Core Psychiatry E-Book

 
 
Saunders Ltd. (Verlag)
  • 3. Auflage
  • |
  • erschienen am 8. Januar 2012
  • |
  • 672 Seiten
 
E-Book | PDF mit Adobe DRM | Systemvoraussetzungen
E-Book | ePUB mit Adobe DRM | Systemvoraussetzungen
978-0-7020-4858-6 (ISBN)
 
New edition of a previously award winning concise textbook for trainee psychiatrists covering in one volume all the subjects required for the new MRCPsych and similar exams.
  • Englisch
  • London
  • |
  • Großbritannien
Elsevier Health Sciences
  • 10,97 MB
978-0-7020-4858-6 (9780702048586)
0702048585 (0702048585)
weitere Ausgaben werden ermittelt
  • Front Cover
  • Core Psychiatry
  • Copyright
  • Preface to Third Edition
  • Preface to Second Edition
  • Preface to First Edition
  • Contributors
  • Contents
  • Part 1: The foundations of psychiatry
  • Chapter 1: A brief history of psychiatry
  • Introduction
  • Ancient and classical times
  • The Middle Ages
  • The Renaissance and the Reformation
  • The asylum and moral therapy
  • Academic psychiatry
  • Nervous illness, rest cures and psychoanalysis
  • Plant alkaloids and the first drugs
  • Sedatives, anticonvulsants and bromides
  • Malaria, insulin coma and ECT
  • Diagnostic precision
  • Psychotherapies
  • The slow emergence of drug treatment
  • Lithium and mood stabilizers
  • Antihistamines, chlorpromazine and the antipsychotics
  • Imipramine and the antidepressants
  • Drugs and biological psychiatry
  • Drug dependence
  • Antipsychiatry
  • Integrating treatment approaches
  • Regulatory authorities
  • Conclusions
  • Further reading
  • References
  • Chapter 2: Clinical neuroanatomy
  • Introduction
  • Brain development
  • Cellular constituents and connective tissues of the brain
  • The neuron
  • Neuroglia
  • Connective tissue
  • Cerebral cortex
  • The lobes and surface markings of the cerebral cortex
  • Cellular constituents of the cortex
  • Intra- and interhemispheric white matter tracts
  • The lobes of the cerebral cortex and their function
  • Cerebral dominance
  • Frontal lobe
  • Functions of the frontal lobe
  • Personality changes
  • Motor changes
  • Other changes
  • Clinical examination
  • Temporal lobe
  • Sensation
  • Memory and amnesia
  • Personality changes
  • Visual field deficit
  • Other changes
  • Klüver-Bucy syndrome
  • Parietal lobe
  • Occipital lobe
  • Specific signs and syndromes seen with cortical lobe dysfunction
  • Apraxia
  • Agnosia
  • Cerebellum
  • Cellular constituents of the cerebellar cortex
  • Connections of the cerebellum
  • Cerebellar function
  • Diencephalon
  • Thalamus
  • Hypothalamus
  • Connections of the hypothalamus
  • Afferent pathways
  • Efferent pathways
  • Epithalamus
  • Subthalamus
  • The limbic system
  • Hippocampus
  • Connections of the hippocampus
  • Afferent pathways
  • Efferent pathway: the fornix
  • Amygdala
  • Nucleus accumbens
  • Basal ganglia
  • Components of the basal ganglia
  • Connections of the basal ganglia
  • Functions of the basal ganglia
  • Basal ganglia dysfunction
  • Brainstem
  • Spinal cord
  • Ascending tracts
  • Proprioception, tactile discrimination and vibration sense
  • Pain and temperature
  • Muscle and tendon function
  • Descending tracts
  • Corticospinal or pyramidal tracts
  • The extrapyramidal tracts
  • Mixed ascending and descending tract
  • Overview of sensory and motor systems
  • Sensory system
  • Receptors
  • Motor system
  • Autonomic nervous system
  • Sympathetic nervous system
  • Anatomy
  • Divisions and functions
  • Cervical ganglia
  • Mesenteric ganglia
  • Parasympathetic nervous system
  • Anatomy
  • Divisions and functions
  • Cranial nerves
  • Olfactory nerve
  • Optic nerve
  • The retina
  • The optic nerve and radiation
  • Effects of lesions of the visual pathway
  • Oculomotor nerve
  • Motor somatic
  • Motor parasympathetic
  • Pupillary reflexes
  • Light reflex
  • Accommodation reflex
  • Effects of lesions
  • Trochlear nerve
  • Abducens nerve
  • Trigeminal nerve
  • Motor somatic
  • Sensory somatic
  • Autonomic
  • Facial nerve
  • Motor somatic
  • Motor parasympathetic
  • Sensory somatic
  • Sensory autonomic
  • Vestibulocochlear nerve
  • Cochlea - hearing
  • Vestibular - balance
  • Glossopharyngeal nerve
  • Motor somatic
  • Motor parasympathetic
  • Sensory somatic
  • Sensory autonomic
  • Vagus nerve
  • Motor somatic
  • Motor parasympathetic
  • Sensory somatic
  • Sensory parasympathetic
  • Accessory nerve
  • Hypoglossal nerve
  • Blood supply of the brain and spinal cord
  • Arterial
  • Venous
  • The ventricular system and cerebrospinal fluid
  • Further reading
  • Chapter 3: Psychiatric genetics
  • Introduction
  • Genetics
  • The history of genetics
  • Chromosomes, cell division and genes
  • Molecular genetics
  • Basic molecular genetics
  • Transcription
  • Translation
  • Regulation
  • Inheritance of disease
  • Point mutations
  • Structural genomic variation
  • DNA variation and genetic markers
  • Mendelian inheritance
  • Inheritance of complex genetic disorders
  • Molecular genetics: techniques and terminology
  • Recombinant DNA technology
  • Vectors and cloning
  • Polymerase chain reaction - enzymatic DNA amplification
  • Visualization
  • Genotyping
  • Human genome project
  • Genomics and bioinformatics
  • Confirming a genetic contribution to disease: family, twin and adoption research
  • Family studies
  • Twin studies
  • Adoption studies
  • Mode of inheritance
  • Quantitative and mathematical aspects of genetics
  • Hardy-Weinberg law
  • Recombination fraction
  • Genetic distance
  • Linkage analysis
  • Genetic association methods and linkage disequilibrium (LD)
  • Clinical and molecular genetics of psychiatric disorders
  • The importance of diagnosis
  • Single gene/chromosomal abnormalities in psychiatry
  • Velocardiofacial syndrome (VCFS)
  • Prader-Willi/Angelman syndrome
  • Huntington disease (HD)/trinucleotide repeat expansion diseases (TREDs)
  • Familial Alzheimer disease (FAD)
  • Common psychiatric disorders with a genetic contribution
  • Schizophrenia
  • Affective disorders
  • Recurrent depressive disorder
  • Bipolar affective disorder (BP)
  • Autism/autistic spectrum disorders
  • Speech, language and reading disorders
  • Anxiety and related disorders
  • Panic disorder
  • Obsessive-compulsive disorder (OCD)
  • Anxiety and fear behaviour
  • Attention deficit hyperactivity disorder (ADHD)
  • Gilles de la Tourette syndrome (TS)
  • Alzheimer disease
  • Alcohol abuse/dependence
  • Eating disorders
  • Genetics and behaviour, treatment response and research ethics
  • Intelligence, memory and cognition
  • Personality and behaviour
  • Pharmacogenetics
  • Ethics and public understanding
  • References
  • Chapter 4: Human personality development
  • Introduction
  • Nature vs nurture
  • Cognitive development
  • Moral development
  • Kohlberg's stages:
  • Gilligan's stages:
  • Learning theory
  • Social learning theory
  • Psychodynamic theory
  • Attachment theory
  • Language development
  • Learning processes
  • Innate processes
  • Family development
  • Family lifecycle
  • Family functioning
  • Parenting
  • Adolescence and development
  • Identity
  • Adolescent turmoil
  • Sexual development
  • Adulthood and development
  • Late adulthood and development
  • Death
  • Further reading
  • References
  • Chapter 5: Psychology
  • Introduction
  • Learning theory
  • Forms of associative learning
  • Classical conditioning
  • Operant/instrumental conditioning
  • Thorndike's law of effect
  • Observational learning
  • Insight learning
  • Linking stimulus-response and cognitive theories: learning sets
  • Motivation
  • Perception
  • Visual perception
  • Set and schema
  • Perceptual organization: figure-ground differentiation
  • When the visual perceptual system makes mistakes
  • Developmental perspectives on visual perception
  • Face preferences
  • Visual acuity
  • Depth perception
  • Auditory perception
  • Shadowing, or dichotic listening experiments
  • Dual task techniques
  • The filter model of attention
  • Memory
  • Memory storage
  • Inputs to the memory system: sensory memory
  • Visual (iconic) stimuli
  • Auditory (echoic) stimuli
  • Short-term memory storage
  • Forgetting and short-term memory
  • Working memory
  • Long-term memory storage
  • Mnemonics: one example of long-term memory organization
  • Retrieval from the long-term memory
  • Context and memory storage
  • Motivational and emotional factors
  • Mood and retrieval
  • Forgetting in long-term memory
