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'Complex patients'are a sizeable population who generally require disproportionate attention for their management and respond poorly to treatment. Their systemic medical, psychiatric and personal needs have a tendency to drain or exceed the capabilities of those who treat them whilst overutilizing health care resources. As this patient population grows, we move ever closer to a crisis in health care delivery. This volume presents an innovative team-based approach for assessing and managing diagnostically complex and management intensive patients. The physician-led'Medical-Psychiatric Coordinating Physician (MPCP)'model not only improves patient treatment, but also provides for the containment of costs by reducing redundancy and curbing excess in the use of services. Other benefits include improved diagnostic accuracy and decision making, as well as better communication among physicians and allied health professionals. This book is essential reading for psychiatrists, primary care physicians, and physicians, directors and administrators working in multidisciplinary specialty clinics.

Many healthcare providers based in primary care, emergency care or other acute care environments encounter patients with psychiatric problems. These presentations can be difficult to manage and often pose significant challenges. A better understanding of most common psychiatric problems can greatly aid both providers and patients. Emergency Psychiatry reviews a wide range of common psychiatric disorders and provides succinct management guidelines. Written by emergency physicians and psychiatrists, Emergency Psychiatry is a rapid reference for the acute management of psychiatric disorders for all care providers, including, but not limited to, emergency physicians, internists, psychiatrists, social workers, family practitioners and other primary care providers.

Emergency physicians, in all practice settings, care for patients with both undifferentiated psycho-behavioral presentations and established psychiatric illness. This reference-based text goes beyond diagnostics, providing practical input from physicians experienced with adult emergency psychiatric patients. Physicians will increase their understanding and gain confidence working with these patients, even when specialized psychiatric back-up is lacking. Behavioral Emergencies for the Emergency Physician is comprehensive, covering the pre-hospital setting and advising on evidence-based practice; from collaborating with psychiatric colleagues to establishing a psychiatric service in your ED. Sedation, restraint and seclusion are outlined. Potential dilemmas when treating pregnant, geriatric or homeless patients with mental illness are discussed in detail, along with the more challenging behavioral diagnoses such as malingering, factitious and personality disorders. This go-to, comprehensive volume is invaluable for trainee and experienced emergency physicians, as well as psychiatrists, psychologists, psychiatric and emergency department nurses and other mental health workers.

Disorders of behavior represent some of the most common and disabling diseases affecting humankind; however, despite their worldwide distribution, genetic influences on these illnesses are often overlooked by families and mental health professionals. Psychiatric genetics is a rapidly advancing field, elucidating the varied roles of specific genes and their interactions in brain development and dysregulation. Principles of Psychiatric Genetics includes 22 disorder-based chapters covering, amongst other conditions, schizophrenia, mood disorders, anxiety disorders, Alzheimer's disease, learning and developmental disorders, eating disorders and personality disorders. Supporting chapters focus on issues of genetic epidemiology, molecular and statistical methods, pharmacogenetics, epigenetics, gene expression studies, online genetic databases and ethical issues. Written by an international team of contributors, and fully updated with the latest results from genome-wide association studies, this comprehensive text is an indispensable reference for psychiatrists, neurologists, psychologists and anyone involved in psychiatric genetic studies.

The meanings and causes of hearing voices that others cannot hear (auditory verbal hallucinations, in psychiatric parlance) have been debated for thousands of years. Voice-hearing has been both revered and condemned, understood as a symptom of disease as well as a source of otherworldly communication. Those hearing voices have been viewed as mystics, potential psychiatric patients or simply just people with unusual experiences, and have been beatified, esteemed or accepted, as well as drugged, burnt or gassed. This book travels from voice-hearing in the ancient world through to contemporary experience, examining how power, politics, gender, medicine and religion have shaped the meaning of hearing voices. Who hears voices today, what these voices are like and their potential impact are comprehensively examined. Cutting edge neuroscience is integrated with current psychological theories to consider what may cause voices and the future of research in voice-hearing is explored.

Humans are remarkably resilient in the face of crises, traumas, disabilities, attachment losses and ongoing adversities. To date, most research in the field of traumatic stress has focused on neurobiological, psychological and social factors associated with trauma-related psychopathology and deficits in psychosocial functioning. Far less is known about resilience to stress and healthy adaptation to stress and trauma. This book brings together experts from a broad array of scientific fields whose research has focused on adaptive responses to stress. Each of the five sections in the book examines the relevant concepts, spanning from factors that contribute to and promote resilience, to populations and societal systems in which resilience is employed, to specific applications and contexts of resilience and interventions designed to better enhance resilience. This will be suitable for clinicians and researchers who are interested in resilience across the lifespan and in response to a wide variety of stressors.

