Differential Diagnosis Treatment Supportive Care and Long-term Management Prognosis Frontotemporal Dementias Definition Epidemiology and Genetic Risk Factors Pathophysiology Clinical Features, Diagnosis, and Differential Diagnosis Treatment Supportive Care and Long-term Management Prognosis Vascular Dementia Definition Epidemiology and Risk Factors Pathophysiology Clinical Features and Diagnosis Differential Diagnosis Treatment Corticobasal Degeneration Progressive Supranuclear Palsy Normal Pressure Hydrocephalus Creutzfeldt–Jakob Disease Conclusions Key References References Suggested Reading Chapter 20: Intellectual Disability Key Points Overview Epidemiology Prevalence Co-Morbid Psychopathology Clinical Features and Diagnosis Clinical Features Diagnosis Treatment Considerations Overview Behavioral Disorders Traditional Psychiatric Disorders Syndrome-associated Disorders Conclusion References Part VII: Mental Disorders Due to Another Medical Condition Chapter 21: Mental Disorders Due to Another Medical Condition Key Points Overview Disorders Psychiatric Differential Diagnosis Primary Mental Disorders Substance-induced Disorders Another Medical Condition Infectious Diseases Herpes Simplex Virus (Figure 21-1) Human Immunodeficiency Virus (Figure 21-3) Rabies Lyme Disease Neurosyphilis Chronic Meningitis Chronic, Persistent Viral or Prion Diseases Epilepsy Complex Partial Seizures Nutritional Deficits Metabolic Encephalopathy Hepatic Encephalopathy Renal Insufficiency Hypoglycemic Encephalopathy Diabetic Ketoacidosis Acute Intermittent Porphyria Endocrine Disorders Thyroid Dysfunction Parathyroid Dysfunction Adrenal Dysfunction Pituitary Dysfunction Demyelinating Disorders Multiple Sclerosis Amyotrophic Lateral Sclerosis Lipid Storage Disorders Mitochondrial Disease Cerebrovascular Disease Toxins Neoplasm Degenerative Disorders Immune Diseases Trauma Evaluation History Examination Treatment Considerations/Strategies Conclusions Key References References Part VIII: Sleep Disorders Chapter 22: Sleep Disorders Key Points Overview The History of Sleep Related to Psychiatry Sleep Physiology Examination of Sleep and Sleep-Related Complaints Polysomnography Multiple Sleep Latency Test Patient-completed Rating Scales Classification of Sleep Disorders Insomnia Principles of Management Medications for Insomnia Potential Adverse Effects of Hypnotics Rebound Insomnia Falls Cognitive and Performance Disturbances Behavior Management Hypersomnia and Excessive Sleepiness Narcolepsy Treatment Excessive Daytime Sleepiness Cataplexy Breathing-Related Sleep Disorders: Obstructive Sleep Apnea, Central Sleep Apnea, and Sleep-Related Hypoventilation Central Sleep Apnea Circadian Rhythm Sleep–Wake Disorders Delayed Sleep Phase Disorder Advanced Sleep Phase Disorder Irregular Sleep–Wake Cycle Disorder Non-24 hour Sleep–Wake Disorder Shift-work Sleep Disorder Parasomnias NREM Sleep Arousal Disorder Sleepwalking or Somnambulism Sleep Terrors (previously known as pavor nocturnus) Sleep-related Eating Disorder, or Nocturnal Binge-eating Disorder Nightmare Disorder, or Dream Anxiety Disorder REM Sleep Behavior Disorder Restless Legs Syndrome Restless Leg Syndrome Treatment Periodic Limb Movements of Sleep (in ICSD-2, Periodic Limb Movement Disorder, formerly called nocturnal myoclonus) Key References References Part IX: Psychiatric Disorders Chapter 23: Impulse-Control Disorders Key Points Overview Intermittent Explosive Disorder Epidemiology and Risk Factors Pathophysiology Clinical Features and Diagnosis Treatment Supportive Care and Long-term Management Kleptomania Epidemiology and Risk Factors Pathophysiology Clinical Features and Diagnosis Differential Diagnosis Treatment Pyromania Incidence and Epidemiology Pathophysiology Clinical Features and Diagnosis Differential Diagnosis Treatment Complications and Prognosis Gambling Disorder Epidemiology and Risk Factors Pathophysiology Clinical Features and Diagnosis Differential Diagnosis Treatment Prognosis Trichotillomania Epidemiology and Risk Factors Pathophysiology Clinical Features and Diagnosis Differential Diagnosis Treatment Prognosis Conclusion Key References References Chapter 24: Somatic Symptom Disorders Key Points Overview Cross-walking DSM-IV to DSM-5 Somatic Symptom Disorder Illness Anxiety Disorder Conversion Disorder Psychological Factors Affecting Other Medical Conditions Factitious Disorders Other Specified Somatic Symptom and Related Disorder Functional Somatic Syndromes Shared Parameters of Somatically- Oriented Conditions Manifestations Production Gratification Treatment Assigning a Leader to Develop a Treatment Plan Informing the Patient about the Treatment Plan Frequent, Scheduled Visits Consideration and Treatment of Co-morbid Conditions The Role of Psychiatrists Suggestibility for Conversion Disorder Conclusions Key References References Chapter 25: Factitious Disorders and Malingering Key Points Overview Factitious Disorders Factitious Disorder Imposed on Self Clinical Features Diagnostic Approach Differential Diagnosis Treatment Approach Factitious Disorder Imposed on Another Clinical Features Diagnostic Approach Treatment Approach Malingering Clinical Features Diagnostic and Management Approach Conclusion References Suggested Reading Chapter 26: Alcohol-Related Disorders Key Points Overview Description and Definition Alcohol-Induced Disorders Alcohol Intoxication Treatment Alcohol-induced Coma Alcohol Withdrawal Syndrome Treatment Alcohol Withdrawal Seizures Treatment Alcohol Withdrawal Delirium Treatment Wernicke–Korsakoff Syndrome Wernicke’s Encephalopathy Treatment Korsakoff’s Psychosis (Alcohol-induced Persisting Amnestic Disorder) Fetal Alcohol Spectrum Disorder Alcohol Use Disorders Etiology AND Epidemiology Etiology Epidemiology Alcohol Use Disorders and Co-occurring Psychiatric Illness Typologies Pathophysiology and Imaging Effects on Neurotransmitters Screening and Assessment Treatment for Alcohol Use Disorders Brief Intervention Intensive-Extensive Interventions Pharmacological Interventions Alcoholics Anonymous and Long-term Support Conclusions Key References References Chapter 27: Drug Addiction Key Points Overview The Neurobiology of Addiction Cocaine Abuse Management Amphetamines Abuse Treatment Club Drugs Opioids Opiate Substitution Therapy Opiate Antagonist Therapy Managing the Opiate-addicted Hospitalized Patient Inpatient Detoxification Outpatient Detoxification Treatment Pain Management for Patients Receiving Opiate Substitution Overdose Prevention and Reversal Benzodiazepines Neurobiology Patterns of Chronic Use versus Abuse Overdose Withdrawal Sedative-Hypnotics Abuse Clinical Syndromes Withdrawal Treatment for Withdrawal Inpatient Management and Referral Bath Salts Mixed-Drug Addiction References Suggested Reading Chapter 28: Psychosis and Schizophrenia Key Points Overview Epidemiology and Risk Factors Pathophysiology Neurochemical Changes Neurocellular Changes Changes in Brain Structure Changes in Brain Function Clinical Features and Diagnosis Evaluation Tests and Laboratory Findings Brain Neuroimaging Differential Diagnosis of Psychosis Pharmacological Treatment Acute Phase Maintenance Phase Rehabilitation and Long-Term Management Prognosis Morbidity and Mortality Rates Prognosis with Regard to Symptoms and Function Current Controversies and Future Considerations Key References References Chapter 29: Mood Disorders: Depressive Disorders (Major Depressive Disorder) Key Points Introduction Major Depressive Disorder Subtypes of Major Depressive Disorder Anxious Depression Mixed Depression Melancholic Depression Atypical Depression Psychotic Depression Catatonic Depression Peri-partum Depression Seasonal Depression Evaluation of the Patient with Potential Major Depressive Disorder Other Depressive Disorders Epidemiology of