  • Intelligence
  • Factor analytic approaches
  • Other models of intelligence
  • Fluid and crystallized intelligence
  • Measurement of intelligence
  • The intelligence quotient
  • Testing intelligence
  • The Stanford-Binet test
  • The Wechsler scales
  • Raven's progressive matrices
  • Cultural and racial factors
  • Factors affecting test performance
  • Indications for testing
  • Emotion
  • Emotions
  • Theories of emotion
  • Emotion and performance
  • Causes of stress
  • Coping
  • Personality and stress
  • Locus of control
  • Personality
  • Nomothetic theories
  • Eysenck
  • Cattell
  • Idiographic theories
  • Allport
  • Kelly and personal construct theory
  • Rogers and client-centred therapy
  • Maslow and the hierarchy of needs
  • Freud and psychoanalytic approaches
  • Consciousness
  • Arousal
  • Hypnosis and suggestibility
  • Uses of hypnosis
  • Meditation and trances
  • Social psychology
  • Attitudes
  • Measurement of attitudes
  • Attitudes and behaviour
  • Cognitive dissonance theory (Festinger 1957)
  • Attitude change
  • Self-psychology
  • Interpersonal psychology
  • Social exchange theory
  • Stereotypes
  • Attribution theory
  • Social interaction and influence
  • Presence of others
  • Conformity
  • Obedience
  • Group decision-making
  • Group polarization
  • Groupthink
  • Further reading
  • References
  • Chapter 6: Descriptive psychopathology
  • Introduction
  • Disorders of perception
  • Sensory distortions
  • False perceptions
  • Auditory hallucinations
  • Diagnostic significance
  • Visual hallucinations
  • Diagnostic significance
  • Bodily senses
  • Diagnostic significance
  • Gustatory hallucinations
  • Diagnostic significance
  • Olfactory hallucinations
  • Diagnostic significance
  • Functional hallucinations
  • Reflex hallucinations
  • Extracampine hallucinations
  • Autoscopy (the Doppelganger phenomenon)
  • Diagnostic significance
  • Pseudohallucinations
  • Diagnostic significance
  • Disorders of thinking
  • Delusions
  • Delusional memories
  • Systematization
  • Bizarre delusions
  • Delusions of reference
  • Diagnostic significance
  • Delusions of persecution
  • Diagnostic significance
  • Delusions of guilt
  • Diagnostic significance
  • Delusions of grandeur
  • Diagnostic significance
  • Religious delusions
  • Diagnostic significance
  • Hypochondriacal delusions
  • Diagnostic significance
  • Overvalued ideas
  • Diagnostic significance
  • Dysmorphophobia
  • Disorders of control of thinking
  • Obsessions
  • Thought alienation
  • Disorders of the flow of thought
  • Flight of ideas
  • Diagnostic significance
  • Retardation
  • Diagnostic significance
  • Thought blocking
  • Diagnostic significance
  • Perseveration
  • Diagnostic significance
  • Circumstantiality
  • Diagnostic significance
  • Formal thought disorder
  • Explanations for thought disorder
  • Diagnostic significance
  • Disorders of motor activity
  • Increased motor activity
  • Decreased motor activity
  • Diagnostic significance
  • Disorders of emotion
  • Abnormal moods
  • Depression
  • Elation
  • Emotional lability
  • Euphoria
  • Ecstasy
  • Apathy
  • Affective blunting
  • Anxiety
  • Panic attacks
  • Diagnostic significance
  • Irritability
  • Diagnostic significance
  • Insight
  • References
  • Chapter 7: Social psychiatry and sociology
  • Introduction
  • Social factors associated with the onset, course and outcome of psychiatric disorders
  • Social and demographic factors associated with mental disorder
  • Social class
  • Definition and measurement
  • Social class and mental illness
  • Age
  • Sex
  • Marital status
  • Ethnic group
  • Employment status
  • Geographic variation
  • Area level factors
  • Intra-urban patterns
  • Urban-rural differences
  • Residential mobility
  • Homelessness
  • Understanding the associations between social factors and psychiatric morbidity
  • Poverty
  • Social isolation
  • Social disorganization
  • Social capital
  • Psychosocial risk factors
  • Life events
  • Trauma/extreme situations
  • Social factors and treatment
  • Provision and resource allocation
  • Access and pathways into care
  • Nature of care
  • Social impact of mental illness
  • Stigma
  • Impact of mental illness on social roles
  • Sociology of residential institutions
  • Social networks
  • Carers
  • Expressed emotion
  • Conclusions
  • References
  • Chapter 8: Cultural psychiatry
  • Introduction
  • Definitions
  • Culture, society and mental health
  • Explanatory models
  • Acculturation and cultural identity
  • The cultural formulation
  • Psychopathology and culture
  • Psychopharmacology and culture
  • Psychotherapy and culture
  • Health service research and minority ethnic people: research data
  • Mental health policy
  • Key further reading on contemporary debates in cultural psychiatry
  • Further reading
  • References
  • Chapter 9: Epidemiology
  • Introduction and overview
  • What is epidemiology?
  • What is the purpose of epidemiology?
  • What do epidemiologists do?
  • Measurement in psychiatric epidemiology
  • Types of measure
  • Domains of measurement
  • Caseness and dimensions
  • Measures of 'caseness'
  • Measures of dimensions
  • Validity
  • Content validity
  • Construct validity
  • Criterion validity
  • Predictive validity
  • Measuring validity
  • Likelihood ratios
  • Reliability
  • Test-re-test reliability (intra-measurement reliability)
  • Inter-observer reliability
  • Measuring reliability
  • Epidemiological study designs
  • Descriptive studies
  • The cross-sectional (prevalence) survey
  • The incidence study
  • Studying geographic variation
  • Studying temporal (secular) variation
  • Analytical studies
  • Case-control studies
  • Cohort studies
  • Experimental studies
  • Randomized controlled trials
  • Inference
  • Chance
  • Sampling error and sampling distributions
  • Standard errors and confidence intervals
  • Statistical tests and p values
  • The relationship between p values and confidence intervals
  • Bias
  • Selection bias
  • Non-response bias
  • Information bias
  • Confounding
  • Causation
  • Further reading
  • References
  • Chapter 10: Critical appraisal
  • Introduction
  • Evidence-based medicine
  • Scientific papers and journals
  • Reading the literature
  • Defining a clinical problem
  • Grades of evidence
  • Reading a paper
  • What are your aims in reading the paper?
  • What were the authors´ aims?
  • Descriptive studies
  • Analytical studies
  • Which study design was used?
  • What are the main results?
  • Ways of describing a finding
  • What alternative explanations are there?
  • Chance
  • Type I and Type II error
  • Points to consider if a study reports one or more positive associations
  • Points to consider if the study reports a `negative finding´
  • Bias
  • Selection bias
  • Information bias
  • Confounding
  • Reverse causality
  • How does it fit in with the rest of the literature?
  • Summary
  • Useful websites
  • Further reading
  • References
  • Chapter 11: Ethics and the law in psychiatry
  • Introduction
  • Ethics in psychiatry
  • Ethical frameworks
  • The four principles
  • Codes and Laws
  • The law of negligence
  • Manslaughter
  • Consent and capacity
  • Coercion and information
  • Capacity
  • Understanding
  • Retention
  • Using information
  • Communication
  • Patients lacking capacity
  • Advance decisions
  • Lasting power of attorney
  • The Court of Protection and court-appointed deputies
  • Deprivation of liberty
  • Research
  • Ill treatment
  • Fluctuating capacity
  • Emergency situations
  • Incapacity for other reasons
  • Children
  • The Mental Health Act
  • Principles: the basis for detention
  • Key provisions
  • The Care Programme Approach (CPA)
  • Other Acts relevant to psychiatry
  • Appointeeship
  • Driving
  • Marriage
  • Voting in elections
  • Jury service
  • Entering into contracts
  • Protection of children and vulnerable adults
  • Confidentiality and record-keeping
  • References
  • Cases
  • Chapter 12: Challenges to psychiatry
  • The antipsychiatry movement
  • Introduction
  • The myth of mental illness
  • Psychiatry and social control
  • Protests and alternatives
  • Influence of antipsychiatry
  • The user movement
  • Introduction
  • Origins of the user movement
  • Consumerism and public healthcare
  • New directions
  • The recovery model
  • Mental illness and stigma
  • Introduction
  • Definition of stigma
  • How does stigma-discrimination operate?