Psychosis has many causes. Psychiatrists typically receive the most thorough training in its diagnosis, but the diagnosis of psychosis secondary to nonpsychiatric conditions is not often emphasized. An understanding of the underlying cause of psychosis is important for effective management. The Diagnosis of Psychosis bridges the gap between psychiatry and medicine, providing a comprehensive review of primary and secondary causes of psychosis. It covers both common and rare causes in a clinically focused guide. Useful both for teaching and reference, the text covers physical and mental state examination, describes key investigations, and summarizes the non-psychiatric features of medical conditions causing psychosis. Particularly relevant for psychiatrists and trainees in psychiatry, this volume will also assist neurologists and general physicians who encounter psychosis in their practice.

In psychiatry, as in many other medical disciplines, training is shifting from an emphasis on testing factual knowledge towards a system based on continuing assessment and the acquisition of practical skills and competencies. Workplace Based Assessments in Psychiatric Training describes current approaches to these new assessment systems around the world, provides practical advice regarding their implementation and makes recommendations for future developments. The book opens with an overview and analysis of methods of workplace based assessments, followed by a review of the trainee assessment from the patient perspective. Chapters contain in-depth, detailed discussion of recent developments in Canada, Denmark, India, the UK and the USA. The book reviews both technical developments in assessment tools and techniques and the socio-political context within which these have taken place. With a practical focus and unique global perspective, this is a'must buy'for anyone responsible for the supervision of psychiatric trainees.

Psychosomatic medicine or consultation-liaison psychiatry is the branch of psychiatry that focuses on the mental health issues which accompany, or develop as a result of, other medical disorders. This subdiscipline forms an important part of training in psychiatry. This book provides an ideal first exposure to the inseparable nature of physical and psychological health and illness, and a comprehensive introduction to the broad range of disorders seen on the psychiatric consult service. Organized into a series of bitesized chapters, each focusing on a typical consult question, this handbook provides a practical and portable reference which should set both strategy and tactics for the next generation of consulting psychiatrists. Essential reading for medical students, psychiatry residents and psychosomatic fellows, this manual will provide immediate, in-the-field guidance on the evaluation and management of common consultation requests.

It is widely accepted that most psychiatric disorders are associated with cognitive impairment and that neuropsychological approaches can help unravel the mechanisms underlying brain function and help us develop a better understanding of these disorders. In this book, a panel of the world's leading experts describe the development of neuropsychological approaches to the investigation, description, measurement and management of a wide range of mental illnesses. Part One explains the rationale for examining neuropsychological processes within clinical disorders, leading into Part Two summarizing and critiquing the methodological approaches to study. Part Three covers each of the major psychiatric disorders and provides a summary of the neuropsychological findings for each condition. The final section brings together the perspectives of neuroscientists, psychiatrists and philosophers. Essential reading for all those studying the healthy as well as the disordered brain, The Neuropsychology of Mental Illness will appeal to specialists from the fields of mental health, psychology, clinical neuroscience and philosophy.

In order to accurately describe and diagnose psychiatric illness, practitioners require in-depth knowledge of the signs and symptoms of behavioral disorders. Descriptive Psychopathology provides a broad review of the psychopathology of psychiatric illness, beyond the limitations of the DSM and ICD criteria. Beginning with a discussion of the background to psychiatric classification, the authors explore the problems and limitations of current diagnostic systems. The following chapters then present the principles of psychiatric examination and diagnosis, described with accompanying patient vignettes and summary tables, and related to different diagnostic concerns. A thought-provoking conclusion proposes a restructuring of psychiatric classification based on the psychopathology literature and its validating data. Written for psychiatry and neurology residents, clinical psychologists, behavioral neurologists, clinical psychology students and psychiatric nurse practitioners, it is invaluable to anyone who accepts the responsibility for the care of patients with behavioral syndromes.

The accreditation process for psychiatry in the United States is considered one of the most difficult among all medical specialties. Although many board review books in psychiatry exist, this is the first fact-based resource that can be used for both written and oral review. Dr William Weiqi Wang has developed a concise, outline-oriented format supplemented with case studies to prepare residents for the oral and written psychiatry boards. Each chapter can stand alone and is presented in'bite-size'clusters to facilitate easy absorption of the material. A section at the end of the book includes 150 board-review-style questions and answers drawn from previous tests. This book is a necessity for any student who plans to score aggressively on the ABPN, PRITE, and even the USMLE for medical students who want to pursue a career in psychiatry.