Major Depressive Disorder Morbidity, Disability, and Mortality Rates in Depression Impact of Depression on Medical Co-Morbidity Impact of Non-Psychiatric Medical Illnesses on Major Depressive Disorder Depression and Primary Care Risk Factors of Depression in Primary Care Associated Features of Depression in Primary Care Indication for Referral to Psychiatrists Conclusions Key References References Chapter 30: Bipolar Disorder Key Points Overview Epidemiology and Risk Factors Historical Context Clinical Features and Phenomenology Associated Illness Features Bipolar I versus II Psychosis Suicide Cognitive Symptoms Features of Longitudinal Course Age at Onset and Prodrome Mood Episodes and Chronicity Rapid Cycling Antidepressant-induced Mania/Hypomania Seasonality and Climate Changes in Episode Frequency Neurobiology and Pathophysiology Hypotheses Animal Models Post-mortem Studies Neuroimaging Studies Genetic Studies Evaluation, Tests, and Laboratory Work-Up Diagnosis of Bipolar Disorder Differential Diagnosis Schizophrenia and Schizoaffective Disorder Major Depressive Disorder Anxiety Disorders Substance Use Disorders Borderline Personality Disorder Secondary Mania Bipolar Spectrum Illness Consequences of Misdiagnosis Role of Diagnostic Testing (Including Neuroimaging and Other Biomarkers) Tools for Screening, Diagnosis, and Symptom Monitoring Treatment Determination of Mood State and Symptom Severity Treatment Strategies General Treatment Strategies Approach to Mania Approach to Mixed States Approach to Depression Approach to Maintenance Treatment Use of Psychosocial Interventions Special Considerations in Treatment Features of Course Psychiatric and Medical Co-Morbidity Bipolar II Pregnancy Childhood, Adolescence, and Geriatric Patients Prognosis Medical Co-Morbidity among Bipolar Patients Controversies Child Bipolar Key References References Chapter 31: Psychiatric Illness during Pregnancy and the Post-partum Period Key Points Overview Diagnosis and Treatment of Mood Disorder during Pregnancy Antidepressant Use during Pregnancy Pharmacological Treatment of Depression during Pregnancy: Clinical Guidelines Bipolar Disorder during Pregnancy Psychotic Disorders during Pregnancy Anxiety Disorders during Pregnancy Electroconvulsive Therapy during Pregnancy Post-Partum Mood and Anxiety Disorders: Diagnosis and Treatment Breastfeeding and Psychotropic Drug Use Perinatal Psychiatry: From Screening to Treatment Key References References Chapter 32: Anxiety Disorders Key Points Overview Panic Disorder and Agoraphobia Introduction Clinical Characteristics and Diagnosis Panic Disorder Agoraphobia Panic Attack Specifier Epidemiology Impairment and Quality of Life Co-morbidity Pathophysiology Neurobiology Psychopathological Processes Social Anxiety Disorder Clinical Characteristics and Diagnosis Epidemiology Impairment and Quality of Life Co-morbidity Pathophysiology Neurobiology Psychophysiology Cognitive-behavioral models Generalized Anxiety Disorder Overview Clinical Characteristics and Diagnosis Epidemiology Impairment and Quality of Life Co-morbidity Pathophysiology Neurobiology Psychopathological processes Conclusion Key References References Chapter 33: Obsessive-compulsive Disorder and Obsessive-compulsive and Related Disorders Key Points Overview Clinical Features and Diagnosis Epidemiology and Risk Factors Prevalence Age of Onset Gender Race and Cultural Factors Risk Factors Genetics Pathophysiology Evaluation, Tests, and Laboratory Findings Treatment Prognosis Current Controversies, Unanswered Questions, and Future Challenges Clinician and Patient Resources Key References References Suggested Reading Chapter 34: Trauma and Posttraumatic Stress Disorder Key Points Overview Diagnosis Etiology Clinical Features Acute Stress Disorder Differential Diagnosis Epidemiology Incidence and Prevalence Co-morbidity Risk Factors Prognosis Recovery and Course of Illness Suicide Attempts Impairment Pathogenesis Psychophysiology Biology Treatment Utilization Psychotherapy Pharmacotherapy Current Status of Posttraumatic Stress Disorder Treatment Current Controversies and Future Directions Key References References Chapter 35: Dissociative Disorders Key Points OVERVIEW History Causes of Dissociation The Epidemiology of Dissociation Different Dissociative Disorders Dissociative Amnesia Dissociative Identity Disorder Depersonalization/Derealization Disorder Dissociative Disorder Not Otherwise Specified Factitious Disorders or Malingering of Dissociative Presentations Conclusion Key References References Chapter 36: Sexual Disorders and Sexual Dysfunction Key Points Overview Epidemiology and Risk Factors Pathophysiology Clinical Features and Diagnosis Approach to Sexual History-taking Physical Examination and Laboratory Investigation Diagnostic Features of Specific Sexual Dysfunctions Male Disorders of Sexual Function Erectile Disorder. Delayed Ejaculation. Premature (Early) Ejaculation. Male Hypoactive Sexual Desire Disorder. Female Disorders of Sexual Function Female Sexual Interest/Arousal Disorder. Female Orgasmic Disorder. Genito-Pelvic Pain/Penetration Disorder. Sexual Dysfunctions Affecting Both Genders Substance/Medication-Induced Sexual Dysfunction. Other Specified and Unspecified Sexual Dysfunction. Diagnostic Features of Specific Paraphilic Disorders Diagnostic Features of Gender Dysphoria Gender Dysphoria in Children. Gender Dysphoria in Adolescents and Adults. Differential Diagnosis of Sexual Disorders Treatment Organically-Based Treatment Premature Ejaculation Erectile Disorder Female Sexual Dysfunction Paraphilic Disorders Gender Dysphoria Psychologically-Based Treatments Sexual Dysfunction Paraphilic Disorders Gender Dysphoria Future Outlook Suggested Reading Chapter 37: Eating Disorders: Evaluation and Management Key Points Overview Classification Epidemiology Course, Co-Morbidity, and Mortality Rate Etiological Factors Diagnostic Features Anorexia Nervosa Bulimia Nervosa Binge-eating Disorder Other Specified Feeding or Eating Disorder Evaluation and Differential Diagnosis Medical Complications Medical Assessment Laboratory Findings Treatment Medical Management Psychotherapeutic Treatment Anorexia Nervosa Bulimia Nervosa Binge-Eating Disorder Pharmacological Treatment Pharmacological Management of Anorexia Nervosa Pharmacological Management of Bulimia Nervosa Pharmacological Management of Binge-eating Disorder Pharmacological Considerations in Treating Children and Adolescents Conclusions Current Controversies and Future Considerations Key References References Suggested Reading Chapter 38: Grief, Bereavement, and Adjustment Disorders Key Points Grief and Bereavement Definition Epidemiology and Risk Factors Clinical Findings and Differential Diagnosis Treatment Options Complications Prognosis Adjustment Disorders Epidemiology Clinical Findings and Differential Diagnosis Treatment Options Prognosis References Suggested Readings Chapter 39: Personality and Personality Disorders Key Points Overview Personality Theory The Origins of Personality Adult Personality Traits DSM-5 Personality Disorders Cluster A Personality Disorders Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder Cluster B Personality Disorders Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder Cluster C Personality Disorders Avoidant Personality Disorder Dependent Personality Disorder Obsessive-compulsive Personality Disorder DSM-5 Personality Disorders DSM-5 Section III: Hybrid Diagnosis Criterion A: Level of Personality Functioning Criterion B: Traits and Types Diagnosing Personality Disorders Treatment of Personality Disorders Psychotherapy Pharmacotherapy Agents Antipsychotics. Mood Stabilizers. Antidepressants. Benzodiazepines. Opioid Antagonists. Approach to the Pharmacotherapy of Personality Disorders Key References