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1
Roger, Herdman, and Institute of Medicine (U.S.). Division of Health Care Services., eds. Non-heart-beating organ transplantation: Medical and ethical issues in procurement. Washington, D.C: National Academy Press, 1997.
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Committee on the Use of Animals in Research (U.S.), National Academy of Sciences (U.S.), and Institute of Medicine (U.S.), eds. Science, medicine, and animals. Washington, D.C: National Academy Press, 1991.
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Kanner, Andres M., and Adriana Bermeo-Ovalle. EEG in Psychiatric Disorders. Edited by Donald L. Schomer and Fernando H. Lopes da Silva. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228484.003.0025.
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Psychiatric symptoms are not restricted to primary psychiatric disorders and are relatively frequent in medical and neurological disorders. They may represent the clinical manifestations of these disorders, of a comorbid psychiatric disorder, or of iatrogenic complications of pharmacological and/or surgical therapies. Clearly, proper diagnosis is of the essence to provide the correct treatment. Electroencephalographic (EEG) studies are used on a regular basis to identify a potential organic cause of psychiatric symptomatology. This chapter reviews the diagnostic yield of EEG recordings in psychiatric symptomatology associated with primary psychiatric disorders, with neurological and medical conditions, and in particular with epilepsy, and provides suggestions on the optimal use of the different types of EEG recordings in clinical practice.
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Thomas, James, and Tanya Monaghan. The psychiatric assessment. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199593972.003.0016.
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White, Susan W., Brenna B. Maddox, and Carla A. Mazefsky, eds. The Oxford Handbook of Autism and Co-Occurring Psychiatric Conditions. Oxford University Press, 2020. http://dx.doi.org/10.1093/oxfordhb/9780190910761.001.0001.
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People with autism spectrum disorder (ASD) are often diagnosed, and treated for, co-occurring mental health disorders. Co-occurring problems are, in fact, a primary reason for referral and treatment-seeking. Research on comorbidity and its management in youth and adults with ASD has expanded at a rapid rate over the last decade. This is the first comprehensive volume on the topic of co-occurring psychiatric conditions and symptoms in ASD. In this Handbook, internationally recognized clinical scientists synthesize the research on assessment and evidence-based treatment for a broad range of conditions as they present in ASD, from childhood through adulthood. In addition to coverage of formal diagnoses that frequently present in ASD (e.g., mood and anxiety disorders), common behavioural concerns (e.g., psychosexual and sleep problems) are also addressed. Each chapter summarizes the condition or disorder as it presents in ASD, and presents the extant research on its prevalence, developmental course, etiology, and assessment and diagnosis in the context of ASD. Each chapter also includes a summary of evidence-based treatment approaches or current best practices for intervention, as well as a case example to demonstrate application. Chapters are also included to synthesize broader issues related to co-occurring psychiatric conditions in ASD, including a historical overview and conceptual framework for co-occurring conditions in ASD, crisis management, and psychopharmacology. In sum, this handbook is comprehensive compilation of the current evidence-base and recommendations for future research to inform clinical practice related to co-occurring psychiatric conditions and symptoms in ASD.
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Shaibani, Aziz. Pseudoneurologic Syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190661304.003.0022.