Recovery is a concept which has emerged from the experiences of people with mental illness. It involves a shift away from traditional clinical preoccupations such as managing risk and avoiding relapse, towards new priorities of supporting the person in working towards their own goals and taking responsibility for their own life. This book sets an agenda for mental health services internationally, by converting these ideas of recovery into an action plan for professionals. The underlying principles are explored, and five reasons identified for why supporting recovery should be the primary goal. A new conceptual basis for mental health services is described - the Personal Recovery Framework - which gives primacy to the person over the illness, and identifies the contribution of personal and social identity to recovery. These are brought to life through twenty-six case studies from around the world.

Although medicine is practised in a secular setting, religious and spiritual issues have an impact on patient perspectives regarding their health and the management of any disorders that may afflict them. This is especially true in psychiatry, as feelings of spirituality and religiousness are very prevalent among the mentally ill. Clinicians are rarely aware of the importance of religion and understand little of its value as a mediating force for coping with mental illness. This book addresses various issues concerning mental illness in psychiatry: the relation of religious issues to mental health; the tension between a theoretical approach to problems and psychiatric approaches; the importance of addressing these varying approaches in patient care and how to do so; and differing ways to approach Christian, Muslim and Buddhist patients.

Psychotic illness is managed and treated with best results when it is recognized at the earliest stages of a person developing the disorder, or when that person is identified as being at high risk of doing so. Describing a stage-specific model highlighting the risk, the clinical and biological factors present during the development of the illness, and the best treatments available for each of these stages, this new edition will guide practitioners and researchers in the adoption of carefully planned management strategies fully integrating treatment with prevention. Issues such as resistance to drugs and vocational recovery are covered, with related topics such as service organization and community education. This will be essential reading for all those involved in the care of people with early psychotic illness, or those responsible for the organization of services.

This is a major international textbook for psychiatrists and other professionals working in the field of mental healthcare. With contributions from opinion-leaders from around the globe, this book will appeal to those in training as well as to those further along the career path seeking a comprehensive and up-to-date overview of effective clinical practice backed by research evidence. The book is divided into cohesive sections moving from coverage of the tools and skills of the trade, through descriptions of the major psychiatric disorders and on to consider special topics and issues surrounding service organization. The final important section provides a comprehensive review of treatments covering all of the major modalities. Previously established as the Essentials of Postgraduate Psychiatry, this new and completely revised edition is the only book to provide this depth and breadth of coverage in an accessible, yet authoritative manner.

This is a book of psychiatry at its most practical level. It aims to answer the sorts of questions psychiatrists ask on a daily basis. What treatments are available for the condition that I think this patient has? What is the relative value of each of these treatments? Are there any other treatments that I should be considering if a first approach has failed? Is there any value in combinations of treatment? And, can I be sure that the evidence and recommendations I read are free from bias? The content is organised into three sections covering disease classification, the major treatment modalities and the application of these treatments to the wide range of psychiatric diagnoses. All professionals in mental health want to give the best treatments for their patients. This book provides clinicians with the knowledge and guidance to achieve this aim.

Effective and capable clinicians need to develop strong interpersonal, intellectual and organisational abilities. This practical and accessible text explores clinical skills that are increasingly assessed in training, postgraduate examinations, continuing professional development programmes and reaccreditation appraisals. It is concerned with balancing the demands of the patient's life circumstances with lessons from empirical science and clinical experience. These skills help clinicians to put interventions together into effective treatment plans, and to develop strategies that facilitate recovery from mental illness. This book is written from a multidisciplinary perspective and it explores new ways of working. Although it is primarily addressed to psychiatrists, it is relevant to mental health nurses, social workers, occupational therapists and clinical psychologists.

Significantly expanded and updated from the first edition, this edition of Psychiatric Intensive Care is essential reading for all healthcare professionals and managers involved in the care of the mentally ill patient, particularly in the intensive care environment. It provides practical and evidence-based advice on the management of disturbed and severely ill psychiatric patients in secure hospital settings. New chapters were added covering multidisciplinary team working, and emphasising the interface of psychiatric intensive care with other mental health specialities; specifically, Interface with General Psychiatry, Interface with Learning Difficulties, Interface with the Child and Adolescent, Interface with Substance Misuse, Interface with Social Work, User and Carer Issues, Legal Issues and National Standards and Good Practice in Psychiatric Intensive Care. This book should be read by all mental health team members working with disturbed psychiatric patients on an inpatient basis, as well as by management staff responsible for establishing and running these services.