  • Stigma and the media
  • Sociological theories
  • Thomas Scheff
  • Social psychology
  • The psychiatric literature
  • What about discrimination?
  • Stigma includes indirect discrimination
  • Solutions at the individual level/clinic-based
  • Solutions at the group-based and structural levels
  • References
  • Part 2: Clinical psychiatry
  • Chapter 13: Psychiatry of learning disability
  • Introduction
  • Definitions and terminology
  • Historical overview
  • UK government policies and philosophy of care
  • Aetiology and prevention
  • Epidemiological aspects and the IQ test
  • Communication
  • Health needs
  • Sensory impairments
  • Epilepsy
  • Vulnerability issues
  • Challenging needs/behaviours
  • Autism
  • Mental health needs
  • The psychiatric assessment
  • Multiaxial classification/diagnosis
  • Treatment issues
  • Antipsychotics
  • Antidepressants
  • Anxiolytics
  • Mood stabilizers
  • Other drugs
  • Parents with learning disability
  • Growing older with learning disability
  • Learning disability and the law
  • People with learning disabilities and the criminal justice system
  • The Mental Health Act (1983): England and Wales - 2007 Amendments
  • The Care Programme Approach (CPA)
  • The Mental Capacity Act (2005) and Deprivation of Liberty Safeguards - England
  • The needs of carers
  • Advocacy and self-advocacy
  • Service provision
  • Further reading
  • References
  • Chapter 14: Child and adolescent psychiatry
  • Introduction
  • Epidemiology
  • Pre-school children
  • Middle childhood
  • Adolescence
  • Classification
  • Hyperactivity
  • Epidemiology
  • Features
  • Associated features
  • Aetiology
  • Genetic factors
  • Environmental factors
  • Treatment
  • Psychological therapy, parent training and support
  • Diet
  • Medication
  • Prognosis
  • Conduct disorder
  • Epidemiology
  • Features
  • Aetiology
  • Treatment
  • Prognosis
  • Pervasive developmental disorder
  • Epidemiology
  • Features
  • Associated features
  • Differential diagnosis
  • Aetiology
  • Treatment
  • Prognosis
  • School refusal
  • Epidemiology
  • Features
  • Associated features
  • Underlying psychiatric problems
  • Differential diagnosis
  • Treatment
  • Prognosis
  • Elimination disorders
  • Encopresis
  • Epidemiology
  • Aetiology
  • Treatment
  • Prognosis
  • Enuresis
  • Epidemiology
  • Nocturnal
  • Diurnal
  • Associated features
  • Treatment
  • Prognosis
  • Tics and Tourette syndrome
  • Simple tics
  • Tourette syndrome
  • Associated features
  • Aetiology
  • Treatment
  • Prognosis
  • Elective mutism
  • Epidemiology
  • Associated features
  • Aetiology
  • Treatment
  • Prognosis
  • Suicide and deliberate self-harm
  • Suicide
  • Associated features
  • Prevention
  • Deliberate self-harm
  • Epidemiology
  • Associated features
  • Treatment
  • Outcome
  • Schizophrenia
  • Differential diagnosis of schizophrenia in children/adolescents
  • Depression
  • Epidemiology
  • Treatment
  • Prognosis
  • Bipolar affective disorder
  • Child maltreatment
  • Physical abuse
  • Munchausen syndrome by proxy (factitious disorder by proxy - DSM IV)
  • Sexual abuse
  • Neglect
  • Emotional abuse
  • Management of abuse
  • Detection and disclosure
  • Child protection and legal proceedings
  • Support and therapeutic intervention
  • Outcome
  • Child and adolescent mental health services
  • Further reading
  • References
  • Chapter 15: Personality disorders
  • Introduction
  • Normal personality
  • Diagnosis and prevalence
  • Severity and co-morbidity
  • Aetiology
  • Prognosis
  • Assessment
  • Management of personality disorders
  • Treatment interventions
  • Personality disorder and risk
  • Specific personality disorders
  • Emotionally unstable or borderline personality disorder (BPD: Cluster B)
  • Aetiology
  • Management
  • Short-term/crisis management
  • Long-term management
  • Therapeutic relationship
  • Psychological interventions
  • Specialist services for BPD
  • Therapeutic communities for personality disorder
  • Pharmacological management
  • Prognosis
  • Dissocial personality disorder or antisocial personality disorder (ASPD: Cluster B)
  • Aetiology
  • ASPD and psychopathy
  • Management
  • Engagement
  • Multi-agency working
  • Staff support
  • Risk management
  • Psychological interventions
  • Co-morbidity
  • Pharmacological treatment
  • Prognosis
  • Prevention
  • Paranoid personality disorder (Cluster A)
  • Differential diagnosis
  • Aetiology
  • Cognitive bias and information processing deficits
  • Social influence
  • Management
  • Risk assessment
  • Interventions
  • Pharmacotherapy
  • Psychological interventions
  • Schizoid personality disorder (Cluster A)
  • Management
  • 'Things we wished we had known earlier'
  • Further reading
  • References
  • Chapter 16: Anxiety disorders
  • Introduction
  • Epidemiology
  • Important surveys
  • Presentation
  • Co-morbidity
  • Sociodemographic correlates
  • Classification of anxiety disorders
  • Aetiology of anxiety disorders
  • Psychological theories
  • Learning theory
  • Psychodynamic and psychoanalytic theory
  • Cognitive psychology
  • Developmental precursors
  • Neuropsychology
  • Neuroanatomy
  • Genetics
  • Neurochemistry
  • Hormones
  • Neurotransmitters
  • Noradrenaline
  • Serotonin
  • GABA
  • Neuropeptides
  • Cholecystokinin (CCK)
  • Galanin
  • Neuropeptide Y
  • Panic disorder and agoraphobia
  • DSM-IV-TR diagnostic criteria for agoraphobia
  • Panic disorder
  • Agoraphobia without a history of panic disorder
  • Epidemiology
  • Course
  • Aetiology
  • Treatment
  • Specific phobia
  • Epidemiology
  • Course
  • Aetiology
  • Treatment
  • Social phobia
  • Epidemiology
  • Course
  • Aetiology
  • Treatment
  • Obsessive-compulsive disorder
  • Classification controversies
  • Epidemiology
  • Course
  • Aetiology
  • Treatment
  • Post-traumatic stress disorder (PTSD)
  • Epidemiology
  • Aetiology
  • Course
  • Treatment
  • Psychological treatment
  • Pharmacological treatment
  • Generalized anxiety disorder
  • Epidemiology
  • Aetiology
  • Course
  • Treatment
  • References
  • Chapter 17: Liaison psychiatry and psychosomatic medicine
  • What do liaison psychiatrists do?