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The term functional has almost replaced psychogenic in the neuromuscular literature for two reasons. It implies a disturbance of function, not structural damage; therefore, it defies laboratory testing such as MRIS, electromyography (EMG), and nerve conduction study (NCS). It is convenient to draw a parallel to the patients between migraine and brain tumors, as both cause headache, but brain MRI is negative in the former without minimizing the suffering of the patient. It is a “software” and not a “hardware” problem. It avoids irritating the patient by misunderstanding the word psychogenic which to many means “madness.”The cause of this functional impairment may fall into one of the following categories:• Conversion reaction: conversion of psychological stress to physical symptoms. This may include paralysis, hemisensory or distal sensory loss, or conversion spasms. It affects younger age groups.• Somatization: chronic multiple physical and cognitive symptoms due to chronic stress. It affects older age groups.• Factions disorder: induced real physical symptoms due to the need to be cared for, such as injecting oneself with insulin to produce hypoglycemia.• Hypochondriasis: overconcern about body functions such as suspicion of ALS due to the presence of rare fasciclutations that are normal during stress and after ingestion of a large amount of coffee. Medical students in particular are targets for this disorder.The following points are to be made on this topic. FNMD should be diagnosed by neuromuscular specialists who are trained to recognize actual syndrome whether typical or atypical. Presentations that fall out of the recognition pattern of a neuromuscular specialist, after the investigations are negative, they should be considered as FNMDs. Sometimes serial examinations are useful to confirm this suspicion. Psychatrists or psychologists are to be consulted to formulate a plan to discover the underlying stress and to treat any associated psychiatric disorder or psychological aberration. Most patients think that they are stressed due to the illness and they fail to connect the neuromuscular manifestations and the underlying stress. They offer shop around due to lack of satisfaction, especially those with somatization disorders. Some patients learn how to imitate certain conditions well, and they can deceive health care professionals. EMG and NCS are invaluable in revealing FNMD. A normal needle EMG of a weak muscles mostly indicates a central etiology (organic or functional). Normal sensory responses of a severely numb limb mean that a lesion is preganglionic (like roots avulsion, CISP, etc.) or the cause is central (a doral column lesion or functional). Management of FNMD is difficult, and many patients end up being chronic cases that wander into clinics and hospitals seeking solutions and exhausting the health care system with unnecessary expenses.It is time for these disorders to be studied in detail and be classified and have criteria set for their diagnosis so that they will not remain diagnosed only by exclusion. This chapter will describe some examples of these disorders. A video clip can tell the story better than many pages of writing. Improvement of digital cameras and electronic media has improved the diagnosis of these conditions, and it is advisable that patients record some of their symptoms when they happen. It is not uncommon for some Neuromuscular disorders (NMDs), such as myasthenia gravis (MG), small fiber neuropathy, and CISP, to be diagnosed as functional due to the lack of solid physical findings during the time of the examination. Therefore, a neuromuscular evaluation is important before these disorders are labeled as such. Some patients have genuine NMDs, but the majority of their symptoms are related to what Joseph Marsden called “sickness behavior.” A patient with carpal tunnel syndrome (CTS) may unconsciously develop numbness of the entire side of the body because he thinks that he may have a stroke.
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Garcia, Erik J., and Warren J. Ferguson. General medical disorders with psychiatric implications. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0038.
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Traditionally the domain of consultation/ liaison psychiatry, the challenge of recognizing and then appropriately treating the psychiatric complications of general medical disorders requires thoughtful planning and attention in corrections. Medical conditions that have psychiatric symptoms represent a significant diagnostic dilemma, particularly in the correctional health setting. Over half of the inmates in the United States have symptoms of a major mental illness, but the pervasiveness of substance use disorders, the increasing prevalence of elderly inmates, and limited access to a patient’s past medical and psychiatric records all contribute to the challenge of discerning when a psychiatric presentation results from an underlying medical condition. One early study underscored this challenge, noting that 46% of the patients admitted to community psychiatric wards had an unrecognized medical illness that either caused or exacerbated their psychiatric illness. A more recent study observed that 2.8% of admissions to inpatient psychiatry were due to unrecognized medical conditions. Emergency room medical clearance of patients presenting for psychiatric admission has revealed an increased risk for such underlying medical conditions among patients with any of five characteristics: elderly, a history of substance abuse, no prior history of mental illness, lower socioeconomic status, or significant preexisting medical illnesses. This chapter examines several of these risk groups and focuses on the presenting symptoms of delirium, mood disorders, and psychosis and the underlying medical conditions that can mimic or exacerbate them.
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Garcia, Erik J., and Warren J. Ferguson. General medical disorders with psychiatric implications. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199360574.003.0038_update_001.
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Traditionally the domain of consultation/ liaison psychiatry, the challenge of recognizing and then appropriately treating the psychiatric complications of general medical disorders requires thoughtful planning and attention in corrections. Medical conditions that have psychiatric symptoms represent a significant diagnostic dilemma, particularly in the correctional health setting. Over half of the inmates in the United States have symptoms of a major mental illness, but the pervasiveness of substance use disorders, the increasing prevalence of elderly inmates, and limited access to a patient’s past medical and psychiatric records all contribute to the challenge of discerning when a psychiatric presentation results from an underlying medical condition. One early study underscored this challenge, noting that 46% of the patients admitted to community psychiatric wards had an unrecognized medical illness that either caused or exacerbated their psychiatric illness. A more recent study observed that 2.8% of admissions to inpatient psychiatry were due to unrecognized medical conditions. Emergency room medical clearance of patients presenting for psychiatric admission has revealed an increased risk for such underlying medical conditions among patients with any of five characteristics: elderly, a history of substance abuse, no prior history of mental illness, lower socioeconomic status, or significant preexisting medical illnesses. This chapter examines several of these risk groups and focuses on the presenting symptoms of delirium, mood disorders, and psychosis and the underlying medical conditions that can mimic or exacerbate them.