Cultural psychiatry is concerned with understanding the impact of social and cultural differences and similarities on mental illness and its treatments. A person's cultural characteristics can often lead to misunderstandings, influenced by language, non-verbal styles, codes of etiquette and assumptions. There may also be perceived misconceptions and differences in beliefs and values. In order to provide appropriate, sensitive and acceptable services for different cultural groups, all service providers need to take these factors into account. Written by leading clinicians and academics from around the world, and integrating both practical and theoretical knowledge, the Textbook of Cultural Psychiatry provides a framework for the provision of mental healthcare in a multi-cultural/ multi-racial society and global economy. It will be essential reading for those providing mental healthcare, or who are involved in the organisation and management of services.

The lack of ability to emphathize is central to many psychiatric conditions. Empathy is affected by neurodevelopment, brain pathology and psychiatric illness. Empathy is both a state and a trait characteristic. Empathy is measurable by neuropsychological assessment and neuroimaging techniques. This book, first published in 2007, specifically focuses on the role of empathy in mental illness. It starts with the clinical psychiatric perspective and covers empathy in the context of mental illness, adult health, developmental course, and explanatory models. Psychiatrists, psychotherapists and mental heath professionals will find this a very useful reference for their work.

Liaison psychiatry, the recognition and management of psychiatric problems in the general medical setting, is an essential component of many doctors'work. Depression, anxiety and somatization disorders occur in about 50% of cases presented to primary care physicians. The Handbook of Liaison Psychiatry was first published in 2007 and is a comprehensive reference book for this fast-growing subspecialty. A team of experts in the field cover the full range of issues, from establishing a service and outlining the commonest problems encountered in general hospitals and primary care, to assessment and treatment guidelines, working with specific units within the hospital setting, disaster planning and legal-ethical considerations. It will be essential reading for doctors and other professionals concerned with the psychological health of patients in acute general hospitals and in primary care.

The spectrum of psychotic disorders encompasses as many as 25 different etiologies, ranging from the primary psychoses through those secondary to medical conditions, drugs and medications, and sensory impairments. This book provides a one-stop, comprehensive review of these disorders and gives quick comparisons for diagnostic decision-making to help with difficult differential diagnoses. Every chapter is uniformly structured to show comparisons between each disorder of presentation, course, and underlying neuropathology. Evidence for each etiology is also rated, indicating the confidence level the reader can place in the current findings. The international team of authors also examines data supporting a unitary neurobiological model of psychosis and the hypothesis that psychosis is a neurobiological syndrome similar to aphasia or apraxia. This book represents a paradigm shift in understanding, classifying and diagnosing these disorders, providing directions for future research and treatment. It will be of great interest to psychiatrists and neuroscientists alike.

This book describes the practice of clinical psychology with special emphasis on providing trainee therapists with the skills and strategies to achieve the core competencies required for a science-informed clinical practice. It will support the reader in making the transition from the lecture theatre to the consulting room. The approach incorporates a contemporary perspective on the multiple roles of clinical psychologists within a competitive health care market, where professional psychologists not only need to be accountable for their outcomes and efficient in achieving them, but also need to be conscious of the social and political context in which psychology is practised. Chapters are organised around the acquisition of key competencies and linked within an evidence-based, science-informed framework. Case studies, handouts, graphics and worksheets are employed to encourage the implementation of the skills described. This book should be read by all those enrolled in, or contemplating, postgraduate studies in clinical psychology.

The role of a genetic counsellor is to mediate between the rapid advances in molecular medicine and an individual's ability to understand and manage the risks of their inheritance. Counsellors therefore need to be fully in command of the psychological impact of their communications. Written by a psychiatrist who later became a psychotherapist, this manual is essential reading for counsellors of all disciplines. It examines the psychological processes and explains why people approach and respond differently. Effective genetic counselling requires a knowledge of attachment behaviour and non-directiveness, and an in-depth understanding of empathy in order to help individuals contain anxiety and process grief and so facilitate their decision-making or help with the effects of reviewing a test result. Along with an up-to-date discussion of similar approaches in family therapy and psychoanalysis, the effect of counselling on the counsellor is also examined creatively in order to enrich the interview with clients.

