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Borderline personality disorder (BPD) is estimated to have a lifetime prevalence in the United States of approximately 1.4%–2.7%. It is characterized by a long-term pattern of instability in interpersonal relationships, unstable self-image, marked impulsivity, and/or affective instability. In addition, features can be evidenced by efforts to avoid real or feared abandonment, chronic feelings of emptiness, mood reactivity, recurrent self-injurious or suicidal behavior, other impulsive behaviors with potential for self-damaging effects, intense anger or difficulty with anger control, and transient paranoid ideation or stress-related dissociative symptoms. Although these manifestations can be quite heterogeneous, the lived experience of BPD can be associated with significant emotional pain and a diminished quality of life. Many individuals with BPD have co-occurring psychiatric or somatic conditions, and all-cause mortality is increased among those with BPD. Furthermore, the lifetime burden and psychosocial impairment associated with BPD can be substantial because it typically has an early onset and can persist for many years. These significant consequences support the need for early identification of BPD. Importantly, in contrast to many earlier views on BPD, treatment is effective, and symptoms can be reduced and managed. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Borderline Personality Disorder reviews current evidence and provides evidence-based statements that are intended to optimize the treatment of BPD. The guideline focuses on evidence-based treatments and includes additional information on assessment and treatment planning, which are an integral part of patient-centered care. It describes approaches to implementing recommendations and suggestions in clinical practice. By providing up-to-date knowledge, the guideline aims to help clinicians feel more confident in their skills for treating patients with BPD, thereby improving the care and well-being of their patients.

Two decades of advances related to electroconvulsive therapy (ECT) prompted the American Psychiatric Association Task Force on Electroconvulsive Therapy to update the recommendations for its use. This volume is the result of that work.This third edition of The Practice of Electroconvulsive Therapy—the first since 2001—captures the body of knowledge on the safety, efficacy, and practice of ECT accumulated over the past 20 years, including more than 1,100 new literature citations. New features of this book include • Chapters on detecting and managing adverse effects, including cognitive side effects, and assessing treatment outcomes to support measurement-based care• A discussion of approaches to optimize response and reduce relapse, including use of maintenance ECT, and guidance for management of patients not responding to an acute ECT course• An overview of the 2018 United States Food and Drug Administration's reclassification of ECT devices and its implications for clinical practice• A chapter on other neuromodulation techniques, including transcranial magnetic stimulation, vagus nerve stimulation, deep brain stimulation, and emerging neuromodulation approaches Like its predecessors, this edition provides comprehensive information on staffing, assessment, and preparation for ECT; informed consent; anesthestic management; stimulus electrode placement; electrical stimulus parameters and dosing; seizure monitoring; and much more. The use of ECT in special circumstances—including in patients with catatonia, in children and adolescents, and during pregnancy—is also discussed.With detailed information on concurrent medications and medical comorbidities that may require modifications to treatment, as well as indications for the use of ECT, this book is an indispensable guide to state-of-the-art ECT practice.

Worldwide, schizophrenia is one of the top 20 causes of disability. The lifetime prevalence of schizophrenia is estimated to be approximately 0.7%, although findings vary depending on the study location, demographic characteristics of the sample, the approach adopted for case finding, the method employed for diagnostic confirmation, and the diagnostic criteria used. Economic burdens associated with schizophrenia are high, with an estimated cost of more than $150 billion annually in the United States on the basis of 2013 data. Additional research since the second edition of the guideline has expanded our knowledge of the effective and evidence-based interventions available to help reduce the mortality, morbidity, and significant psychosocial and health consequences of this important psychiatric condition.The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia seeks to reduce these substantial psychosocial and public health consequences for the individuals affected by schizophrenia. The guideline focuses specifically on evidence-based pharmacological and nonpharmacological treatments for schizophrenia and includes statements related to assessment and treatment planning, which are an integral part of patient-centered care. The guideline provides direction on implementing these recommendations into clinical practice, with the goal of improving the quality of care and treatment outcomes for patients with schizophrenia.

Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality.The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.

Anxiety Disorders: DSM-5® Selections is crafted around a specific disorder cited in DSM-5®. This selection provides a comprehensive overview of the process of diagnosing anxiety disorders while serving as a reference guide to assist in the diagnosis of individual patients. The disorder-specific resource is an invaluable addition to the DSM-5® collection and an important contribution to the mental health profession.This book contains the critical disorder-specific content from these four titles: • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®) • DSM-5® Clinical Cases• DSM-5® Self-Exam Questions• DSM-5® Guidebook