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Trelles, M. Pilar, Paige M. Siper, and Dorothy E. Grice. Current Treatments for Pediatric Psychiatric Disorders. Edited by Dennis S. Charney, Eric J. Nestler, Pamela Sklar, and Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0068.
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Many psychiatric disorders of childhood have a chronic course. As such, they impact multiple developmental epochs and negatively influence developmental trajectories. While early identification and intervention may minimize, or even prevent, symptoms being carried into adulthood, the availability of evidence-based treatments is sparse in children and adolescents compared to adult populations. Establishing effective interventions for psychiatric symptoms presenting in childhood is critical given the chronic course of most psychiatric disorders. This chapter describes psychopharmacological and psychosocial interventions used for the treatment of childhood psychiatric conditions, with an emphasis on empirically supported treatments. Both symptom- and diagnosis-specific approaches are described as well as the use of combined interventions for the following childhood psychiatric conditions: autism spectrum disorder (ASD), intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), anxiety, depression, obsessive compulsive disorder (OCD), chronic tic disorders, eating disorders, and conduct problems.
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Lyketsos, Constantine, Phillip R. Slavney, John R. Lipsey, and Peter V. Rabins, eds. Psychiatric Aspects of Neurologic Diseases. Oxford University Press, 2008. http://dx.doi.org/10.1093/oso/9780195309430.001.0001.
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Psychiatric Aspects of Neurologic Diseases: Practical Approaches to Patient Care is targeted at neurologists, psychiatrists, and other physicians who care for patients with the most common neurologic diseases ranging from Alzheimer's to stroke to headaches to multiple sclerosis to epilepsy. The book provides a practical approach to the evaluation and treatment of the psychiatric conditions that affect the vast majority of these patients and are as disabling as the neurologic symptoms. Drawing from the collective wisdom and clinical expertise of the faculty of the Johns Hopkins Division of Geriatric Psychiatry and Neuropsychiatry, one of the largest and most well known faculties in this specialized field, the book provides a wealth of useful clinical information for physicians who care for these patients. The volume is divided into three parts: the first part (2 chapters) provides a detailed approach to the evaluation and differential diagnosis of the neurologic patient with psychiatric symptoms followed by a discussion of the common psychiatric syndromes seen in these patients. The second part discusses in detail the epidemiology, clinical presentation, and treatment of psychiatric conditions in 12 neurologic diseases, written by experts in each of these diseases. The third discusses in depth the range of psychiatric treatments, both pharmacologic and non-pharmacologic, available to treat the psychiatric aspects of neurologic diseases, specifically tailored to their use with the neurologic patient. The book is intended to serve as a practical reference for clinicians and is written in clear language, with distinct separated text segments, linked to the frequent use of tables. A glossary of terms, used throughout the book, is provided at the end for easy reference.
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Bhugra, Dinesh, Antonio Ventriglio, and Kamaldeep S. Bhui. Mental state assessment: Specific conditions. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198723196.003.0004.
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Mental state assessment or mental state examination is important not only in reaching a diagnosis but also in engaging patients and their families and planning therapeutic interventions. In addition to the basic principles of assessment, specific psychiatric conditions require additional details. Working with children and adolescents, with older individuals, and those with intellectual disabilities brings with it special challenges. It is crucial that clinicians are aware of the cultural context of the individual being assessed and that they take care and spend time to carry out the assessment, which may need to continue over a number of sessions. To achieve optimal results and outcomes, good therapeutic alliance is essential. It is critical that clinicians are aware of the impact of culture on the genesis, perpetuation, and prognosis of symptoms. Clinicians must be even more careful when working with special groups and psychiatric disorders, which are described further in this chapter.
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Keuck, Lara, and Allen Frances. Reflections on what is normal, what is not, and fuzzy boundaries in psychiatric classifications. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198722373.003.0008.