  • Models of liaison psychiatry
  • Consultation model
  • Liaison model
  • Liaison psychiatry in the UK
  • Components of a liaison service
  • Assessment and management of deliberate self-harm
  • Managing mental disorders in people with physical illness
  • Management of people with established mental illness
  • Provision of specialized services
  • Education of non-psychiatric staff
  • Advise on issues of capacity and consent
  • Recommended structure of an ideal liaison service
  • Clinical issues in liaison psychiatry
  • Medically unexplained symptoms
  • Definitions
  • Engagement issues
  • Rule out anxiety and depression
  • Aetiology of medically unexplained symptoms
  • Consequences
  • Somatoform disorders
  • Epidemiology
  • Diagnostic criteria
  • Somatization disorder
  • Hypochondriacal disorder
  • Somatoform pain disorder and chronic pain
  • Conversion (or dissociative motor) disorder
  • Body dysmorphic disorder
  • Functional somatic syndromes
  • Chronic fatigue syndrome (also known as myalgic encephalomyelitis)
  • Epidemiology
  • Illness attributions
  • Treatment
  • Management of medically unexplained symptoms, somatoform disorders and functional somatic syndromes
  • Psychotherapy
  • Pharmacotherapy
  • Special medical services
  • Psycho-oncology
  • Epidemiology
  • Management
  • Breaking bad news
  • Care of the dying and bereaved
  • Bereavement and physical health
  • Bereavement and psychiatric disorders
  • The role of the liaison psychiatrist
  • Substance misuse in the general hospital
  • Epidemiology
  • Presentation
  • Management
  • Problem drinkers
  • Delirium tremens
  • Wernicke-Korsakoff syndrome
  • Primary care liaison psychiatry
  • References
  • Chapter 18: Eating disorders
  • Introduction
  • Diagnosis
  • Binge eating disorder
  • Psychogenic vomiting
  • Eating and feeding disorders in childhood
  • Differential diagnoses and psychiatric co-morbidity
  • Organic conditions
  • Depression
  • Anxiety disorders
  • Alcohol and drug misuse
  • Personality disorder
  • Suicidality
  • Psychoses
  • Epidemiology
  • Aetiology
  • Anorexia nervosa
  • Genetic factors
  • Personality and psychological factors
  • Family factors
  • Adverse life events
  • Sociocultural factors
  • Biological factors
  • Bulimia nervosa
  • Genetic factors
  • Psychological factors
  • Sociocultural factors
  • Biological factors
  • Assessment
  • Presenting complaint
  • Past psychiatric history
  • Family and personal history
  • Information gathering
  • Physical review and examination
  • Investigations
  • Psychological assessment instruments
  • Treatment
  • General principles
  • Engagement and motivation
  • Psychoeducation
  • Medical monitoring and management
  • Physical health monitoring and management
  • Harm minimization
  • Treatment of osteoporosis
  • Pharmacotherapy
  • Individual psychotherapy
  • Cognitive behaviour therapy (CBT)
  • Interpersonal psychotherapy
  • Cognitive analytic therapy (CAT)
  • Psychodynamic models
  • Family approaches
  • Family therapy
  • Carer skills training
  • Inpatient and day-patient care
  • Day-patient treatment
  • Legal framework for treatment
  • Prognosis
  • Children and adolescents
  • Eating disorders and chronic physical illness
  • Pregnancy and eating disorders
  • Eating disorders in men
  • Night-time eating disorders
  • References
  • Chapter 19: Schizophrenia and related disorders
  • Introduction
  • Schizophrenia
  • Definition of schizophrenia
  • History of the concept of schizophrenia
  • Emil Kraepelin
  • Eugen Bleuler
  • Kurt Schneider
  • Contemporary authorities
  • Epidemiology of schizophrenia
  • General epidemiology
  • Sex and age
  • Social epidemiology
  • Clinical features of schizophrenia
  • Schneider's symptoms of the first rank
  • Crow's Type 1 and 2 schizophrenia
  • Andreasen's positive and negative symptoms of schizophrenia
  • Presentation of schizophrenia
  • Premorbid schizophrenia
  • Acute schizophrenia
  • Chronic schizophrenia
  • Classification and diagnosis
  • Classification
  • Paranoid schizophrenia
  • Hebephrenic (disorganized) schizophrenia
  • Catatonic schizophrenia
  • Simple schizophrenia
  • Post-schizophrenic depression
  • Residual schizophrenia
  • Disorders similar to schizophrenia
  • Acute and transient psychotic disorders
  • Induced delusional disorder
  • Diagnosis
  • Differential diagnosis
  • Investigations
  • The aetiology of schizophrenia
  • Environmental factors
  • Temporal and physical factors
  • Psychological factors
  • Social factors
  • Predisposing genes
  • Family, twin and adoption studies
  • Molecular genetics
  • Neurostructural, neurochemical and neurofunctional brain changes
  • Neurostructural brain changes
  • Neurochemical brain changes
  • The dopamine hypothesis
  • The serotonin hypothesis
  • The excitatory amino acid hypothesis
  • The phospholipid membrane hypotheses
  • Neurofunctional brain changes
  • The neurodevelopmental hypothesis of schizophrenia
  • The treatment of schizophrenia
  • General treatment of schizophrenia
  • Treating acute episodes of schizophrenia
  • Preventing recurrences of schizophrenia
  • Treatment-resistant schizophrenia
  • Atypical and typical antipsychotic drugs
  • Rapidly acting intramuscular injections
  • Long-acting intramuscular injections
  • Extrapyramidal syndromes: side-effects of antipsychotic drugs or symptoms of schizophrenia?
  • Educational, psychological and social interventions in schizophrenia
  • Course and outcome in schizophrenia
  • Course
  • Outcome
  • Outcome following the introduction of atypical antipsychotic drugs
  • Suicide
  • Predicting outcome for schizophrenia
  • The cost of schizophrenia
  • Criminality and schizophrenia
  • Schizotypal disorder
  • Schizoaffective disorder
  • Persistent delusional disorders
  • References
  • Chapter 20: Unipolar depression
  • Introduction
  • Clinical features
  • Phenomenology of depression
  • Behavioural features
  • Emotional features
  • Cognitive features
  • Form of thought
  • Content of thought
  • Biological symptoms
  • Psychotic features
  • Subtypes and variants of the depressive syndrome
  • Melancholic depression
  • DSM-IV depression
  • Psychotic depression
  • Atypical depression
  • Somatization
  • Other descriptors
  • Co-morbidity
  • Abnormal grief reactions
  • Course-based groupings of depression
  • Depression with a seasonal recurrence (seasonal affective disorder)
  • Postpartum affective disorder
  • Subsyndromal depression
  • International classification systems
  • DSM-IV TR
  • ICD-10
  • Epidemiology
  • Aetiology
  • Neurobiological components
  • Genetics
  • Neurochemistry
  • Serotonergic theories
  • Noradrenergic theories
  • Dopaminergic theories
  • Cholinergic theories
  • GABAergic theories
  • Interactions of monoamines
  • Neuroendocrinology
  • Hypothalamo-pituitary-adrenal axis
  • Hypothalamo-pituitary-thyroid axis
  • Dehydroepiandrostenedione (DHEA)
  • Cerebral pathophysiology
  • Structural neuroimaging studies
  • Functional neuroimaging studies
  • Cellular factors
  • Kindling
  • Intracellular signalling
  • Immunology
  • Sleep studies
  • Neurobiology of atypical depression
  • Neurobiology of psychotic depression
  • Psychological components
  • Psychodynamic
  • Cognitive
  • Behavioural
  • Social components
  • Predisposing factors (vulnerability)
  • Precipitating factors (life events)
  • Social networks
  • Expressed emotions
  • Integrative models of the aetiology of depression
  • Clinical assessment
  • Differential diagnosis
  • Normal sadness/bereavement
  • Anxiety disorders
  • Obsessive-compulsive disorder
  • Persistent affective disorders (dysthymia)
  • Personality disorder
  • Non-affective psychosis
  • Organic disorders
  • Dementia
  • Others
  • Management
  • General management
  • Treatments
  • Pharmacological
  • Physical
  • Electroconvulsive therapy
  • Sleep deprivation
  • Transcranial magnetic stimulation
  • Vagus nerve stimulation
  • Light therapy
  • Exercise
  • Neurosurgery
  • Psychological
  • Behavioural therapy
  • Cognitive therapy
  • Psychotherapy
  • Interpersonal therapy
  • Couple therapy
  • Mindfulness-based cognitive therapy (MBCT)
  • Social
  • Relative efficacy of treatments
  • Illness phase
  • Other treatment considerations
  • Treatment-resistant depression
  • Psychotic depression
  • Residual symptoms of depression
  • Predictors of treatment response
  • Biological effects of antidepressant treatment
  • Outcome and prognosis
  • Effect on physical illness