Neurodevelopmental Disorders: DSM-5® Selections is crafted around a specific disorder cited in DSM-5®. This selection provides a comprehensive overview of the process of diagnosing neurodevelopmental disorders while serving as a reference guide to assist in the diagnosis of individual patients. The disorder-specific resource is an invaluable addition to the DSM-5® collection and an important contribution to the mental health profession.This book contains the critical disorder-specific content from these four titles: • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®) • DSM-5® Clinical Cases• DSM-5® Self-Exam Questions• DSM-5® Guidebook

The long-awaited report of the APA's Work Group to Revise the APA Guidelines on Psychiatric Services in Correctional Facilities, Psychiatric Services in Correctional Facilities comes at a time of growing incarceration rates, more rigid sentencing policies, harsher sanctions, and tougher public attitudes toward crime. The result is a near-doubling of the incarcerated population since the first report was issued in 1989 and a significant increase of inmates with serious mental health issues. The work group members address the implications of this troubling state of affairs for psychiatrists and other mental health practitioners who diagnose and treat within the correctional environment.On the basis of extensive input from multiple sources and perspectives, they have developed clear guidelines that equip clinicians to navigate the special challenges they face. This edition has been thoroughly updated and is structured to flow from the foundational principles that govern the delivery of psychiatric care in correctional facilities, to the guidelines for screening, referral, evaluation, treatment, and community reentry planning, to special applications of the principles and guidelines to specific disorders/ syndromes, patient populations, housing locations, treatment modalities, and inmate special needs.Readers will find the book well written, with clear guidance for the clinician, as well as challenges to think beyond the needs of individual patients to the larger relationship between mental illness and incarceration. • Approximately three of every four incarcerated people with a serious mental illness have a co-occurring substance use disorder, complicating both diagnosis and treatment. The book offers strategies for treating co-occurring disorders and explores the need for evidence-based screening tools. • Because some inmate populations have unique evaluation and treatment needs because of their disorders, demographics, or other characteristics, separate sections are devoted to women; youths in adult correctional facilities; geriatrics; lesbian, gay, bisexual, and transgender patients; veterans; and patients with intellectual and developmental disabilities.• New management and programmatic topics include hospice, mental illness and segregation, seclusion and restraint, telepsychiatry, and the spiritual lives of inmates.• The appendix is a valuable resource that includes a selection of APA position statements on topics relevant to psychiatric services in correctional settings, such as capital punishment, access to care for transgender and gender-variant individuals, and the adjudication of youths as adults in the criminal justice system. Correctional psychiatry is an evolving field, and serious questions remain. The work group sees an expanded role for clinicians as physician leaders, managers, and directors, more effectively advocating for their patients and helping to shape optimal care delivery systems that empower patients and support successful transition back to the community. Psychiatric Services in Correctional Facilities provides the current knowledge and professional support clinicians need to meet these challenges.

Schizophrenia Spectrum and Other Psychotic Disorder: DSM-5® Selections is crafted around a specific disorder cited in DSM-5®. This selection provides a comprehensive overview of the process of diagnosing schizophrenia spectrum and other psychotic disorders while serving as a reference guide to assist in the diagnosis of individual patients. The disorder-specific resource is an invaluable addition to the DSM-5® collection and an important contribution to the mental health profession.This book contains the critical disorder-specific content from these four titles: • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®) • DSM-5® Clinical Cases• DSM-5® Self-Exam Questions• DSM-5® Guidebook

Feeding and Eating Disorders:DSM-5® Selections is crafted around a specific disorder cited in DSM-5®. This selection provides a comprehensive overview of the process of diagnosing feeding and eating disorders while serving as a reference guide to assist in the diagnosis of individual patients. The disorder-specific resource is an invaluable addition to the DSM-5® collection and an important contribution to the mental health profession.This book contains the critical disorder-specific content from these four titles: • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®) • DSM-5® Clinical Cases• DSM-5® Self-Exam Questions• DSM-5® Guidebook

Depressive Disorders: DSM-5® Selections is crafted around a specific disorder cited in DSM-5®. This selection provides a comprehensive overview of the process of diagnosing depressive disorders while serving as a reference guide to assist in the diagnosis of individual patients. The disorder-specific resource is an invaluable addition to the DSM-5® collection and an important contribution to the mental health profession.This book contains the critical disorder-specific content from these four titles: • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®) • DSM-5® Clinical Cases• DSM-5® Self-Exam Questions• DSM-5® Guidebook