References Part X: Treatment Approaches Chapter 40: Psychiatric Neuroscience: Key Points Overview History of Psychiatric Neuroscience Psychiatric Diagnosis: Biomarkers and Biological Validity Methods in Psychiatric Neuroscience Brain Lesions and Behavior Neuropsychology and Endophenotypes Neuroimaging Neurophysiology Brain Stimulation and Neuromodulation Neuropathology Psychopharmacology Animal Experiments Human Genetics and Molecular Biology Biological Case Formulation: Neuroscientific Content and Process Process Content Overview of the Structure of the Central Nervous System Cellular Diversity in the Brain: Neurons and Glia Neurons Glia The Structure of the Synapse Neurotransmitters Synaptic Transmission, Second Messenger Systems, and Activity-Dependent Gene Expression A Review of Clinically Relevant Neurotransmitter Systems Glutamate The N-methyl-d-aspartate Receptor and the Role of Glutamate in Neuropsychiatric Illness GABA GABA Receptors GABA in Neuropsychiatric Illness Dopamine Dopamine Pathways and Relevance to Neuropsychiatry Dopamine Synthesis, Binding, and Inactivation and More Clinical Correlates Norepinephrine Norepinephrine in Opiate Withdrawal Serotonin Acetylcholine Acetylcholine and Cognition Histamine Other Neurotransmitters, and Interactions among Neurotransmitters Genes, Environment, and Epigenetics Conclusion Acknowledgments Key References References Chapter 41: The Pharmacotherapy of Anxiety Disorders Key Points Overview Panic Disorder and Agoraphobia Antidepressants Tricyclic Antidepressants (TCAs) Monoamine Oxidase Inhibitors Benzodiazepines Other Agents Generalized Anxiety Disorder Antidepressants Selective serotonin Reuptake Inhibitors and Serotonin Norepinephrine Reuptake Inhibitors Tricyclic Antidepressants Benzodiazepines Buspirone Anticonvulsants Antipsychotics Other agents Riluzole Chamomile Kava Social Anxiety Disorder Selective serotonin Reuptake Inhibitors and Serotonin Norepinephrine Reuptake Inhibitors Beta-blockers Monoamine Oxidase Inhibitors Benzodiazepines Other medications Conclusions and Future Directions References Chapter 42: Antipsychotic Drugs Key Points Introduction History Chlorpromazine and the Early Agents Clozapine, the First Atypical Antipsychotic Other Atypical Agents The CATIE Study Currently Available Antipsychotic Agents General Clinical Considerations Drug Selection First-Generation (“Typical”) Antipsychotics Extrapyramidal Symptoms and Tardive Dyskinesia Neuroleptic Malignant Syndrome Second-Generation (“Atypical”) Antipsychotics Clozapine Risperidone and Paliperidone Olanzapine Quetiapine Ziprasidone Aripiprazole Iloperidone Asenapine Lurasidone Drug Interactions with Antipsychotic Agents Ongoing Challenges Key References References Chapter 43: Antidepressants Key Points Overview Mechanism of Action Mechanism of Action of Selective Serotonin Re-uptake Inhibitors Mechanism of Action of Serotonin Norepinephrine Re-uptake Inhibitors Mechanism of Action of Norepinephrine Re-uptake Inhibitors Mechanism of Action of Serotonin Receptor Agonist/Antagonists Mechanism of Action of Norepinephrine/Dopamine Re-uptake Inhibitors Mechanism of Action of Alpha2-Adrenergic Receptor Antagonists Mechanism of Action of Tricyclic Antidepressants Mechanism of Action of Monoamine Oxidase Inhibitors Clinical Uses of Antidepressants Continuation and Maintenance of Antidepressant Treatment Suicide Risk Choice of an Antidepressant Selective Serotonin Re-uptake Inhibitors Dosage Side-effect Profile Selective Serotonin Re-uptake Inhibitors Discontinuation Syndrome Drug Interactions Use of Selective Serotonin Re-uptake Inhibitors in Pregnancy and the Post-partum Period Serotonin Norepinephrine Re-uptake Inhibitors Venlafaxine and Desvenlafaxine Duloxetine Levomilnacipran and Milnacipran Norepinephrine Re-uptake Inhibitors Reboxetine Atomoxetine Norepinephrine/Dopamine Re-uptake Inhibitors Bupropion Serotonin Receptor Antagonists/Agonists Trazodone Nefazodone Vilazodone Vortioxetine Ritanserin Agomelatine Buspirone and Gepirone Alpha2-Adrenergic Receptor Antagonists Mirtazapine Mianserin Tricyclic and Related Cyclic Antidepressants Side-effect Profile Prescribing Tricyclic and Related Cyclic Antidepressants Use of Tricyclic and Related Cyclic Antidepressants during Pregnancy and the Post-partum Period Overdoses with Tricyclic and Related Cyclic Antidepressants Drug Interactions Monoamine Oxidase Inhibitors Side-effect Profile Dietary Restrictions and Drug Interactions Dosage Overdose Drug Interactions Key References References Chapter 44: Pharmacological Approaches to Treatment-Resistant Depression Key Points OVERVIEW Definition of Treatment-Resistant Depression Staging Models of Treatment-Resistant Depression Clinical Features Associated with Treatment-Resistant Depression Clinical Approach to Treatment-Resistant Depression Common Treatment Strategies for Treatment-Resistant Depression Switching an Antidepressant Combining Two Antidepressants with Different Mechanisms of Action Augmentation Lithium Triiodothyronine (T3) Atypical Antipsychotics Buspirone l-Methylfolate S-adenosyl-l-methionine Novel Therapeutic Agents Non-pharmacological Interventions Research Challenges Conclusions References Chapter 45: Electroconvulsive Therapy Key Points Overview Indications for Electroconvulsive Therapy Risk Factors Associated with Electroconvulsive Therapy Technique for Conducting Electroconvulsive Therapy Adverse Effects of Electroconvulsive Therapy Maintenance Electroconvulsive Therapy Treatment Electroconvulsive Therapy in Children Conclusion References Chapter 46: Neurotherapeutics Key Points Overview Ablative Limbic System Surgery Deep Brain Stimulation Vagus Nerve Stimulation Electroconvulsive Therapy Transcranial Magnetic Stimulation Conclusion Key References References Chapter 47: Lithium and Its Role in Psychiatry Key Points Historical Context Lithium’s Mechanism of Action Pharmacokinetics and Pharmacodynamics Evidence for Lithium’s Efficacy Lithium in Acute Mania Lithium in Acute Bipolar Depression Lithium for Maintenance Treatment and Relapse Prevention of Bipolar Disorder Lithium in Rapid-cycling Bipolar Disorder Lithium in Suicide Prevention Lithium in Children and Adolescents Pediatric Bipolar Disorder Conduct Disorder Other Uses of Lithium Augmentation of Antidepressants in Treatment-refractory Major Depressive Disorder Relapse Prevention in Major Depressive Disorder Lithium in Psychotic Disorders Lithium in Alcohol Dependence Principles of Lithium Treatment Predictors of Lithium Response Laboratory Monitoring Lithium Dosing Adverse Effects and Their Management Other Bothersome Adverse Effects Lithium in Pregnancy and Breast-feeding Lithium Adherence Current Controversies and Future Directions Key References References Chapter 48: The Use of Antiepileptic Drugs in Psychiatry Key Points Overview: Historical Context Valproic Acid Lamotrigine Carbamazepine Pharmacokinetics, Pharmacodynamics, Adverse Effects, and Monitoring Valproic Acid Lamotrigine Carbamazepine Other Anticonvulsants Oxcarbazepine Gabapentin Levetiracetam Pregabalin Tiagabine Topiramate Zonisamide Conclusion References Chapter 49: Pharmacotherapy of Attention-Deficit/Hyperactivity Disorder across the Life Span Key Points Overview Stimulants Pharmacodynamic Properties of Stimulants Methylphenidate Amphetamines Clinical Use of Stimulants Side Effects of Stimulants Growth Sleep Appetite Suppression Medication Interactions with Stimulants Atomoxetine Clinical Use of Atomoxetine Side Effects of Atomoxetine Alpha-adrenergic Agonists Suggested Management Strategies Across the Life span Safety of Medications Used to Treat Attention-Deficit/Hyperactivity Disorder Cardiovascular Safety of Attention-Deficit/Hyperactivity Disorder Treatments Aggression during Treatment with Attention-Deficit/Hyperactivity Disorder