This book will help mental health professionals to develop the fundamental generic skills in interviewing and assessment which form the foundation of psychiatric practice. It is about the process of reaching a diagnosis and is a practical guide to help the reader make the transition from novice to competent clinician. It is based on real problems encountered in modern general adult psychiatric practice, and is set in a range of environments, in the clinic and in the community. The text is punctuated by a selection of case studies to illustrate the principles highlighted in the book. This book will be essential reading for all members of the mental health team. Its practical grounding in everyday clinical experience will appeal to trainee psychiatrists and more experienced clinicians alike, as well as to nurses, social workers and psychologists.

Andrew Lakoff argues that a new'pharmaceutical'way of thinking about and acting upon mental disorder is coming to reshape not only the field of psychiatry, but also our very notions of self. Drawing from a comprehensive ethnography of psychiatric practice in Argentina (a country which boasts the most psychoanalysts per capita in the world) Lakoff looks at new ways of understanding and intervening in human behaviour. He charts the globalization of pharmacology, particularily the global impact of US psychiatry and US models of illness, and further illustrates the clashes, conflicts, alliances and reformulations that take place when psychoanalytic and psychopharmacological models of illness and cure meet. Highlighting the social and political implications that these new forms of expertise about human behaviour and human thought bring, Lakoff presents an arresting case-study that will appeal to scholars and students alike.

Brief and acute psychotic disorders with a short duration and a generally good prognosis have long intrigued psychiatrists. Although they are included in internationally accepted diagnostic systems, understanding of these disorders remains minimal. This book is the first comprehensive overview of the clinical features, biology, course and long-term outcome of brief and acute psychoses. The authors review the world literature on the topic and they also present data from their own longitudinal study - the most complete investigation of this group of disorders so far conducted. The book concludes with considerations of the nosological status of brief and acute psychoses and their impact on our understanding of the continuum of psychotic and affective disorders.

People with somatoform disorder (which used to be known as hysteria) present with a range of symptoms that typically last for years and can't be traced to a specific physical cause. Such symptoms may include frequent headaches; back pain; abdominal cramping and pelvic pain; pain in the joints, legs and arms; chest or abdominal pain, and gastrointestinal problems. This book is an in-depth, clinically orientated review of the somatoform disorders and related clinical presentations (such as chronic fatigue syndrome) and how they present in a medico-legal setting. It is aimed at both clinicians and lawyers who deal with injury claims where these disorders impact much more frequently than is generally recognised.

This volume represents a burgeoning perspective on the origins of psychopathology, one that focuses on the development of the human central nervous system. The contemporary neurodevelopmental perspective assumes that mental disorders result from etiologic factors that alter the normal course of brain development. Defined here in its broadest sense, neurodevelopment is a process that begins at conception and extends throughout the life span. We now know that it is a complex process, and that its course can be altered by a host of factors, ranging from inherited genetic liabilities to psychosocial stressors. This book features the very best thinking in the converging fields of developmental neuroscience and developmental psychopathology. The developmental window represented is broad, extending from the prenatal period through adulthood, and the authors cover a broad range of etiologic factors and a spectrum of clinical disorders. Moreover, the contributors did not hesitate to use the opportunity to hypothesize about underlying mechanisms and to speculate on research directions.

Delusional disorder, once termed paranoia, was an important diagnosis in the late nineteenth and early twentieth centuries, and only in 1987 was it reintroduced into modern psychiatric diagnosis after being subsumed with schizophrenia. This book provides a comprehensive review of delusional disorder for psychiatrists and other clinicians. Beginning with the emergence of the concept of delusional disorder, the book goes on to detail its manifold presentations, differential diagnosis and treatment. Many instructive case histories are provided, illustrating manifestations of the various subtypes of delusional disorder, and related conditions in the paranoid spectrum. This is the most wide-ranging and authoritative text on the subject to have appeared for many years, and the first to suggest, based on the author's extensive experience, that the category of delusional disorder should contain not one but several conditions. It also emphasizes that, contrary to traditional belief, delusional disorder is a treatable illness.

The treatment of early psychosis has been bedevilled by an entrenched pessimism, stemming from the asylum era and the Kraepelinian model of schizophrenia. More recently, however, there has been a surge of interest in preventively oriented treatment of patients showing the first signs of psychotic illness, with the realization that these illnesses are frequently highly responsive to early treatment. This is the first text to focus on the potential of early detection of psychosis, and the practicalities of treatment. Based on the pioneering experience and research of a now well-established prevention and intervention centre, and with contributions from international authorities, the book outlines a framework for intervention, reviews the evidence available to guide clinical practice, and describes models of treatment. Incorporating many personal narratives and case histories, it is strong on theory, sensitive on practical issues, and will challenge, inform and guide clinicians.