  • References
  • Chapter 21: Bipolar disorders
  • Introduction
  • History of bipolar disorder
  • The bipolar spectrum
  • Clinical features
  • Mania and hypomania
  • Appearance
  • Behaviour
  • Speech
  • Mood
  • Vegetative signs
  • Psychotic and related symptoms
  • Cognition
  • Insight
  • Manic stupor
  • Mixed states
  • Cyclothymia
  • Classification
  • ICD-10
  • Hypomania
  • Mania
  • Bipolar affective disorder
  • Cyclothymia
  • DSM-IV
  • Hypomania
  • Mania
  • Bipolar disorders
  • Bipolar I disorder
  • Bipolar II disorder
  • Cyclothymic disorder
  • Differential diagnoses
  • Cyclothymia
  • Schizophrenia
  • Organic brain syndromes
  • Illicit substance misuse
  • Iatrogenic causes
  • Epidemiology
  • Aetiology
  • Biological
  • Genetic studies
  • Family, twin and adoption studies
  • Linkage studies
  • Association studies
  • Ethical considerations
  • Neuroendocrine studies
  • The hypothalamic-pituitary-adrenal axis
  • The hypothalamic-pituitary-thyroid axis
  • Neuropathological studies
  • Psychological theories
  • Course and outcome
  • Illness course
  • Initial presentation
  • Number of episodes
  • Frequency of episodes and length of cycles
  • Length of episodes
  • Precipitants
  • Rapid cycling
  • Antidepressant-induced cycling
  • Outcome
  • Suicide
  • Co-morbidity
  • Neuropsychology
  • Management
  • Early identification and relapse signatures
  • Appropriate referral and treatment settings
  • Hospital admission
  • Physical treatment
  • Drugs used in the management of bipolar disorders (Table 21.2)
  • Mood-stabilizers
  • Lithium
  • Sodium valproate
  • Carbamazepine
  • Other mood-stabilizing agents
  • Antipsychotics
  • Antidepressants
  • Benzodiazepines
  • Electroconvulsive therapy (ECT)
  • Treatment of different phases of bipolar illness
  • Drug management of acute mania or mixed episodes
  • Drug management of acute depression
  • Maintenance treatment
  • Drug treatment of rapid cycling
  • Drug treatment during pregnancy
  • Experimental drug treatments
  • Omega-3 fatty acids
  • Antiglucocorticoids
  • Non-physical management
  • Psychoeducation
  • Interpersonal and social rhythms therapy
  • Cognitive therapy
  • Conclusions
  • Further reading
  • References
  • Chapter 22: Suicide and deliberate self-harm
  • Suicide
  • Epidemiology
  • Patient characteristics associated with suicide
  • The social characteristics associated with suicide
  • Contact with services and communication of risk
  • Characteristics of adolescent suicides
  • Deliberate self-harm
  • Definitions
  • Epidemiology
  • Patient characteristics
  • Social characteristics associated with deliberate self-harm
  • The family and the suicidal person
  • The impact of suicide on mental health professionals
  • Psychoanalytic theories of suicide and suicidal behaviour
  • Internal motives and suicide phantasies
  • Behavioural and cognitive theories
  • Social theories
  • Ethological theories
  • Suicide bombing
  • Physician-assisted suicide
  • Factors that increase the risk of suicide attempts
  • Management of suicidal behaviour
  • Assessment
  • The characteristics of the attempt
  • The patient's psychopathology and the continuing risk of suicide
  • The patient's coping resources, and family and social supports
  • Counter-transference feelings
  • Treatment
  • References
  • Chapter 23: Unusual psychiatric syndromes
  • Introduction
  • Capgras syndrome
  • Clinical aspects
  • Diagnostic significance
  • Explanatory theories
  • Management
  • Dangerousness
  • De Clerambault syndrome
  • Clinical aspects
  • Diagnostic significance
  • Management
  • Dangerousness
  • Othello syndrome
  • Clinical aspects
  • Aetiology
  • Diagnostic significance
  • Management
  • Dangerousness
  • Folie à deux
  • Clinical aspects
  • Explanatory theories
  • Diagnostic significance
  • Management
  • Cotard syndrome
  • Clinical aspects
  • Diagnostic significance
  • Management
  • Ekbom syndrome
  • Clinical aspects
  • Diagnostic significance
  • Management
  • Munchausen syndrome
  • Clinical aspects
  • Explanatory theories
  • Diagnostic significance
  • Management
  • Munchausen syndrome by proxy
  • Clinical aspects
  • Diagnostic significance
  • Management
  • Ganser syndrome
  • Diagnostic significance
  • Management
  • Culture-bound syndromes
  • Koro
  • Amok
  • Latah
  • Wendigo
  • Possession states
  • Other culture-bound conditions
  • References
  • Chapter 24: Gender and sexuality in psychiatry
  • Introduction
  • Epidemiology of psychiatric disorders
  • Disorders specifically associated with gender identity
  • Gender identity disorders
  • Disorders specifically associated with sexual orientation
  • Disorders specifically associated with being female
  • Menarche
  • Menstrual cycle
  • Clinical features
  • Aetiology
  • Treatment
  • Disorders associated with childbirth
  • Pregnancy
  • Pregnancy in women with major mental illness
  • Managing pregnancy in women with severe mental illness
  • Pharmacological treatment of pregnant women with severe mental illness
  • Disorders associated with the puerperium
  • Postpartum blues (maternity blues, postnatal blues)
  • Clinical features
  • Treatment
  • Postnatal depression (PND)
  • Postnatal depression in men
  • Clinical features
  • Aetiology
  • Treatment
  • Prevention
  • Prognosis
  • Postnatal depression and child development
  • Puerperal (postnatal) psychosis
  • Epidemiology
  • Aetiology
  • Clinical features
  • Management
  • Treatment
  • Breast-feeding
  • Prognosis
  • Other disorders associated with childbirth
  • Menopause
  • The role of hormone replacement therapy (HRT)
  • Hormonal aspects of psychiatric illness
  • Disorders showing a higher prevalence in women
  • Disorders showing a higher prevalence in men
  • Psychopathy/aggression/violent crime
  • Suicide
  • Addiction
  • Disorders presenting differently in women compared to men
  • Schizophrenia
  • Bipolar illness
  • Gender differences in treatment
  • Service provision
  • References
  • Chapter 25: Adult sequelae of childhood sexual abuse
  • Introduction
  • History
  • Definition
  • Methodological difficulties
  • Prevalence
  • The consequences of childhood sexual abuse
  • Long-term effects
  • Emotional/psychological
  • Depression, low self-esteem and suicidal behaviour
  • Anxiety, post-traumatic stress and dissociation
  • Eating disorders and somatization
  • Emotionally unstable/borderline personality disorder, multiple personality disorder and psychotic symptoms
  • Learning disability
  • Sexual adjustment
  • Interpersonal relationships
  • Social functioning
  • Prostitution
  • Drug and alcohol abuse
  • Sexual offending and victim to abuser cycles: male and female perpetrators
  • Factors that influence outcome
  • Children most at risk
  • Theories of childhood sex abuse effects
  • Post-traumatic stress disorder
  • Finkelhor´s traumagenic factors
  • Psychodynamics and attachment theory
  • Therapeutic approaches
  • Cognitive and solution-focused therapy
  • Psychodynamic therapy
  • Couple therapy
  • Family therapy
  • Group therapy
  • Conclusion
  • References
  • Chapter 26: Sexual disorders
  • Introduction
  • A history of sexual disorders
  • The epidemiology of sexual disorders
  • The classification of sexual disorders
  • The general classification of sexual disorders
  • ICD-10 and DSM-IV classification of sexual disorders
  • Sex therapy
  • Referral
  • Assessment
  • Treatment
  • Psychological/behavioural techniques
  • Premature ejaculation
  • Delayed or absent ejaculation
  • Vaginismus
  • Female anorgasmia
  • Erectile dysfunction or impotence
  • Relationship issues and their impact on sexuality
  • Behavioural relational therapies
  • Clear communication
  • Negotiation of problems
  • Arguments and assertiveness
  • The negotiated timetable
  • Mechanical and pharmacological treatments
  • Erectile dysfunction (failure of genital response)
  • Management
  • Advanced investigations
  • Management
  • Treatment options
  • Phosphodiesterase-5 inhibitors
  • Intracavernosal injections
  • Yohimbine
  • Hormonal treatment
  • Surgical treatments
  • Future developments in treatment
  • References
  • Online resources
  • Chapter 27: Organic psychiatry and epilepsy
  • Introduction
  • Organic psychiatry - general considerations
  • Acute and chronic organic psychiatric syndromes
  • Focal and generalized organic psychiatric syndromes
  • Clinical evaluation of patients with organic psychiatric syndromes