Le DSM-5 est le fruit de 12 années de travail impliquant des centaines d'experts internationaux dans tous les domaines de la santé mentale. Cet ouvrage de référence propose une classification des troubles mentaux, tous décrits de façon claire, concise et systématique. Ce qui est nouveau dans le DSM-5 : - Les troubles apparus dans l'enfance sont pris en compte dans une perspective développementale et longitudinale, ce qui aboutit à un chapitre sur les troubles neurodéveloppementaux et à la définition d'un « trouble du spectre de l'autisme ». - De nombreux chapitres sont nouveaux ou profondément remaniés tels que ceux sur les troubles de l'humeur du DSM-IV scindés en troubles bipolaires et troubles dépressifs, les troubles obsessionnels-compulsifs et les troubles liés à des traumatismes ou à des facteurs de stress qui sont distingués des troubles anxieux, les troubles neurocognitifs qui intègrent des paramètres issus des recherches biologiques récentes. - D'autres chapitres évoluent significativement pour ce qui est de la définition des troubles qui les composent, sans changer d'intitulé, tels les troubles disruptifs, du contrôle des impulsions et des conduites, les troubles bipolaires, la schizophrénie, les troubles dissociatifs, les dysfonctions sexuelles, les troubles à symptomatologie somatique. - Des troubles nouveaux apparaissent dans la classification principale, tels que le trouble de la communication sociale (pragmatique), le trouble disruptif avec dysrégulation émotionnelle, le sevrage du cannabis, les accès hyperphagiques, le sevrage de la caféine, la thésaurisation pathologique, la dermatillomanie, le jeu d'argent pathologique. - Une attention particulière est portée aux dimensions symptomatiques, qui transcendent parfois les frontières des catégories diagnostiques, comme l'évaluation dimensionnelle de la sévérité des symptômes psychotiques par le clinicien et le modèle alternatif pour les troubles de la personnalité dans la section III du DSM-5. En outre, l'organisation des chapitres du DSM-5 a été conçue pour être compatible avec la future CIM-11, sachant que le DSM-5 permet d'enregistrer les diagnostics avec les codes actuels de la classification internationale des maladies de l'OMS (CIM-10). Cet ouvrage, destiné à tous les professionnels concernés par la santé mentale, reste une référence incontournable en France comme au niveau international.

Sleep-Wake Disorders: DSM-5® Selections is crafted around a specific disorder cited in DSM-5®. This selection provides a comprehensive overview of the process of diagnosing sleep-wake disorders while serving as a reference guide to assist in the diagnosis of individual patients. The disorder-specific resource is an invaluable addition to the DSM-5® collection and an important contribution to the mental health profession.This book contains the critical disorder-specific content from these four titles: • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®) • DSM-5® Clinical Cases• DSM-5® Self-Exam Questions• DSM-5® Guidebook

FOCUS Psychiatry Review, Volume 2, contains 400 new board-type multiple-choice questions derived from material in the annual FOCUS Self-Assessment Examinations that can help psychiatrists prepare for examinations and identify areas for further study. These new questions, developed by the FOCUS Self-Assessment Editorial Board, are consistent in form and process with the questions used by high-stakes examinations. They cover important clinical areas of psychiatric practice and closely follow the American Board of Psychiatry and Neurology (ABPN) outline of topics for the recertification examination in psychiatry.FOCUS Psychiatry Review is designed to test current knowledge and its clinical application. The workbook is flexible in format, allowing readers to use the educational approach that works best for them. Readers can review resource materials prior to answering questions, or they can use the workbook to review the references listed in the critiques after scoring test sections. The workbook will be useful for anyone committed to lifelong learning in the field -- practicing psychiatrists psychiatric residents, and psychiatrists preparing for examinations. The FOCUS Psychiatry Review, Volume 2 • Contains 400 new clinical questions that can be used to identify areas of strength and weakness• Provides up-to-date critiques and current references to facilitate further study• Complements a larger overall program of lifelong learning for the psychiatrist who wants to keep current in the field This volume covers the following topics: • Anxiety Disorders• Child and Adolescent Psychiatry• Disorders of Sleep, Eating, and Sex• Ethics and Professionalism• Genetics and Genomics• Geriatric Psychiatry• Mood Disorders• Obsessive-Compulsive Disorder• Personality and Temperament• Posttraumatic Stress Disorder and Disaster Psychiatry• Psychopharmacology• Psychosomatic Medicine• Psychotherapy• Schizophrenia• Substance Abuse APA is accredited by ACCME to provide continuing medical education for physicians. APA designates this educational activity for a maximum of 50 AMA PRA Category 1 Credits™. Physicians should claim credit commensurate with the extent of their participation in the activity.Program start date: February 2011Program end date: February 2014