Medications Psychotic or Manic Symptoms during Treatment with Attention-Deficit/Hyperactivity Disorder Medications Alternative (Not FDA-Approved) Treatments for Attention-Deficit/Hyperactivity Disorder Bupropion Tricyclic Antidepressants Modafinil Novel Treatments for Attention-Deficit/Hyperactivity Disorder Nicotinic Agents Medications Used in the Treatment of Alzheimer’s Disease Metadoxine Selegiline Pharmacotherapy of Attention-Deficit/Hyperactivity Disorder and Common Co-Morbid Psychiatric Disorders Attention-Deficit/Hyperactivity Disorder and Aggression Attention-Deficit/Hyperactivity Disorder Plus Anxiety Disorders Attention-Deficit/Hyperactivity Disorder Plus Obsessive-compulsive Disorder Attention-Deficit/Hyperactivity Disorder Plus Tic Disorders Attention-Deficit/Hyperactivity Disorder Plus Depression Attention-Deficit/Hyperactivity Disorder Plus Bipolar Disorder Attention-Deficit/Hyperactivity Disorder Plus Substance Use Disorders Attention-Deficit/Hyperactivity Disorder Plus Autism Spectrum Disorders Attention-Deficit/Hyperactivity Disorder Plus Epilepsy Managing Sub-Optimal Responses Conclusion Key References References Chapter 50: Drug–Drug Interactions in Psychopharmacology Key Points Overview Classification Pharmacokinetics Absorption Distribution Metabolism Excretion Antipsychotics Mood Stabilizers Lithium Valproic Acid Lamotrigine Carbamazepine Antidepressants Selective Serotonin Reuptake Inhibitors and Other Newer Antidepressants P450 2D6 P450 3A4 P450 2C P450 1A Tricyclic Antidepressants Monoamine Oxidase Inhibitors St. John’s Wort Benzodiazepines Psychostimulants and Modafinil Key References References Chapter 51: Side Effects of Psychotropic Medications Key Points Overview Antidepressants Tricyclic Antidepressants Selective Serotonin Reuptake Inhibitors Serotonin-Norepinephrine Reuptake Inhibitors Venlafaxine Duloxetine Monoamine Oxidase Inhibitors Other Antidepressants Bupropion Mirtazapine Trazodone Vilazodone Mood Stabilizers Lithium Valproic Acid Carbamazepine Oxcarbazepine Lamotrigine Antipsychotics Typical Antipsychotics Atypical Antipsychotics Risperidone Paliperidone Iloperidone Asenapine Lurasidone Ziprasidone Aripiprazole Olanzapine Clozapine Antianxiety and Sleep Agents Benzodiazepines Short-acting Sedative-Hypnotic Sleep Agents (Zolpidem, Zaleplon, and Eszopiclone) Ramelteon Buspirone Gabapentin Other Agents Used in the Treatment of Psychiatric Conditions Beta-blockers Clonidine Stimulants Modafinil Atomoxetine Anticholinergics Topiramate Acamprosate Naltrexone Buprenorphine Key References References Chapter 52: Natural Medications in Psychiatry Key Points Overview Efficacy and Safety Mood Disorders Omega-3 Fatty Acids St. John’s Wort S-Adenosylmethionine Folate and Vitamin B12 Inositol Anxiety and Insomnia Valerian Melatonin Kava Premenstrual and Menopausal Symptoms Black Cohosh Chaste Tree Berry Cognition and Dementia Ginkgo biloba Dehydroepiandrosterone Conclusion Key References References Part XI: Special Topics in Psychiatry Chapter 53: The Suicidal Patient Key Points Overview Epidemiology and Risk Factors Epidemiology Psychiatric Risk Factors Medical Risk Factors Familial and Genetic Risk Factors Social Risk Factors Past and Present Suicidality Contact with Physicians Pathophysiology Neurobiology Psychological, Psychodynamic, and Neuropsychological Perspectives Clinical Features and Diagnosis Treatment of Suicide Risk Difficulties in the Assessment of Suicide Risk Key References References Suggested Reading Part XII: Psychosomatic Medicine Chapter 54: Psychiatric Consultation to Medical and Surgical Patients Key Points Overview Epidemiology and Differential Diagnosis Principles of Psychiatric Evaluation of Medical and Surgical Patients Speak with the Consultee Review the Record Review Medications Gather Information from Family and Others Interview the Patient Conduct a Mental Status Examination Arousal Attention Motivation Language Memory Executive Function Structured Instruments Conduct Physical and Neurological Examinations Write a Note Speak with the Consultee Treatment Biological Psychological Social Special Situations Diagnosis, Treatment, and Patient Advocacy Somatic Symptom Disorders The Reticent Patient Difficult and Hateful Patients Conclusions Key references References Chapter 55: Life-threatening Conditions in Psychiatry: Catatonia, Neuroleptic Malignant Syndrome, and Serotonin Syndrome Key Points Overview Catatonia Definition Epidemiology and Risk Factors Subtypes Clinical Features and Diagnosis Pathophysiology Management and Treatment Prognosis and Complications Neuroleptic Malignant Syndrome Epidemiology and Risk Factors Clinical Features and Diagnosis Management and Treatment Serotonin Syndrome Definition Epidemiology Clinical Features and Diagnosis Pathophysiology Management and Treatment Prognosis and Complications Key References References Chapter 56: Psycho-oncology: Psychiatric Co-morbidities and Complications of Cancer and Cancer Treatment Key Points The Role of Psychiatry in the Care of Cancer Patients Denial and “Middle Knowledge” Hope and the Doctor–Patient Relationship Medical Choices Distress Screening Psychosocial Interventions Anxiety Syndromes Nausea and Vomiting Depression Fatigue Prevalence Diagnosis Treatment Stimulants Exercise Behavioral Interventions Confusion and Cognitive Impairment Hypercalcemia Hyponatremia Brain Tumors Leptomeningeal Disease Delirium in Hematopoietic Stem Cell Transplantation Hyperviscosity Syndrome Cushing’s Syndrome Paraneoplastic Neurological Disorders Paraneoplastic Limbic Encephalitis Toxic Leukoencephalopathy Chemotherapy-related Cognitive Impairment Effects of Hormonal Therapy in Cancer Patients Survivors of Childhood Cancer Key References References Chapter 57: Psychiatric Aspects of HIV Infection and AIDS Key Points Overview Epidemiology Basic Biology Classification and Diagnosis General Approach to Psychiatric Care Psychiatric Disorders Substance Use Disorders Depressive and Anxiety Disorders Psychotic Disorders HIV-associated Psychosis “AIDS Mania” Cognitive Disorders Delirium HIV-associated Neurocognitive Disorder Neurological Disorders Treatment Special Clinical Problems Adherence Fatigue Suicide Serious Mental Illness Co-infection with HIV and Hepatitis C Cigarette Smoking Internet Resources Key References References Chapter 58: Organ Transplantation: Pre-transplant Assessment and Post-transplant Management Key Points Overview Psychiatric Evaluation of the Transplant Patient Pre-transplant Psychiatric Evaluation Pre-transplant Psychiatric Disorders Treatment of the Pre-Transplant Patient Care of the Post-Transplant Patient Short-term Care Long-term Care Pediatric Transplantation Pre-transplant Evaluation Post-transplant Care Conclusion References Chapter 59: Approaches to Collaborative Care and Primary Care Psychiatry Key Points Overview Epidemiology Barriers to Treatment The Goals of Collaboration Access Treatment Outcomes Communication Roles, Relationships, and Expectations Models of Collaboration Outpatient Consultation Models Specialty Psychiatric Clinics Consultation Psychiatrists Three-component Model Psychiatrist on the Primary Care Clinic Medical Staff Staff Consultant Parallel Care Collaborative Management Primary-care-driven Model Choosing the Right Model Conclusion Key References References Chapter 60: Psychiatric and Ethical Aspects of Care at the End of Life Key Points Overview Goals of Treatment The Role of the Psychiatrist Depression Anxiety Personality Considerations Delirium and Cognitive Changes Pain Psychosocial Considerations Challenges for Care Providers Ethics and End-of-Life Care Principles Limitation of Life-sustaining Treatment Physician-assisted Suicide Conclusion Key References References Part XIII: Psychiatric Epidemiology and Statistics Chapter 61: Psychiatric Epidemiology Key Points Overview Epidemiological Measures of Disease Frequency Criteria for Assessment Instruments Assessment of New Instruments Study Designs Descriptive Studies Ecological Studies Cross-sectional Studies Case-control Studies Cohort Studies Randomized Controlled Trials Development of Assessment Tools Case Definition Standardized Instruments for Case Assessment Contemporary Studies in Psychiatric Epidemiology The Baseline National Comorbidity Survey (NCS) The NCS General Findings NCS-Replication Survey Mental Health Services Utilization The European Study of the Epidemiology of Mental Disorders Project Epidemiology Under utilization of Health Services Epidemiology of Major Psychiatric Disorders Schizophrenia Epidemiology Risk Factors Bipolar I Disorder Epidemiology Risk Factors Co-morbidities Major Depressive Disorder Epidemiology Risk Factors Depression as the Cause of Disability Generalized Anxiety Disorder Epidemiology Risk Factors Panic Disorder Epidemiology Risk Factors Social Burdens of Panic Alcohol Abuse and Dependence Epidemiology Risk Factors Co-morbidity References Chapter 62: Statistics in Psychiatric Research Key Points Three Classes of Statistics in Psychiatric Research Concrete Examples of the Three Classes of Statistics in a Research Article Experiment-wise Error Rate Selecting an Appropriate Statistical Method The Importance of Assessing Statistical Power Statistical Terms and Their Definitions Analysis of Covariance Analysis of Variance Analysis of Variance with Repeated Measure(s) Bonferroni Correction Canonical Correlation Chi-Square (χ2) Test Cluster Analysis Confidence Interval Contingency Table Analysis by Chi-Square (χ2) Correlation Correlation Matrix Covariate Dependent t-Test Dependent Variable Descriptive Statistics Discriminant Function Analysis Effect Size End-point Experiment-wise Error Rate Factor Analysis Frequencies Intent-to-Treat Analysis Interaction Effect Level of Measurement Logistic Regression MANCOVA Mann–Whitney U Test MANOVA Mean Median Mediation Mixed-effect Model Repeated Measure Model Moderation Multiple Linear Regression Multivariate Analysis of Variance Multivariate Statistical Analysis Null Hypothesis Outcome Variable P-Value Pearson Correlation Coefficient Phi Correlation Coefficient Planned Comparisons Point-Biserial Correlation Power r Random Assignment Rank-Order Correlation Regression Reliability Rho Standard Deviation Statistical Analysis Software Statistical Power Tau t-Test t-Test for Dependent Means Univariate Statistical Analysis Validity Variance Current Controversies and Future Directions Suggested Reading Part XIV: Genetics and Psychiatry Chapter 63: Genetics and Psychiatry Key Points Overview Basic Organization of the Human Genome Genetic Variation and Polymorphism Linkage Disequilibrium and Haplotypes Gene Expression The Complex Genetic Architecture of Psychiatric Disorders Approaches to the Study of Psychiatric Genetics Genetic Epidemiology Family Studies. Twin Studies. Adoption Studies. Linkage Analysis. Association Analysis. Candidate Gene Studies Genome-Wide Association Studies Copy Number Variants Whole-Exome Sequencing Gene–Environment Interaction Intermediate Phenotypes and Endophenotypes Genetics of Psychiatric Disorders Genetic Aspects of Psychopathology Disorders of Childhood and Adolescence Attention-Deficit/Hyperactivity Disorder Genetic Epidemiology. Molecular Genetic Studies. Autism Genetic Epidemiology. Molecular Genetic Studies. Tourette Syndrome Genetic Epidemiology. Molecular Genetic Studies. Dementia Alzheimer’s Disease Genetic Epidemiology. Molecular Genetic Studies. Psychotic Disorders Schizophrenia Genetic Epidemiology. Molecular Genetic Studies. Mood Disorders Bipolar Disorder Genetic Epidemiology. Molecular Genetic Studies. Major Depressive Disorder Family Studies. Molecular Genetic Studies. Anxiety Disorders Panic Disorder Family Studies. Molecular Genetic Studies. Phobic Disorders Genetic Epidemiology. Molecular Genetics. Generalized Anxiety Disorder Genetic Epidemiology. Molecular Genetics. Obsessive-Compulsive Disorder Genetic Epidemiology. Molecular Genetic Studies. Substance Use Disorders Alcohol Abuse and Dependence Family Studies. Molecular Genetic Studies. Drug Abuse and Dependence Genetic Epidemiology. Molecular Genetic Studies. Pharmacogenetics Psychiatric Aspects of Medical Genetic Disorders Psychiatric Symptoms Secondary to Genetic Syndromes Selected Genetic Syndromes with Psychiatric and Behavioral Symptoms (Table 63-2) Disorders Due to Chromosomal Abnormalities and Microdeletions Klinefelter Syndrome Turner Syndrome Duplication 15 Prader-Willi Syndrome Velocardiofacial Syndrome Smith-Magenis Syndrome Williams Syndrome Disorders Due to Single Gene Mutations Fragile X Syndrome Huntington Disease Rett Syndrome Tuberous Sclerosis Selected Inborn Errors of Metabolism with Psychiatric and Behavioral Symptoms (see Table 63-3) Autosomal Dominant Disorders Acute Intermittent Porphyria Autosomal Recessive Disorders Homocystinuria Metachromatic Leukodystrophy (Juvenile- or Adult-onset Forms) Niemann-Pick, Type C Tay-Sachs, Late-onset Form Wilson Disease X-Linked Disorders Adrenoleukodystrophy Mitochondrial Disorders Conclusion Clinical Applications of Psychiatric Genetics References Part XV: Social and Community Psychiatry Chapter 64: Serious Mental Illness Key Points Overview Definition and Scope of the Problem Complications of Serious Mental Illness Comprehensive Assessment Treatment and Recovery Goals Establishing a Collaborative Treatment Relationship Preventing Suicide Preventing Violence Preventing Late-stage Psychiatric Disease and Disability Preventing Medical Morbidity and Mortality Reducing Substance Misuse Improving Quality of Life Ongoing Challenges Key References References Chapter 65: Aggression and Violence Key Points Overview Epidemiology and Risk Factors Pathophysiology Clinical Features and Diagnosis Medical Causes Psychiatric Causes Psychotic Disorders Affective Disorders Disruptive, Impulse-control, and Conduct Disorders Post-traumatic Stress Disorder Personality and Developmental Disorders Psychosocial Factors Assessment in the Acute Setting The Interview History Examination of the Violent Patient Management in the Acute Setting Strategies for Long-Term Management Current Controversies and Future Considerations Key References References Chapter 66: Culture and Psychiatry Key Points Overview Cultural Assessment Determination of Cultural Identity of the Individual Determination of Cultural Conceptualizations of Distress Determination of Psychosocial Stressors and Cultural Features of Vulnerability and Resilience Determination of the Cultural Features between the Individual and the Clinician Impact of Ethnicity on Psychiatric Diagnosis Differences in Presentation of Illness Acculturation and Immigration Culture-Bound Syndromes (Cultural Concept of Distress) Working with Interpreters Recommendations When Working with Interpreters Ethnicity and Psychopharmacology Biological Aspects of Psychopharmacology Techniques to Minimize Cultural Clashes, Misdiagnosis, and Adverse Events References Chapter 67: Community Psychiatry Key Points Overview Terms and Definitions Related Fields Social and Public Health Terms Terms of Managed Care Historical Background The Age of Enlightenment Early Twentieth-century Awareness Mid-twentieth Century Birth of the American Community Mental Health Movement Late Twentieth Century Start of the Twenty-first Century Underlying Principles of Community Mental Health Population Responsibility Prevention Community-based Care Continuity of Care Components and Services of Community Mental Health Systems Inpatient Care Partial Hospitalization Outpatient Services Emergency Services Community Consultation/Education Case Management Homeless Outreach