  • Standard cognitive examination in all psychiatric patients
  • Cognitive examination in psychiatric patients with suspected organic psychiatric syndromes
  • Neuropsychological evaluation of patients with organic psychiatric syndromes
  • Investigation of patients with organic psychiatric syndromes
  • Haematology and biochemistry
  • Electroencephalography
  • Neuroimaging
  • Focal organic psychiatric syndromes
  • Lesions of the frontal lobe
  • Personality changes
  • Cognitive dysfunction
  • Behavioural changes
  • Lesions of the temporal lobe
  • Disorders of memory (the amnestic syndrome)
  • Disorders of language
  • Lesions of the parietal and occipital lobes
  • Lesions of the diencephalon and other brain regions
  • Generalized organic psychiatric syndromes
  • Delirium
  • The dementias
  • Alzheimer disease
  • Vascular dementia and Binswanger disease
  • Lewy body dementia
  • Frontotemporal dementias and Pick disease
  • Pick disease
  • Dementia of frontal lobe type
  • Dementia associated with alcohol
  • Prion protein dementias (spongiform encephalopathies)
  • Kuru
  • Creutzfeldt-Jakob disease
  • Gerstmann-Straüssler-Scheinker syndrome
  • Fatal familial insomnia
  • New variant Creutzfeldt-Jakob disease
  • Prevention:
  • Symptomatic treatment:
  • Subcortical dementias
  • Parkinson disease
  • Huntington disease
  • Aetiology:
  • Pathology:
  • Clinical aspects and outcome:
  • Genetic testing for Huntington disease:
  • Progressive supranuclear palsy
  • Human immunodeficiency virus (HIV)-associated dementia
  • Neuropathology:
  • Clinical features, treatment and outcome:
  • Other dementias
  • Metachromatic leucodystrophy
  • Adrenocortical leucodystrophy
  • Gaucher disease
  • Kuf disease
  • Potentially reversible dementias and pseudodementia
  • Normal pressure hydrocephalus
  • Pseudodementia
  • Specific movement disorders
  • Eponymous specific movement disorders
  • Friedreich ataxia
  • Sydenham chorea
  • Gilles de la Tourette syndrome
  • Wilson disease
  • Non-eponymous specific movement disorders
  • Benign essential tremor
  • Focal dystonias
  • Epilepsy
  • Definition
  • Classification
  • Aetiology
  • Aetiology of epilepsy
  • Aetiology of seizures
  • Epidemiology
  • The diagnosis of epilepsy
  • Investigations
  • Epilepsy and psychiatry
  • Co-morbid psychiatric illness and epilepsy
  • Peri-ictal psychiatric illness
  • Interictal psychiatric illness
  • The treatment of epilepsy
  • Medical treatment
  • Surgical treatment
  • Legal aspects of epilepsy
  • Non-epileptic seizures
  • Sleep disorders (parasomnias)
  • Insomnia
  • Nightmares and night terrors
  • Sleep walking, sleep paralysis and Kleine-Levin syndrome
  • Narcolepsy
  • Sequelae of cerebral insults
  • Focal cerebral insult
  • Head injury
  • Classification and pathophysiology
  • General clinical features
  • Psychiatric features
  • Postconcussive syndrome:
  • Personality disorder:
  • Cognitive disorder:
  • Anxiety disorder:
  • Affective disorder:
  • Psychotic disorder:
  • Epilepsy:
  • Psychiatric treatment of head-injured patients
  • Outcome
  • Sequelae of head injuries associated with boxing and other sports
  • Cerebrovascular disease
  • Cerebrovascular accident
  • Subarachnoid haemorrhage
  • Intracranial haematoma
  • Infection
  • Encephalitis
  • Meningitis
  • Neurosyphilis
  • Cerebral abscess
  • Malaria
  • Acquired immune deficiency syndrome
  • Cerebral tumours
  • Generalized cerebral insult
  • Metabolic disorders
  • Hypoxia
  • Electrolyte imbalance
  • Uraemia and renal dialysis
  • Hepatic failure
  • Polydipsia
  • Porphyria
  • Carcinoma (non-metastatic psychiatric effects)
  • Carcinoid syndrome
  • Vitamin deficiencies
  • Thiamine (B1) deficiency (cerebral beri-beri):
  • Nicotinic acid (B3) deficiency (pellagra):
  • Pyridoxine (B6) deficiency:
  • Cyanocobalamin (B12) deficiency (pernicious anaemia):
  • Folate deficiency (folate dementia):
  • Endocrine disorders
  • Hypopituitarism:
  • Acromegaly:
  • Hyperprolactinaemia:
  • Hypothyroidism:
  • Hyperthyroidism:
  • Hypoparathyroidism:
  • Hyperparathyroidism:
  • Diabetes mellitus:
  • Hypoglycaemia:
  • Addison disease:
  • Cushing syndrome:
  • Phaeochromocytoma:
  • Poisoning
  • Carbon monoxide poisoning
  • Poisoning with drugs
  • Antibacterial and antituberculous drugs:
  • Anticholinergic/antimuscarinic and dopaminergic drugs:
  • Anticonvulsant drugs:
  • Barbiturates, benzodiazepines and related drugs:
  • Cardiovascular drugs:
  • Corticosteroid drugs:
  • Contraceptive drugs:
  • Cytotoxic drugs:
  • Opiate drugs:
  • Toluene poisoning
  • Heavy metal poisoning
  • Autoimmune and other disorders
  • Amyotrophic lateral sclerosis (motor neuron disease)
  • Cerebral sarcoidosis
  • Systemic lupus erythematosus
  • Multiple sclerosis
  • Myasthenia gravis
  • References
  • Chapter 28: Alcohol misuse
  • Introduction
  • Metabolism
  • Dependency
  • Identification and assessment
  • Epidemiology of alcohol use
  • Prevalence
  • Patterns of use
  • Age
  • Gender
  • Beverage type
  • Religion and culture
  • Occupation
  • Marital status
  • Socioeconomic class
  • Economic cost
  • Co-morbidity
  • Taking a drinking history
  • Aetiology
  • Biological
  • Genetic
  • Biological markers
  • Biochemical
  • Psychological
  • Psychoanalytic theory
  • Conditioning theory
  • Personality traits
  • Life events and stress
  • Sociological
  • Neurobiology of ethanol, tolerance, dependence and withdrawal
  • Other effects
  • Alcohol-related physical problems
  • Gastrointestinal tract
  • Liver
  • Cardiovascular
  • Metabolic
  • Endocrine and reproductive
  • Musculoskeletal
  • Bone
  • Haematological
  • Respiratory
  • Dermatological
  • Neurological problems
  • Acute intoxication
  • Pathological drunkenness
  • Methanol poisoning
  • Wernicke encephalopathy and Korsakoff psychosis
  • Aetiology
  • Prognosis
  • Other neurological consequences of alcohol
  • Cerebellar degeneration
  • Amblyopia
  • Marchiafava Bignami syndrome
  • Central pontine myelinosis
  • Epilepsy
  • Dementia
  • Amnesia
  • Fetal alcohol syndrome
  • Alcohol-related psychological disorders
  • Alcoholic hallucinosis
  • Psychiatric co-morbidity
  • Affective disorder
  • Suicide
  • Dissocial personality disorder
  • Pathological jealousy (Othello syndrome)
  • Anxiety states
  • PTSD
  • Eating disorders
  • Other drug use
  • Social consequences of excessive alcohol use
  • Employment
  • Family
  • Crime and violence
  • Drinking and driving
  • Alcohol withdrawal
  • Alcohol withdrawal features
  • Detoxification and withdrawal management
  • Treatment regimen for medically assisted withdrawal from alcohol
  • Delirium tremens
  • Post-detoxification relapse prevention
  • Pharmacotherapy
  • Disulfiram
  • Naltrexone and acamprosate
  • Developing pharmacotherapies
  • Psychological interventions
  • Psychosocial relapse prevention strategies
  • Motivational interviewing
  • Brief interventions
  • Alcoholics Anonymous
  • Residential rehabilitation
  • Provision of service
  • Prognosis
  • Further reading
  • References
  • Chapter 29: Psychoactive drug misuse
  • Introduction
  • Definitions
  • Reward
  • Tolerance and neuroadaptation
  • Withdrawal
  • Dependence
  • The effect of drugs
  • Prevalence of substance abuse
  • Aetiology
  • Individual factors
  • Genetics
  • Personality
  • Psychological models
  • Social
  • Dual diagnosis
  • Management
  • Taking a drug history
  • Investigations
  • Viral screens
  • HIV and AIDS
  • Hepatitis B and C
  • Drugs of abuse
  • Opiates: opium, heroin, methadone and buprenorphine
  • Mode of action and neurobiology
  • Route of administration
  • Heroin metabolism
  • Patterns of use
  • Epidemiology
  • The effects of opiates
  • Heroin withdrawal
  • Physical complications
  • Opiate overdose
  • Psychiatric co-morbidity
  • Treatment options
  • Methadone
  • Starting methadone treatment
  • Starting buprenorphine (Subutex, Suboxone, Temgesic) treatment
  • Buprenorphine
  • Levo-alpha acetylmethadol (LAAM)
  • Other opiate pharmacotherapies: slow release oral morphine, injectable diamorphine and methadone and naltrexone
  • Long-term benefits of opiate substitution treatment (OST)
  • Detoxification from heroin and coming off maintenance treatment
  • Prescribing drugs to opiate addicts
  • Other treatment interventions
  • Psychological
  • Physical
  • Social and educational
  • Pregnancy
  • Criminal justice system
  • Prisoners
  • HIV-positive
  • Outcome
  • Stimulants: amphetamines, cocaine and MDMA ('ecstasy')
  • D-amphetamine and methamphetamine