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This chapter takes the need to save ‘normal’ and avoid diagnostic inflation as a point of departure to reflect on what is normal, what is not, and what is in-between. It argues that ‘normal’ is a fallible and vulnerable comparative class to define mental disorders. Mental disorders must be distinguished from behaviours and mental states that reflect individual difference but not clinically significant psychopathology. Risk conditions, mild symptoms, and prodromal stages signify that a person is not yet or not severely diseased. Such notions of unclear cases and in-between states exhibit both vagueness and ambiguity. These considerations are used to suggest ways of limiting the (mis)uses of DSM in fields other than clinical psychiatry.
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Keshav, Satish, and Alexandra Kent. Psychiatry in gastrointestinal medicine. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0206.
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This chapter discusses psychiatric conditions with gastrointestinal (GI) consequences (including eating disorders, depression, and side effects of psychiatric medications), and GI diseases with psychiatric symptoms (including hepatic encephalopathy, coeliac disease, Wilson’s disease, acute intermittent porphyria, functional GI disease, and inflammatory bowel disease).
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Frierson, Richard L., and Shilpa Srinivasan. Evaluation of Elderly Persons in the Criminal Justice System. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199374656.003.0020.
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The assessment of the elderly defendant presents a specific set of challenges in the forensic psychiatric evaluation process. In this special population, a neurocognitive disorder or the presence of cognitive, psychiatric, and behavioral symptoms can impair a defendant’s understanding of the legal system or their ability to work effectively with an attorney in the preparation of a defense. Therefore, assessments of capacity to stand trial may require special attention to the mental health conditions and symptoms more commonly seen in elderly persons, and the evaluation process may require modification to accurately assess this population and to rule out malingering. Unique challenges are also encountered in the evaluation of elderly defendants for criminal responsibility and in presentencing evaluations. This chapter provides an overview of these challenges and strategies to promote accurate evaluation of the elderly defendant.
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Rakel, Birgit. Integrative Treatment of Anxiety. Edited by Anthony J. Bazzan and Daniel A. Monti. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190690557.003.0019.
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Anxiety and anxiety disorders are among the most common complaints of people in all populations. Fear and anxiety are similar, but fear relates to immediate threats while anxiety refers to anticipation of future threats. Patients with anxiety symptoms frequently seek integrative approaches to help reduce their symptoms. Medications such as benzodiazepines are useful in certain anxiety conditions but have a number of side effects and may be addictive. Dietary influences can have a significant effect of augmenting or alleviating anxiety. Gut microbiota may play an important role in anxiety and other emotions. Mind–body techniques such as meditation or mindfulness programs have been shown to significantly reduce anxiety symptoms. Several supplements such as kava kava, lavender, and chamomile may also have anti-anxiety effects. This chapter reviews the current data on the use of integrative therapies in psychiatric symptoms and disorders.
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Markowitz, John C., and Myrna M. Weissman, eds. Casebook of Interpersonal Psychotherapy. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199746903.001.0001.
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Interpersonal psychotherapy (IPT) is based on evidence that interpersonal problems contribute to the onset of psychiatric disorders, and it helps patients to change interpersonal behavior in order to improve psychosocial functioning and relieve symptoms. IPT both relieves psychiatric symptoms and helps to build social skills. This online resource provides a wealth of real life treatment material, and illustrates the use of IPT in the hands of expert psychotherapists treating patients with a range of conditions and complications in different IPT treatment formats. The detailed cases give a sense of how IPT proceeds and how it works. Chapter authors describe specific adaptations of IPT for patients with particular disorders, including mood disorders, anxiety disorders, eating disorders, and personality disorders. It also covers different contexts in which IPT may be practiced, including group therapy, inpatient settings, and telephone therapy.
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Zabrecky, George. The Role of Chiropractic in Mind–Body Health. Edited by Anthony J. Bazzan and Daniel A. Monti. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190690557.003.0009.
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The chiropractic approach is based on the principles that diseases, both psychiatric and medical, are caused by disturbances in the nervous system and that such disturbances are often related to musculoskeletal problems. Thus chiropractic therapies utilize an integrative approach to health and well-being that includes various spinal manipulations as well as an integrative approach to the patient. Chiropractic therapies are most well known for the management of chronic and acute pain, which frequently can be accompanied by anxiety and depression symptoms. There is little direct evidence that chiropractic care improves mental health outside of the benefits related to pain alleviation. However, based on the overall chiropractic model, chiropractic therapy can potentially benefit a wide variety of psychological symptoms, but more research is needed. This chapter reviews the principles of chiropractic care, particularly in the context of psychiatric conditions, and provides information for future clinical and research programs.