Disaster or Trauma Response Evaluation and Research Trends Disenfranchisement Managed Care: The “Fourth Psychiatric Revolution?” Primary Care Creative Solutions Conclusion Key References References Chapter 68: Managed Care and Psychiatry Key Points Overview The History of Mental Health Care Finance in the United States The Rise of Private Health Insurance The Community Mental Health Center Movement and Deinstitutionalization The Rise of Public Health Insurance: Medicare and Medicaid Insuring Mental Health Care: Moral Hazard, Adverse Selection, and the Rise of Managed Behavioral Carve-Outs Managed Care and the Rise of “Carve-Out” Plans Recent Trends in Mental Health Care Financing Gross Spending on Mental Health Care Sources of Health Care Expenditures Parity, Expansion of Coverage, and the Future of Mental Health Care in the United States Conclusion Key References References Part XVI: Child Psychiatry Chapter 69: Child and Adolescent Psychiatric Disorders Key Points Overview Developmental Variations in Psychopathology Childhood Anxiety Disorders Separation Anxiety Treatment of Separation Anxiety Psychosocial Treatments for Separation Anxiety. Pharmacotherapy for Separation Anxiety. Obsessive-compulsive Disorder Treatment of Obsessive-compulsive Disorder Psychosocial Treatment of Obsessive-compulsive Disorder. Pharmacotherapy of Obsessive-compulsive Disorder. Generalized Anxiety Disorder Treatment of Generalized Anxiety Disorder Psychosocial Treatments for Generalized Anxiety Disorder. Pharmacotherapy for Pediatric Generalized Anxiety Disorder. Acute Stress Disorder/Post-traumatic Stress Disorder Treatment of Acute Stress Disorder/Post-traumatic Stress Disorder Psychosocial Treatments of Acute Stress Disorder/Post-traumatic Stress Disorder. Pharmacotherapy for Acute Stress Disorder/Post-traumatic Stress Disorder. Tic Disorders Treatment of Tic Disorders Psychosocial Treatments for Tic Disorders Pharmacotherapy for Tic Disorders Attention-Deficit/Hyperactivity Disorder Treatment of Attention-deficit/ Hyperactivity Disorder Psychosocial Treatments of Attention-deficit/Hyperactivity Disorder Pharmacotherapy of Attention-deficit/ Hyperactivity Disorder Oppositional Defiant Disorder Treatment of Oppositional Defiant Disorder Psychosocial Interventions Pharmacotherapy of Oppositional Defiant Disorder Mood Disorders Depression Treatment of Depressive Disorders Psychosocial Treatment of Juvenile Depression. Pharmacotherapy of Juvenile Depression. SSRI Antidepressants and Suicidality Clinical Use of SSRIs Disruptive Mood Dysregulation Disorder Bipolar Disorder Treatment of Pediatric Bipolar Disorders Psychosocial Treatments for Bipolar Disorder. Pharmacotherapy of Bipolar Disorder. Lithium. Anticonvulsants. Antipsychotics for Juvenile Bipolar Disorder. Autism Spectrum Disorder Treatment of Autism Spectrum Psychosocial Treatments for Autism Spectrum Disorder Pharmacotherapy of Autism Spectrum Disorder Psychotic Disorders Treatment of Childhood-onset Schizophrenia Psychosocial Treatments for Childhood- onset Schizophrenia Pharmacotherapy of Childhood-onset Schizophrenia Key References References Chapter 70: Psychiatric and Substance Use Disorders in Transitioning Adolescents and Young Adults Key Points Overview Salient Neurobiology of Transitioning Adolescents and Young Adults Epidemiology Substance Abuse in Transitioning Adolescents and Young Adults Medication Misuse in Transitioning Adolescents and Young Adults Signs and Symptoms of Prescription Drug Abuse Treatment Issues Conclusion Acknowledgments Key References References Part XVII: Geriatric Psychiatry Chapter 71: Geriatric Psychiatry Key Points Overview Mental Health Disorders Common in Late Life Late-life Depression Late-life Depression and Suicide Alcoholism Anxiety Psychosis Dementia Behavioral and Psychological Symptoms of Dementia Schizophrenia Bipolar Disorder Personality Disorders Disasters Caregiver Stress and Burden Elder Abuse References Part XVIII: Neuropsychiatry Chapter 72: Neuroanatomical Systems Relevant to Neuropsychiatric Disorders Key Points Overview Prefrontal Cortex Orbitofrontal Cortex Medial Prefrontal Cortex Dorsolateral Prefrontal Cortex Prefrontal Cortex: Summary and Conclusions Basal Ganglia Basal Ganglia Anatomy Nuclei Connections Basal-Ganglia-Thalamocortical Circuits or “Loops” Striatal Organization Pallidal Complex Organization Subthalamic Nucleus Organization Substantia Nigra Organization Basal Ganglia Function Overall Motor Cognition Affective and Reward-Related Functions Medial Temporal Lobe: Amygdala and Hippocampus Amygdala Nuclear and Cellular Structure Intrinsic Amygdala Connections Extrinsic Amygdala Connections Outputs Inputs Functions of the Amygdala The Amygdala and Emotional Processing in Health and Psychiatric Disease Genetic and Neurotransmitter Associations of the Amygdala Hippocampal and Parahippocampal Cellular Structure Intrinsic Connections of the Medial Temporal Lobe Memory System Extrinsic Connections of the Medial Temporal Lobe Memory System Genetic Influences on the Medial Temporal Lobe Memory System The Medial Temporal Lobe Memory System in Neuropsychiatric Disorders Conclusion References Chapter 73: The Neurological Examination Key Points Overview The Examination The Psychiatric Portion of the Mental Status Examination Initial Observations of the Patient General Appearance. Behavioral Appearance. Speech. Mood and Affect. Thought Process. Thought Content. Perceptions. Insight/Awareness/Concern. Judgment. The Neurological Portion of the Cognitive Mental Status Examination Level of Consciousness Attention Performance of Serial 7s. Spelling Tests. Other Tests. Language Comprehension. Repetition. Memory Immediate Recall. Short-term Memory. Long-term Memory. Visuospatial/Constructional Skills Describing the Results Cortical Sensory or Secondary Sensory Modalities. Double Simultaneous Stimulation. Abstraction. Praxis (Greek for “Action”). Executive Function. Principles of Interpretation of the Mental Status Examination Cranial Nerves Olfaction (Cranial Nerve [CN] I) Optic Nerve (CN II) Visual Acuity (CN II) Visual Fields (CN II) Pupillary Responses (CNs II and III) Funduscopy (CN II) and the Retina Ocular Movements (CNs III, IV, and VI) Trigeminal Nerve (CN V) Muscles of Mastication Facial Nerve (CN VII) Vestibulocochlear Nerve (CN VIII) Glossopharyngeal and Vagus Nerves (CNs IX and X) Speech (CNs IX and X) Palate (CNs IX and X) Spinal Accessory Nerve (CN XI) Hypoglossal Nerve (CN XII) Motor Examination Muscle Bulk Tone Strength Abnormal Movements Sensory Examination Coordination Testing Rapid Alternating Movements Heel to Shin Gait Testing Reflex Assessment Deep Tendon Reflexes Cutaneous or Superficial Reflexes Plantar Reflex Primitive Reflexes or Atavistic Reflexes (Mistakenly Called “Frontal Release Signs”) Key References References Chapter 74: Neuropsychiatric Principles and Differential Diagnosis Key Points General Principles of Neuropsychiatry Cognitive-Behavioral Neuroanatomy Cortical Networks Frontal-Subcortical Networks Neuropsychiatric Evaluation Neuroimaging Electroencephalogram Sleep Studies Lumbar Puncture for Cerebrospinal Fluid Analysis Neuropsychiatric Differential Diagnosis Clinical Symptoms and Signs Suggesting Neurological or General Medical Conditions Treatment Principles Conclusions Key References References Chapter 75: Neuroimaging in Psychiatry Key Points Overview Structural Neuroimaging Modalities Computed Tomography Technology Contrast Clinical Utility Magnetic Resonance Imaging Technology Magnetic Resonance Contrast Clinical Utility Use of Structural Neuroimaging in Psychiatry Functional Neuroimaging Modalities Positron Emission Tomography Single-Photon Emission Computed Tomography Use of Functional Neuroimaging in Psychiatry Use of Neuroimaging in Psychiatric Research