  • Pattern of use
  • Effects
  • Other physical complications
  • Dependence and withdrawal
  • Treatment
  • Psychiatric conditions
  • Cocaine ('Charlie', 'coke', 'snow', 'crack')
  • Mechanism of action
  • Route of administration
  • Patterns of use
  • Effects and toxicity
  • Psychiatric conditions
  • Treatment
  • MDMA (`ecstasy´)
  • Mechanism of action
  • Metabolism
  • Patterns of use and sought after effects
  • Unwanted effects
  • Neurotoxicity
  • Psychiatric and cognitive co-morbidity and MDMA
  • Dependence
  • Physical morbidity
  • ?-Hydroxybutyrate (GHB, GBH, liquid ecstasy)
  • Hallucinogens: lysergic acid diethylamide (LSD), ketamine and psilocybin - mushrooms
  • Lysergic acid diethylamide (LSD)
  • Mechanism of action
  • Clinical features
  • Treatment
  • Ketamine
  • 'Magic mushrooms'
  • General sedatives: benzodiazepines and barbiturates
  • Benzodiazepines
  • Mechanism of action
  • Metabolism
  • Tolerance
  • Dependence
  • Withdrawal
  • Management of withdrawal
  • Barbiturates
  • Clinical features
  • Tolerance and withdrawal
  • Treatment
  • Cannabis
  • Structure and mechanism of action
  • Preparations
  • Route of administration
  • Effects
  • Physical complications
  • Psychological complications
  • Laboratory detection
  • Dependence
  • Volatile substances
  • Epidemiology
  • Mechanism of action
  • Method of administration
  • Effects
  • Complications
  • Chronic use
  • Recognition
  • Areca (betel) nut
  • Legal highs
  • References
  • Chapter 30: The organization and development of mental health services
  • Introduction
  • Historical background
  • Keys to success
  • Clinical leadership
  • Clinical governance
  • Working practices
  • Case management
  • The Care Programme Approach
  • Needs assessment
  • Individual needs assessment
  • Population needs assessment
  • Multidisciplinary working
  • Advocacy and service user involvement
  • Specific service elements
  • Community mental health teams
  • Inpatient care
  • Crisis care
  • Crisis resolution teams
  • Acute day hospital care
  • Non-hospital residential care
  • A&E departments
  • Assertive outreach teams
  • Early intervention teams
  • Primary care
  • Day-care and occupation
  • Housing
  • Conclusions
  • References
  • Chapter 31: Forensic psychiatry
  • Introduction
  • Services where forensic psychiatry is practised
  • Mental Health Act 1983 (as amended 2007)
  • Civil law
  • Criminal law
  • Remand powers
  • Diversion sentences
  • Transfer to hospital of prisoners
  • Oversight of detained patients
  • Civil law, mental disorder and legal implications
  • Offending and mental disorder
  • Violent crimes
  • Sexual offences
  • Property offences
  • Specific mental disorders and offending
  • Organic disorders
  • Schizophrenia
  • Affective illness
  • Personality disorder
  • Dual and triple diagnoses
  • Mental impairment and developmental disorders
  • Neurosis
  • Epilepsy
  • The mentally disordered offender and the criminal justice system
  • Pre-trial stage issues
  • Court diversion
  • Trial stage issues
  • Fitness to plead
  • Legal defences
  • Diminished responsibility
  • Automatisms
  • Intoxication
  • Multi-agency public protection arrangements (MAPPA)
  • Prison psychiatry
  • Risk assessment and risk management
  • Forensic psychotherapy
  • Future developments
  • Writing psychiatric reports and appearing in court
  • Preliminary matters
  • The psychiatrist as expert witness
  • Planning the written report
  • Appearing in court
  • Further reading
  • References
  • Chapter 32: Psychiatry of old age
  • Introduction
  • Demography
  • Epidemiology
  • Dementia
  • Depression
  • Neurosis
  • Schizophrenia and late paraphrenia
  • Dementia
  • Definition
  • Non-cognitive features
  • Alzheimer disease
  • Definition
  • Pathology
  • Aetiology
  • Vascular dementia
  • Definition
  • Pathology
  • Aetiology
  • Dementia with Lewy bodies
  • Other dementias
  • The management of dementias
  • Diagnosis
  • General treatment
  • Pharmacological treatments
  • Depression
  • Clinical features
  • Aetiology
  • Management
  • Mania
  • Late paraphrenia
  • Squalor syndrome
  • Suicide and attempted suicide
  • Suicide
  • Epidemiology
  • Correlates of suicide
  • Medical contact
  • Methods
  • Suicide notes
  • Attempted suicide
  • Psychiatry of old age services
  • Sources and mode of referrals
  • Site and nature of initial assessment
  • Outpatient clinics
  • Day hospitals
  • Inpatient care
  • Role of the general practitioner
  • Liaison service
  • Mental health legislation and elderly patients
  • References
  • Part 3: Diagnosis, investigation and treatment
  • Chapter 33: Clinical examination of psychiatric patients
  • Introduction
  • Taking a psychiatric history
  • Establishing the reason for referral and the presenting complaint
  • Establishing the history of the presenting complaint
  • Establishing the family history
  • Establishing the personal history
  • Establishing the forensic history
  • Assessing a patient's personality
  • Performing a mental state examination
  • Appearance
  • Posture and movement
  • Behaviour
  • Speech
  • Mood and affect
  • Thought
  • Perception
  • Cognition
  • Insight
  • Psychodynamic aspects of clinical examination
  • Transference, counter-transference, projective identification and acting out
  • Counter-transference, hate and malignant alienation
  • External and internal stability
  • Difficulties that may be encountered when interviewing psychiatric patients
  • The stuporose patient
  • The elderly patient
  • The mentally handicapped patient
  • The agitated patient
  • Interviewing patients via an interpreter
  • Emergency consultations
  • References
  • Chapter 34: Diagnosis and classification in psychiatry
  • Introduction
  • Types of classification systems in psychiatry
  • Our current classification systems: DSM and ICD
  • How to determine whether something is an entity
  • The problem of co-morbidity
  • The problem of the Axes
  • How to determine whether a putative diagnostic entity belongs with others
  • Classifying behaviours
  • Are dimensional approaches better?
  • Alternative approaches to psychiatric classification
  • Future prospects: clinical or biological classification in psychiatry?
  • References
  • Chapter 35: Electroencephalography and neuroimaging
  • Introduction
  • Electroencephalography in psychiatry
  • The normal electroencephalogram
  • Normal EEG frequencies
  • Age and the EEG
  • Activation of the EEG
  • The EEG and sleep
  • The effects of psychotropic drugs on the EEG
  • The EEG and electroconvulsive therapy (ECT)
  • The EEG and psychiatric illness
  • Epilepsy
  • Acute organic psychosis and encephalitis
  • Dementia
  • Personality, affective and anxiety disorders
  • Schizophrenia
  • Evoked potentials
  • Magnetoencephalography
  • Structural neuroimaging in psychiatry
  • Skull X-ray
  • Computed X-ray tomography (CT)
  • Magnetic resonance imaging (MRI)
  • The role of CT and MR structural neuroimaging in psychiatry
  • Functional neuroimaging in psychiatry
  • Positron emission tomography (PET)
  • Single photon emission tomography (SPET)
  • The role of PET and SPET in psychiatry
  • Functional MRI (fMRI)
  • MR spectroscopy (MRS)
  • References
  • Chapter 36: Emergency psychiatry
  • Introduction
  • A general clinical approach to psychiatric emergencies
  • The request for an emergency consultation
  • Subjective emergency assessment of a patient
  • Objective emergency assessment of a patient
  • Completing the emergency assessment
  • The plan of treatment
  • Aggression and violence in the emergency setting
  • Threatened violence
  • De-escalation techniques
  • Actual violence
  • Violence of organic origin
  • Violence of psychotic origin
  • Violence of non-organic, non-psychotic (behavioural disturbance) origin
  • Physical restraint
  • Seclusion
  • Pharmacotherapy (rapid tranquillization)
  • Haloperidol
  • Lorazepam
  • Olanzapine
  • Self-harm and attempted suicide in the emergency setting
  • Assessment of needs
  • Assessment of risk
  • Conclusions
  • References
  • Chapter 37: Psychotherapy - individual, family and group
  • Introduction
  • Jerome Frank's 'common features'
  • Psychodynamic/psychoanalytic psychotherapy
  • Freud's models of the mind
  • Ego defence mechanisms
  • Repression
  • Denial
  • Projection
  • Identification
  • Projective identification
  • Reaction formation
  • Identification with the aggressor
  • Turning against the self
  • Displacement