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Espinel, Zelde, and Jon A. Shaw. PTSD in Children. Edited by Charles B. Nemeroff and Charles R. Marmar. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190259440.003.0012.
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This chapter reviews the psychobiological effects on children and adolescents upon exposure to a traumatic happening where there is a real or imaginary threat of bodily harm or death to the self and/or others. Morbidity may involve the classic symptoms associated with post-traumatic stress disorder such as a readiness to re-experience the psychological and physiological effects of trauma exposure, autonomic arousal, somatic ills and subsequent avoidant behavior as well as a host of other psychological morbidities such as depression, mood dysregulation and other internalizing and externalizing symptoms. Multimodal treatment approaches implementing family and social supports, psychoeducation, and cognitive behavioral techniques have the strongest evidence base. Psychopharmacologic interventions are not generally used, but may be necessary as an adjunct to other interventions for children with severe reactions or coexisting psychiatric conditions.
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Boisseau, Christina L., Carly M. Schwartzman, and Steven A. Rasmussen. Quality of Life and Psychosocial Functioning in OCD. Edited by Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0006.
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This chapter examines quality of life (QoL) and psychosocial functioning in obsessive-compulsive disorder (OCD). More specifically, it summarizes recent investigations demonstrating that: (1) OCD negatively impacts multiple areas of life, such as social and family relationships, functioning at work and in the household, and aspects of physical and mental health; (2) the negative relation between OCD and QoL is as great as (or greater than) that observed in other psychiatric disorders and chronic medical conditions; (3) the degree of the QoL impairment is generally proportional to the severity of OCD symptoms; (4) specific OCD symptoms differentially impact aspects of psychosocial functioning; and (5) adequate treatment of OCD is associated with significant improvements in QoL. Finally, the chapter discusses future perspectives involved in the evaluation of QoL in OCD populations and the critical need to address these issues in assessment and treatment of individuals with OCD.
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Soileau, Michael J., and Kelvin L. Chou. Parkinson Disease. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0002.
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Parkinson disease is a neurodegenerative disorder characterized clinically by tremor, rigidity, bradykinesia, and postural instability and pathologically by loss of nigrostriatal neurons and deposition of alpha-synuclein in neuronal cell bodies and neuritis. Non-motor symptoms such as psychiatric disorders, cognitive abnormalities, sleep dysfunction, autonomic dysfunction, and sensory manifestations are also common. This chapter gives a broad overview of this disorder. Sections cover pathophysiology, genetics, clinical manifestations, and disease course. The chapter also briefly discusses how to make the diagnosis, and alternative conditions that should be considered.
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Hechtman, Lily. Summary. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190213589.003.0010.
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Outcomes in adults with ADHD are not uniform. They vary and can be generally described as falling into three groups: (1) those who have fairly normal outcome that does not differ from matched normal controls (about 30%) (Weiss & Hechtman, 1993); (2) those who continue to have significant symptoms of the syndrome with impaired functioning in academic, occupational, social, and emotional domains (50% of the group); and finally, (3) a small subgroup, about 10% to 20%, who have significant negative outcome with poor educational attainment, poor work history, marked unemployment, significant alcohol/substance use disorder, and important psychiatric and antisocial symptoms. Given that ADHD is a chronic condition that continues into adulthood, treatment (both medication and psychosocial treatments) needs to address both ADHD and comorbid conditions and needs to be ongoing with varying intensity and careful follow-up. Only with such an approach can we hope to improve adult outcomes for patients with ADHD.
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Cowen, Philip, Paul Harrison, and Tom Burns. Shorter Oxford Textbook of Psychiatry. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199605613.001.0001.