Structural Neuroimaging Functional Neuroimaging Conclusion References Chapter 76: Clinical Neurophysiology and Electroencephalography Key Points Overview The Normal Routine EEG EEG and Age EEG Abnormalities Non-epileptic EEG Abnormalities Epileptic EEG Abnormalities Clinical Utility of the EEG in Psychiatry The EEG in Delirium and Patients with an Altered Mental Status The Effect of Medications and Toxins on the EEG The EEG in Dementia and in Pseudodementia The EEG in Mood Disorders, Anxiety Disorders, and Obsessive-compulsive Disorder The EEG in Psychosis Quantitative EEG Evoked Potentials Nerve Conduction Peripheral Nerve Conduction Studies Sensory Nerve Conduction Motor Nerve Conduction Late Responses Electromyography Findings on the Electromyogram Acute Partial Injury (e.g., Partial Laceration of a Nerve) Chronic Partial Injury Complete Injury Myopathy Neuromuscular Junction Studies Key References References Chapter 77: Psychiatric Manifestations and Treatment of Seizure Disorders Key Points Overview Epidemiology and Risk Factors Pathophysiology Basic Mechanism and Genetics Classification of Seizures and Epilepsies Classification of Seizures Classification of Epilepsy by Etiology and Electro-clinical Syndrome Clinical Manifestation of Seizures Generalized Seizures Focal (Partial) Seizures Focal Motor Seizures Experiential Seizures, Epileptic Auras, and Ictal Hallucinations. The Post-ictal State Selected Epilepsies and Epileptic Syndromes Mesial Temporal Lobe Epilepsy Idiopathic/Genetic Generalized Epilepsy Status Epilepticus Evaluation of a Patient with a Seizure History Laboratory Investigations Electroencephalogram Neuroimaging Differential Diagnosis Psychogenic Non-epileptic Seizures Other Conditions Mimicking Seizures Treatment for Seizure Disorders Medical Treatment Surgery Vagus Nerve Stimulation Psychiatric Disturbances in Epilepsy Depression Psychosis Anxiety and Panic Neuropsychological Disturbances in Epilepsy Cognitive Impairments Inter-ictal Personality Traits Supportive Care and Long-Term Management Key References References Chapter 78: Differential Diagnosis and Treatment of Headaches Key Points Overview Epidemiology and Risk Factors Genetics Pathophysiology Differential Diagnosis Headache “Red Flags” Other Secondary Headaches Treatment Headache Syndromes: Clinical Features, Diagnosis, and Treatment Primary Headaches Tension-type Headaches Migraine Chronic Daily Headache Cluster Headaches Other Primary Headache Syndromes Secondary Headaches Post-traumatic Headache Intracranial Hemorrhage Subarachnoid Hemorrhage Aneurysm Intracranial Mass Lesions Ischemic Stoke Cerebral Venous Thrombosis Pheochromocytoma Acute and Chronic Meningitis Encephalitis Temporal Arteritis Trigeminal Neuralgia Medication-overuse Headaches Headaches due to Substances of Abuse Headaches due to Withdrawal from Substances Conclusion Key References References Suggested Reading Chapter 79: Pathophysiology, Psychiatric Co-morbidity, and Treatment of Pain Key Points Overview Epidemiology Pathophysiology of Pain Transmission Cortical Substrates for Pain and Affect Interactions between Pain and Psychopathology Pain Terminology Assessment of Pain Core Psychopathology and Pain-Related Psychological Symptoms Pain and Co-Morbid Psychiatric Conditions Major Depression Symptoms Medication Treatment Selective Serotonin Reuptake Inhibitors. Other Antidepressants. Coping and Psychotherapy Anxiety Disorders Symptoms Treatment Antidepressants Somatoform Disorders Classification Symptom Presentation Treatment Concepts Conversion Disorder Hypochondriasis Pain Disorder Factitious Disorder with Physical Symptoms General Principals of Multimodal Analgesia Major Medication Classes Non-steroidal Anti-inflammatory Drugs Side Effects. Muscle Relaxants Tricyclic Antidepressants Serotonin-norepinephrine Reuptake Inhibitors Antiepileptic Drugs Opioids Treatment of Neuropathic Pain Sympathetically-Maintained Pain Treatment of Pain Behavior and the Use of Multidisciplinary Pain Clinics Rehabilitation Conclusions References Chapter 80: Psychiatric Aspects of Stroke Syndromes Key Points Overview Definition Anatomy of Cerebral Circulation Epidemiology/Risk Factors Epidemiology Risk Factors Risk-profile Generation Ischemic Stroke Types Clinical Presentation Differential Diagnosis Examination Diagnosis Treatment Acute Management Primary Prevention Secondary Prevention Prognosis Hemorrhagic Stroke Overview Intracerebral Hemorrhage Subarachnoid Hemorrhage Subdural Hematoma/Epidural Hematoma Clinical Presentation Differential Diagnosis History/Examination Diagnosis Treatment Prognosis Neuropsychiatric Sequelae of Stroke Acute Symptoms Following Stroke Post-stroke Delirium Post-stroke Mania Post-stroke Psychosis Other Syndromes Post-acute Symptoms Following Stroke Post-stroke Depression Post-stroke Anxiety Post-stroke Dementia Conclusion Key References References Suggested Reading Chapter 81: Movement Disorders Key Points Overview Pathophysiology Circuitry Pharmacology Electrophysiology Clinical Findings Patient History Physical Examination Hypokinetic Signs Rigidity. Bradykinesia. Mixed Signs Rest Tremor. Action Tremor. Dystonia. Hyperkinetic Signs Chorea and Athetosis. Dyskinesia. Akathisia. Tics. Myoclonus. Gait Movement Disorders with Psychiatric Symptoms Hypokinetic Syndromes Idiopathic Parkinson’s Disease “Parkinson’s Personality”. Depression. Treatment-induced Mood Lability and Mania. Dementia. Psychosis. Atypical Parkinsonism Hyperkinetic Syndromes Huntington’s Disease Tourette’s Disorder Wilson’s Disease Action Tremors Drug-Induced Movement Disorders Acute Drug Reactions Neuroleptic Malignant Syndrome Diagnosis. Treatment. Akathisia Acute Dystonia Drug-induced Ataxia Drug-induced Action Tremor Drug-induced Parkinsonism Tardive Drug Reactions Diagnosis. Treatment. Psychogenic Movement Disorders Pathophysiology Diagnosis Treatment Key References References Chapter 82: Psychiatric Manifestations of Traumatic Brain Disorder Key Points OVERVIEW Epidemiology and Risk Factors Pathophysiology Clinical Features Cognitive Impairment (Table 82-4) Personality and Behavioral Changes Psychiatric Disorders Diagnosis Evaluation Treatment Medications Antidepressants Anxiolytics Benzodiazepines. Antiepileptic Drugs Antipsychotics Stimulants Environmental Interventions Cognitive Rehabilitation Psychotherapy Conclusion Key References References WebSites Part XIX: Law and Psychiatry Chapter 83: Intimate Partner Violence Key Points OVERVIEW Epidemiology Risk Factors for Victims and Perpetrators Clinical Presentation of Victims Clinical Presentation of Perpetrators The Nature of Violent Relationships Evaluation Differential Diagnosis Treatment Considerations Conclusion Key References References Chapter 84: Psychiatric Correlates and Consequences of Abuse and Neglect Key Points Overview Types of Abuse and Neglect Child Abuse and Neglect Types of Maltreatment Physical Abuse Emotional Abuse Neglect Emotional Neglect. Physical Neglect. Medical Neglect. Failure to Thrive. Educational Neglect. Epidemiology Risk Factors Child-associated Risk Factors Family-associated Risk Factors Environmental Characteristics Clinical Features of Abuse and Neglect Physical Abuse Emotional Abuse Neglect Treatment Parental Treatment Child Treatment Elder Abuse and Neglect Epidemiology and Risk Factors Detection and Reporting Treatment Key References References Suggested Reading Child and Adolescent Elderly Websites Child and Adolescent Elderly Chapter 85: Legal and Ethical Issues in Psychiatry I: Informed Consent, Competency, Treatment Refusal, and Civil Commitment Key Points Overview An Introduction to Interactions with the Legal System Basic Concepts Informed Consent Treatment Refusal Consent to Participate in Research Civil Commitment Civil Commitment of Sex Offenders Outpatient