  • Regression
  • Isolation and undoing
  • Splitting
  • Acting out
  • Intellectualization
  • Sublimation
  • Psychosexual stages
  • The 'Oedipus complex'
  • Dreams
  • Freud's works
  • Developments following Freud
  • Alfred Adler (1870-1937)
  • Carl Gustav Jung (1885-1961)
  • Object relations theorists (Fairbairn, Guntrip, Balint, Winnicott)
  • Donald Winnicott (1896-1971)
  • John Bowlby and attachment theory
  • Melanie Klein (1882-1960)
  • Wilfred Bion (1897-1974)
  • Post-Kleinian developments
  • Otto Kernberg (born 1928) and Heinz Kohut (1913-1981)
  • Margaret Mahler (1897-1985)
  • Jacques Lacan (1901-1981)
  • The practice of psychotherapy and psychoanalysis
  • Psychoanalysis as a treatment
  • Key concepts
  • Transference and counter-transference
  • Interpretations
  • Therapeutic alliance
  • Cawley's levels of psychotherapy
  • Selection of patients for dynamic psychotherapy
  • Variants and developments of psychodynamic psychotherapy
  • Brief dynamic psychotherapy
  • Cognitive analytic therapy (CAT)
  • Interpersonal psychotherapy (IPT)
  • Psychodynamic interpersonal therapy (Hobson)
  • Mentalization-based treatment
  • Family therapy
  • Origins of family therapy
  • Structural family therapy
  • Systemic family therapy
  • Strategic family therapy
  • Foundations of family therapy
  • Group psychotherapy and analysis
  • Therapeutic communities
  • Research in psychotherapy
  • The role of psychotherapy and the psychotherapist within psychiatry - overt and covert functions
  • Overt roles of the psychotherapist
  • Covert roles of the psychotherapist
  • References
  • Chapter 38: Behavioural and cognitive psychotherapies
  • Introduction
  • Behaviour therapy
  • Learning theory
  • Classical conditioning
  • Operant conditioning
  • Modern developments of conditioning theories
  • Characteristics of behaviour therapy
  • Exposure therapy
  • Case example
  • Behaviour modification and social skills training
  • Cognitive therapy
  • Cognitive theories
  • Beck´s cognitive model
  • The cognitive model of depression
  • The cognitive model of anxiety
  • Cognitive models of specific anxiety disorders
  • Vulnerability to emotional disorder
  • Cognitive model of personality disorders
  • Characteristics of cognitive therapy
  • Conceptualization
  • Case example
  • Initial phase of cognitive therapy
  • Middle phase of therapy
  • Thought monitoring and challenging
  • Behavioural experiments
  • Final phase of therapy
  • Efficacy of cognitive therapy for depression and anxiety
  • CBT in psychosis
  • Family interventions in schizophrenia
  • CBT for hallucinations and delusions
  • Recent developments in CBT
  • Conclusions
  • Further reading
  • References
  • Chapter 39: Psychopharmacology
  • Introduction
  • Basic psychopharmacology
  • Neurotransmitters and neuroreceptors
  • Ligand gated ion channel receptors
  • G-protein coupled receptors
  • Mechanisms of action of psychotropic drugs
  • Dopamine
  • The mesocorticolimbic system
  • The nigrostriatal system
  • The tuberoinfundibular system
  • Biochemistry
  • Clinical aspects
  • Noradrenaline (norepinephrine)
  • Biochemistry
  • Clinical aspects
  • Serotonin
  • Biochemistry
  • Clinical aspects
  • Acetylcholine
  • Biochemistry
  • Clinical aspects
  • ?-Amino butyric acid
  • Biochemistry
  • Clinical aspects
  • Glycine
  • Glutamate
  • Clinical aspects
  • Opioid peptides
  • Substance P
  • Clinical psychopharmacology
  • Pharmacokinetics
  • Absorption
  • Distribution
  • Metabolism
  • Elimination
  • Psychotropic drug development
  • The main classes of psychotropic drugs
  • Antipsychotic drugs
  • Pharmacokinetics and pharmacodynamics
  • Mechanism of action
  • Efficacy
  • Schizophrenia
  • Bipolar disorder
  • Safety
  • Extrapyramidal adverse effects
  • Neuroleptic malignant syndrome
  • Hyperprolactinaemia
  • Cardiovascular adverse effects
  • Antidepressant drugs
  • Pharmacokinetics and pharmacodynamics
  • Newer antidepressant drugs
  • Selective serotonin reuptaka inhibitors
  • Experimental tryptophan depletion
  • Serotonin/noradrenergic reuptake inhibitors
  • Agomelatine
  • Moclobemide
  • Mirtazapine
  • Reboxetine
  • Tryptophan
  • Older antidepressant drugs
  • Tricyclic and tricyclic related antidepressant drugs
  • Experimental noradrenaline (norepinephrine) depletion
  • Monoamine oxidase inhibitor drugs
  • Efficacy
  • Major depressive disorder
  • Major depressive disorder in children and adolescents
  • Bipolar depression
  • Treatment-resistant depression
  • Safety
  • Newer antidepressant drugs
  • Older antidepressant drugs
  • Antimanic drugs
  • Lithium and other mood stabilizing drugs
  • Lithium
  • Pharmacokinetics and pharmacodynamics
  • Mechanism of action
  • Efficacy
  • Safety
  • Drugs used in the treatment of anxiety disorders including sedative and hypnotic drugs
  • Antidepressant drugs as anxiolytics
  • Benzodiazepine drugs
  • Pharmacokinetics and pharmacodynamics
  • Mechanism of action
  • Efficacy
  • Anxiety disorders
  • Insomnia
  • Equivalent doses
  • Safety
  • Paradoxical disinhibition
  • Tolerance, dependence and withdrawal syndrome
  • Non-benzodiazepine drugs
  • Sedative and hypnotic drugs
  • Drugs used in the treatment of psychiatric disorders in children
  • Nocturnal enuresis
  • Attention deficit hyperactivity disorder
  • Methylphenidate
  • Pharmacokinetics and pharmacodynamics
  • Efficacy
  • Safety
  • Dexamphetamine
  • Pharmacokinetics and pharmacodynamics
  • Efficacy
  • Safety
  • Atomoxetine
  • Pharmacokinetics and pharmacodynamics
  • Efficacy
  • Safety
  • Autism
  • Sleep disorders
  • Tic disorders
  • Conduct disorder
  • Anxiety disorders
  • Depression
  • Psychosis
  • Antiepileptic drugs
  • General pharmacological treatment of epilepsy
  • Partial or focal epilepsy
  • Generalized epilepsy
  • Status epilepticus
  • Contraception and reproduction
  • Discontinuation of antiepileptic drugs
  • Alternative psychosis or forced normalization
  • Valproate
  • Pharmacokinetics and pharmacodynamics
  • Mechanism of action
  • Efficacy
  • Safety
  • Lamotrigine
  • Pharmacokinetics and pharmacodynamics
  • Mechanism of action
  • Efficacy
  • Safety
  • Carbamazepine
  • Pharmacokinetics and pharmacodynamics
  • Mechanism of action
  • Efficacy
  • Safety
  • Drugs used in the treatment of erectile impotence, premature ejaculation and antisocial sexual behaviour
  • Phosphodiesterase type 5 inhibitors
  • Older drugs
  • Premature ejaculation
  • Antisocial sexual behaviour
  • Drugs used in the treatment of dementia
  • Acetylcholinesterase inhibitors
  • Donepezil
  • Galantamine
  • Rivastigmine
  • N-methyl-d-aspartate antagonists
  • Memantine
  • Vascular dementia
  • Drugs used in the treatment of parkinsonism and related disorders
  • Pharmacokinetics and pharmacodynamics
  • Mechanism of action
  • Efficacy
  • Safety
  • Drugs used in the treatment of alcohol and drug dependence and cigarette smoking
  • Alcohol misuse
  • Disulfiram
  • Acamprosate
  • Opiate misuse
  • Methadone
  • Buprenorphine
  • Lofexidine
  • Naltrexone
  • Cigarette smoking
  • Nicotine replacement therapy
  • Bupropion
  • Varenicline
  • Special populations of patients
  • Children
  • Women
  • Oral contraceptive pill
  • Reproductive function
  • Hyperprolactinaemia
  • Elderly patients
  • Motorists
  • The impact of biotechnology on the treatment of psychiatric disorders
  • References
  • Chapter 40: Electroconvulsive therapy and therapeutic neuromodulation
  • Introduction
  • Electroconvulsive therapy
  • Background
  • History
  • Refinement and development
  • Stimulus dosing
  • Electrode placement and treatment frequency
  • ECT and the media
  • Physical principles of ECT
  • Neurobiology of ECT
  • Molecular mechanism of action
  • Neuroimaging and ECT
  • Clinical practice of ECT
  • Indications and guidelines
  • Depression
  • Mania and affective psychoses
  • Catatonia
  • Neurological disorders
  • Consent and capacity
  • Pre-anaesthetic assessment
  • Anaesthesia
  • Safety
  • Psychotropic medications and ECT
  • Side-effects
  • Physical side-effects
  • Cognitive side-effects
  • Contraindications
  • ECT and the multidisciplinary team
  • Therapeutic neuromodulation
  • Vagus nerve stimulation (VNS)
  • Repetitive transcranial magnetic stimulation (rTMS)
  • Transcranial direct current stimulation (tDCS)
  • Neurosurgery for mental illness
  • Deep brain stimulation (DBS)
  • Summary
  • References
  • Index

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