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Widely recognised as the standard text for trainee psychiatrists, the Shorter Oxford Textbook of Psychiatry stands head and shoulders above the competition. Honed over five editions it displays a rare fluency, authority and insight, and it makes the process of assimilating information as smooth and enjoyable as possible. The resource provides an introduction to all the clinical topics required by the trainee psychiatrist, including all the sub-specialties and major psychiatric conditions. Throughout, the authors emphasize the basic clinical skills required for the full assessment and understanding of the patient. Discussion of treatment includes not only scientific evidence, but also practical problems in the management of patients their family and social context. It emphasizes an evidence-based approach to practice and gives full attention to ethical and legal issues. Introductory chapters focus on recognition of signs and symptoms, classification and diagnosis, psychiatric assessment, and aetiology. Further chapters deal with all the major psychiatric syndromes as well as providing detailed coverage of pharmacological and psychological treatments. It also gives equal prominence to ICD and DSM classification - often with direct comparisons.
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Cavanna, Andrea E. Gabapentin. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198791577.003.0006.
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Gabapentin is a second-generation antiepileptic drug characterized by few antiepileptic indications, with very good interaction profile in polytherapy. The therapeutic indications of gabapentin for the treatment of epileptic seizures have been largely overshadowed by its widespread use for the treatment of neuropathic pain (especially post-herpetic neuralgia, diabetic neuropathy, and pain caused by a spinal cord injury). Gabapentin has a good behavioural tolerability profile and a good range of psychiatric uses (unlicensed indications for anxiety disorders and alcohol withdrawal symptoms). Despite the widespread use of gabapentin for behavioural conditions, its potential usefulness as adjunctive treatment of bipolar affective disorder is still controversial.
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Markowitz, John C. In the Aftermath of the Pandemic. Oxford University Press, 2021. http://dx.doi.org/10.1093/med-psych/9780197554500.001.0001.
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The Covid-19 pandemic is an ongoing disaster on a scale no one living can recall. Since the end of 2019, it is causing not only countless deaths and physical debility, but also extraordinary social disruption, changing every aspect of people’s working and social lives. As a consequence, in the wake of the virus has come a second wave of psychiatric consequences, mostly prominently anxiety, depression, and posttraumatic stress. This flood of illness and distress will likely continue at least until an effective vaccine is found and distributed and, even then, will leave psychic scars. How best to treat the slew of psychiatric suffering from such tragedy or, indeed, from any ongoing disaster? Interpersonal psychotherapy (IPT) is an evidence-based, time-limited, affect- and life event–focused psychotherapy, repeatedly tested in more than forty years of treatment research and shown to help patients with mood, anxiety, and trauma disorders. With adaptation to the particular current conditions, IPT appears an excellent fit for the strong feelings and symptoms arising from these horrific life events. his manual by Dr. John Markowitz, a leading IPT expert, equips therapists to treat the most common psychiatric consequences of the pandemic.
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García-Cazorla, Angels, and Rafael Artuch. Brain Serotonin Deficiency. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199972135.003.0032.
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Brain serotonin deficiency is a heterogeneous condition whose etiology remains unknown in the majority of cases. Strong evidence supports a major role for brain serotonin deficiency in common conditions such as depression and other psychiatric and cognitive disorders, which are probably due to interactions between genetic and environmental factors. Mendelian monogenic conditions leading to brain serotonin deficiency have also been identified, but they are rare. These diseases are associated with defects in other neurotransmitters (primarily dopamine), and it is difficult to link serotonin deficiency with specific neurological syndromes. Secondary serotonin deficiency is also common. In adults, when serotonin deficiency is thought to contribute to neurological symptoms such as sleep disturbance and alterations in behavior, treatment with serotonin precursors may be useful.
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Rosenstock, Jason B. Diagnosis and Assessment of Schizophrenia and Related Psychoses. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199331505.003.0002.
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It can be difficult assessing patients who present with psychotic symptoms. In this chapter, we will present a framework for how to make (and share) a definitive diagnose that will inform future treatment. In our approach, assessment requires both detailed cross-sectional and longitudinal components. Presentations may be heterogeneous, although diagnosis is grounded in key DSM-5 criteria, based on history and clinical assessment. Providers must rule out other psychiatric and medical conditions that can cause psychosis, before settling on a primary psychotic disorder. Finally, we must be careful when making a diagnosis of a psychotic disorder: it takes time, and when the news is delivered to patients and families, providers must be encouraging and hopeful about possibilities for recovery.
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Pirelli, Gianni. Mental Health. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190630430.003.0003.