Commitment Conclusion Key References References Chapter 86: The Role of Psychiatrists in the Criminal Justice System Key Points OVERVIEW Criminal Competencies Competency to Plead, Decline Counsel, and Represent Oneself Competency to be Executed Criminal Responsibility Justification Defenses Excuse Defenses Ignorance Compulsion Duress. Extreme Passion. Compulsion Due to Addiction or Insanity. Lack of Criminal Responsibility Evaluations of Criminal Responsibility Demographics of the Insanity Defense Conclusion Key References References Chapter 87: Legal and Ethical Issues in Psychiatry II: Malpractice and Boundary Violations Key Points Overview The Medical Liability Climate Malpractice Liability Liability and Managed Care Selected Areas of Liability Risk in Psychiatry Assault, Battery, and False Imprisonment Misdiagnosis Failure to Treat Abandonment Liability for the Acts of Others Confidentiality and Privilege Psychotherapist–Patient Privilege Suicide Boundary Violations Reducing Malpractice Risk Conclusion Key References References Part XX: Care in Special Settings Chapter 88: Emergency Psychiatry Key Points Overview Demographics Types of Delivery Models The Psychiatric Interview The Medical Evaluation The Safety Evaluation Psychiatric Symptoms and Presentations The Depressed Patient The Anxious Patient The Psychotic Patient The Manic Patient The Patient with Intoxication or Withdrawal Alcohol Benzodiazepines and Barbiturates Opiates Cocaine Crystal Methamphetamine Phencyclidine Marijuana and Herbal Marijuana Alternatives Bath Salts The Patient with a Change in Mental Status The Agitated Patient Management of Acute Symptoms Environmental Intervention Psychological Intervention Intervention with Medication Restraint and Seclusion Treatment after the Acute Crisis Special Populations The Personality-Disordered Patient The Grieving Patient Victims of Domestic Violence and Trauma The Homeless Patient Emergency Assessment of Children Demographics Basic Principles The Evaluation Management Legal Responsibilities of the Emergency Psychiatrist Capacity Evaluation Confidentiality and Release of Information Civil Commitment Mandatory Reporting Role of the Psychiatrist in Disaster Preparation References Chapter 89: Rehabilitation Psychiatry Key Points Overview Psychiatric Complications that Arise in the Context of Chronic Medical Illness and Rehabilitation Problems that May Occur During Rehabilitation The Rehabilitation Environment Common Psychiatric Problems in Patients Undergoing Rehabilitation and in Those with Chronic Medical Illnesses Some Disabling Neurological Conditions and Their Potential Impact on Psychiatric Diagnosis and Treatment Depression, Cardiovascular Disease and Cardiac Rehabilitation Pathophysiology Diagnosis Rehabilitation Treatment Smoking Diagnostic Dilemmas Issues in Patients Receiving Psychiatric Care Who are Also Likely Receiving Rehabilitative Services Making the Connection Key References References Chapter 90: Military Psychiatry Key Points Overview Psychiatric Syndromes in the Immediate Aftermath of Military Operations and Terrorist Events Delirium Depression Acute Stress Disorder and Post-traumatic Stress Disorder Somatic Symptom Disorder and Illness Anxiety Disorder (Formerly Hypochondriasis) Unexplained Physical Symptoms and Conversion Symptoms Dissociation and Dissociative Disorders Battle Fatigue and Operational Stress Effects of Resuscitative Medications Confidence in a Potentially Toxic Environment Levels of Clinical Prevention and Intervention: Symptoms Versus Function Factors Related to Development of Psychiatric Disorders Among Service Members Exposed to Combat or Terrorist Attack Neurobiological Factors Predisposing Factors Protective Factors Precipitating Factors Mitigating or Perpetuating Factors Management and Care Delivery General Principles Therapeutic Interventions in Psychiatric Casualties Military Psychiatric Care in Peacetime Ethical Challenges Conclusion References Chapter 91: Disaster Psychiatry Key Points Overview History Disaster Psychiatry Clincal and Research Challenges Preparation for a Disaster Systems Staged Disaster Intervention Practical Pointers Victims of Disaster Cultural Awareness Resiliency Diagnosis General Principles of Intervention and Treatment Psychopharmacology Psychotherapy Critical Incident Stress Debriefing Psychological First Aid Conclusion References Suggested Reading Websites Part XXI: Preparing for the Future Chapter 92: Coping with the Rigors of Psychiatric Practice Key Points Overview Epidemiology Etiologies for Stress and Burnout Frequent Encounters with Distress Ethical Dilemmas Transference and Countertransference The Perception of Failure Controlling Affect Responsibility and Uncertainty Disruption of Social Relationships Delayed Gratification Being the Caregiver Financial Stress Special Situations in Psychiatry Coping with Patient Suicide A Profound and Enduring Effect Reactions to Suicide Coping Treating Dying Patients Coping with Boundary Crossings and Violations Boundary Violations Decreasing Vulnerability Coping with Malpractice Litigation Protecting Yourself Coping with a Lawsuit Coping with Residency Training When the Cobbler’s Children Have No Shoes Denial of Vulnerability Negation of Personal and Familial Concerns Deferment of Seeking Help How to Recognize Stress in Oneself Healing the Wounded Healer Be Your Own Most Important Patient Process Experiences Regularly Review Your Own History and Keep a List of Methods That Work Decrease Vulnerability to Stress Mentally Rehearse Potential Problems Engage in Directed Fantasy Cultivate and Maintain Professional and Personal Relationships Communicate with Family and Friends about Anticipated Unavailability Enjoy Your Achievements and Your Goals Learn and Practice Relaxation Techniques Maintain a Pleasurable Existence When to Seek Consultation Types of Professional Help Psychotherapy Psychopharmacology Couples Therapy Group Therapy Autognosis Rounds Conclusion Acknowledgment References Suggested Reading Chapter 93: Psychiatry and the Media Key Points Overview How the Mass Media Affect Public Understanding of Mental Illness How Mass Media Interventions Can Affect Stigma Effects of Mass Media on Suicide Effects of Media Content on Children’s Behavior Media Literacy: Advising Parents on Media Use The Media as Part of the Psychiatric Interview The Use of Mass Media to Educate and Counteract Stigma Key References References Chapter 94: Global Mental Health in the Twenty-first Century Key Points Overview The Cost of Mental Illness The Prevalence of Mental Disorders Ethiopia and Mental Health in the Developing World: an Example of Global Mental Health Primary Care Mental Health Services in the Developing World The Ethiopian Public Health Training Initiative Child and Adolescent Psychiatry Psychiatry in Areas of Conflict Definitions of Torture Types and Purpose of Torture Medical and Psychiatric Effects of Torture Medical and Psychiatric Treatment for Torture Survivors Ask about the Patient’s Trauma Story Identify Concrete Physical and Mental Effects Diagnose and Treat Use of Screening Instruments for Treatment of Psychiatric Diagnosis. Psychiatric Treatment. Refer Reinforce and Teach Recommend Work, Altruism, and Spirituality Reduce High-risk Behaviors Be Culturally Attuned in Communicating and Prescribing Prescribe Identify Target Symptoms. Pay Attention to the Patient’s “Explanatory Model.” Use Counseling. Keep the Medication Regimen Simple. Pay Attention to Ethnic Differences in Metabolism of, and Response to, Medication. Schedule Follow-up Visits Prevent Burnout Evaluation Psychiatric Research in the Developing World World Health Organization Mental Health Global Action Program Conclusion Key References References Index A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