La presente obra proporciona una actualización de las innovaciones que aconsejan cambiar las categorías diagnósticas de los trastornos somatoformes en el DSM-V. Por ello, una de las ventajas de la obra es que en ella se anuncian los criterios que regirán la nueva clasificación unificada de la APA (DSM-V) y la OMS (CIE-11) sobre este tipo de trastornos. Es, pues, un tema de gran interés debido al insatisfactorio estatus nosológico de estos trastornos.Las contribuciones de expertos internacionales proporcionan perspectivas únicas de factores culturales que afectan a la presentación y el tratamiento de los trastornos somáticos en conjunto. Así, los autores llevan a cabo una revisión fascinante y práctica de los conocimientos sobre la epidemiología, el diagnóstico y el tratamiento de las diferentes manifestaciones somáticas en los trastornos mentales, abarcando aspectos teóricos y prácticos.Además de proporcionar una referencia inestimable a los clínicos de diversas disciplinas, identifican lagunas específicas en la bibliografía de investigación y tratan temas nosológicos como avance a la publicación del DSM-V.Organizado desde el punto de vista del clínico, el libro revisa la más reciente investigación sobre fenomenología, etiología, curso clínico y opciones de tratamiento. A diferencia de otras publicaciones sobre el tema,'Manifestaciones somáticas de los trastornos mentales'explora el rango completo de esta categoría de trastornos, incluyendo el trastorno de conversión, el dolor crónico y la fatiga, la hipocondría, la somatización y la multitud de presentaciones de los síntomas médicamente no explicados, y revisa los retos culturales, diagnósticos y clínicos para tales problemas. Se trata de una lectura recomendada para psiquiatras, psicólogos clínicos, médicos de Atención Primaria, médicos de familia e internistas interesados en los trastornos somatoformes.La presente obra proporciona una actualización de las innovaciones que aconsejan cambiar las categorías diagnósticas de los trastornos somatoformes en el DSM-V. Por ello, una de las ventajas de la obra es que en ella se anuncian los criterios que regirán la nueva clasificación unificada de la APA (DSM-V) y la OMS (CIE-11) sobre este tipo de trastornos. Es, pues, un tema de gran interés debido al insatisfactorio estatus nosológico de estos trastornos.Las contribuciones de expertos internacionales proporcionan perspectivas únicas de factores culturales que afectan a la presentación y el tratamiento de los trastornos somáticos en conjunto. Así, los autores llevan a cabo una revisión fascinante y práctica de los conocimientos sobre la epidemiología, el diagnóstico y el tratamiento de las diferentes manifestaciones somáticas en los trastornos mentales, abarcando aspectos teóricos y prácticos.Organizado desde el punto de vista del clínico, el libro revisa la más reciente investigación sobre fenomenología, etiología, curso clínico y opciones de tratamiento. La obra explora el rango completo de esta categoría de trastornos, incluyendo el trastorno de conversión, el dolor crónico y la fatiga, la hipocondría, la somatización y la multitud de presentaciones de los síntomas médicamente no explicados, y revisa los retos culturales, diagnósticos y clínicos para tales problemas.

Inviting the help of colleagues worldwide, the concise Diagnostic Issues in Substance Use Disorders is part of the new series Advancing the Research Agenda for DSM-V. Its 19 chapters by an international group of experts are designed to stimulate questions that will help guide research related to the development of the next editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the International Classification of Diseases (ICD-11), with the goal of ensuring that the major substance use diagnoses represent the same condition in both references. They cover 10 major issues in three main sections: • Overarching issues relevant for the development of international diagnostic systems -- statistical modeling techniques and whether DSM-V should use categorical and/or dimensional diagnostic approaches; methods review, emphasizing new hybrid techniques for developing and testing diagnostic concepts; the need for separate clinical and research-oriented diagnostic criteria, incorporating both categorical and dimensional attributes; neurobiological changes characterizing substance dependence; the importance of cultural attributes in developing definitions of substance use disorders; and the history of the development of diagnostic systems and how to optimize the'crosswalk'between DSM and ICD.• Research questions more specific to the substance use disorders section of DSM -- comorbidity between substance use disorders and other psychiatric conditions, the relatively unique clinical course of substance-induced mental disorders and appropriate treatment approaches; the precision of the criteria and threshold for a diagnosis and how to improve them; the subtypes of substance use disorder, including how they have been derived and the extent to which they relate to neurobiological processes; the seemingly high prevalence of alcohol dependence in young people; suggested research questions to evaluate the application of diagnostic criteria to adolescents; and the specific psychoactive substances cannabis and nicotine.• Whether substance use disorders should be included in a broader section termed'addictive disorders'-- impulse-control disorders (especially pathological gambling and the advantages and disadvantages of adding it to the current substance use disorders section), identifying research opportunities regarding their assessment and neurocognitive and physiological bases, discussing the specifics of the research agenda and how it might be implemented, and presenting questions generated by the research agenda developmental process. This informative compendium distills the findings of a wealth of recent research and concludes with recommendations for exploiting research opportunities that promise to inform decisions regarding DSM-V and other classification systems. As such, it will prove invaluable for clinicians and researchers everywhere.