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In this chapter, the authors provide a broad overview of diagnosable psychiatric disorders, their symptoms, and examples of current theoretical and empirical thought underlying these conditions. In providing a primer concerning mental health, they first review the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), with respect to how psychopathology is defined and the nature of the diagnostic system. They then shift to definitions, key examples, and example theories for (i) clinical disorders (e.g., depressive and anxiety disorders), (ii) personality disorders (with an emphasis on borderline and antisocial personality disorders), and (iii) substance use disorders. While this chapter draws heavily from the DSM-5, such is done primarily for educational and illustrative purposes within the broader context of discussing key issues related to the behavioral science of firearms.
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Teixeira, Antonio, Erin Furr Stimming, and William G. Ondo, eds. Movement Disorders in Psychiatry. Oxford University PressNew York, 2022. http://dx.doi.org/10.1093/med/9780197574317.001.0001.
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Abstract Movement Disorders in Psychiatry examines the complex interface between movement disorders and psychiatry, addressing both specific movement disorders in psychiatry, and behavioral syndromes associated with diseases categorized as movement disorders. After an overview of the clinical definitions and pathophysiology of movement disorders in Part 1, Part 2 reviews a series of movement disorders associated with drugs of abuse and psychotropic medications, including tardive dyskinesia, akathisia, and neuroleptic malignant syndrome. Part 3 discusses movement disorders seen in primary psychiatric disorders such as autism and schizophrenia. Finally, Part 4 examines diseases with concurrent movement disorder and behavioral symptoms, including Huntington’s disease, Parkinson’s disease, frontotemporal dementia, Tourette’s syndrome, and autoimmune conditions. The book provides an in-depth and up-to-date perspective of the field, also discussing the challenges in the clinical practice.
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Lee, Li-Wen. Interviewing in correctional settings. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0012.
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Conducting psychiatric interviews is oftentimes a unique challenge in jails and prisons. Interviews are conducted in a wide array of conditions and settings, acute or chronic, privacy and safety issues, contentious or collaborative. According to the Bureau of Justice Statistics in 2005, more than half of all jail and prison inmates had a recent history of symptoms of a mental health problem. This high rate of mental illness is both an opportunity for, and a challenge to, providing much needed treatment. Without adequate assessment and treatment, inmates with mental illness may harm themselves, other inmates, correctional staff, become victimized, or disrupt facility operations. An essential component in assessment and appropriate management is the psychiatric interview. While there are helpful standards and guidelines regarding mental health services in correctional settings, relatively little has been written about the specific impact of the correctional setting on conducting mental health interviews, or on the specific features of the correctional population that should be understood when conducting the mental health interview. Given the importance of the interview in providing mental health treatment, the essential elements and complexities involved in conducting an effective interview in the correctional setting will be presented in the following chapter. Various aspects of the psychiatric interview will be reviewed with particular attention given to how the correctional population and setting can impact the interview process. Issues of countertransference are also present and are discussed. This chapter discusses both the contexts as well as the practices that are appropriately adapted to correctional settings.
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Carrico, Adam W., and Michael H. Antoni. Psychoneuroimmunology and HIV. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0021.
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Psychoneuroimmunology (PNI) examines the biological and behavioral pathways whereby psychosocial factors may influence the course of chronic medical conditions, including HIV/AIDS. This chapter summarizes PNI research conducted examining the possible role of negative life events (including bereavement), stress reactivity, personality factors, cognitive appraisals, and affective states (depression) in HIV illness progression. Because much of this research was conducted in the era prior to the advent of effective antiretroviral therapy, important questions remain regarding whether there the associations of psychosocial factors with HIV illness progression are independent of medication adherence and persistence. There is also increasing recognition that chronic viral infections such as HIV have neuropsychiatric effects, and more recent PNI research has focused on studying the bidirectional communication between the immune system and central nervous system in HIV. Future research should focus on obtaining definitive answers to these questions to inform the development of novel approaches for reducing psychiatric symptoms and optimizing health outcomes among persons with HIV.
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Grassi, Luigi, Maria Giulia Nanni, and Rosangela Caruso. Psychotherapeutic interventions. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198806677.003.0010.
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Psychotherapy is an integrative and integrated part of modern patient/relation-centered care in the advanced and terminal phases of physical illness. Psychiatric disorders (e.g. depressive spectrum, stress-related, and anxiety disorders), other clinically significant psychosocial conditions (e.g. demoralization, existential pain) and interpersonal, psychological, and spiritual needs have to be addressed by psychological intervention. Supportive-Expressive Group Psychotherapy (SEGT), Meaning-Centered Psychotherapy (MCT), Managing Cancer and Living Meaningfully Therapy (CALM), cognitive-existential therapy, dignity therapy (DT) and other psychotherapeutic interventions have been developed over the last 40 years. These treatments have proved to be effective in increasing the patients’ sense of dignity, purpose, and meaning, and to reduce demoralization, anxiety, and existential distress at the end of life. Also Family Focused Grief Therapy (FFGT) and grief therapy have shown to be effective in overcoming anxiety, depression, and complicated grief symptoms both before and after loss. Psychotherapy should thus be considered a mandatory ingredient of palliative care.
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Balog, Daniel J., Robert Koffman, and Joseph M. Helms. Acupuncture. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190205959.003.0006.
Full textAbstract:
People who acquire posttraumatic stress disorder (PTSD) after experiencing a traumatic event endure a constellation of debilitating symptoms, including intrusion, avoidance, negative mood alteration, and marked increases in reactivity. They have difficulty falling or staying asleep, and often have comorbid physical and pain-related diagnoses secondary to their trauma. Despite evolving definitions and measures, estimates of prevalence of lifetime PTSD in U.S. population have remained quite consistent since the advent of theDiagnostic and Statistical Manual of Mental Disorders(DSM), third edition, revised (III-R). In civilian populations, lifetime DSM-III-R PTSD prevalence rates of 9.2%; DSM, fourth edition, PTSD prevalence rates of 6.8%; and DSM, fifth edition, PTSD estimate rates of 5.4% have been reported. In U.S. military populations, prevalence rates as high as 17% after combat deployments have been reported. Importantly, persons with PTSD experience higher prevalence of other psychiatric and physical comorbid conditions, including mood, substance use, and pain disorders.
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Tavares, Hermano. Assessment and Treatment of Pathological Gambling. Edited by Jon E. Grant and Marc N. Potenza. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195389715.013.0091.
Full textAbstract:
As gambling becomes more popular, more people will be exposed to it; thus, the prevalence of and demand for gambling-related treatments are expected to increase. Pathological gambling (PG) is the most severe level of gambling compromise, characterized by unrestrained gambling to the point of financial and psychosocial harm. Classified among the impulse control disorders, PG resembles other addictive disorders. A host of scales for screening and diagnosing PG are available for both the specialist and the general practitioner. The diagnosis of PG, like that of other addictions, is based upon signs of loss of control over the target behavior (i.e., gambling), dose escalation (increasing amounts wagered to get the same excitement as in previous bets), withdrawal-like symptoms, psychosocial harm, persistent desire, and persistent betting despite the negative consequences. Its treatment requires thorough assessment of psychiatric related conditions, motivational intervention, gambling-focused psychotherapy, relapse prevention, and support for maintenance of treatment gains. Psychopharmacological tools to treat craving and gambling recurrence are an incipient but promising field.
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Keshav, Satish, and Alexandra Kent. Chronic abdominal pain. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0024.
Full textAbstract:
Separating chronic and acute abdominal pain is often difficult, and an arbitrary time limit of 4 weeks is often used. However, many chronic conditions (e.g. chronic pancreatitis) can cause relapsing symptoms, which may be acute during each episode. Pain receptors in the abdomen respond to chemical and mechanical stimuli. Stretch is the commonest mechanical stimulus to the viscera, although distension, torsion, and contraction are also sensed. Chemical receptors are stimulated by inflammation and infection, and this stimulation leads to the production of various substances, including serotonin, bradykinin, substance P, prostaglandins, and histamine. There are inter-individual differences in pain perception, with some people (e.g. patients with irritable bowel syndrome) being more sensitive to painful stimuli. Chronic abdominal pain occurs in 9%–15% of all children, and is present on questioning in 75% of adolescents and 50% of adults who are otherwise healthy. It is often a non-specific symptom that alone has a poor sensitivity for organic disease. Usually, it is the associated symptoms, and/or abnormal blood tests, that direct the doctor to a diagnosis. This chapter covers the approach to the diagnosis of chronic abdominal pain, key diagnostic tests, therapies, prognosis, and dealing with uncertainty.
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Smith, Martha J. Chronic Pelvic Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190217518.003.0020.
Full textAbstract:
Nonmalignant chronic pelvic pain is defined as nonmenstrual pain below the level of the umbilicus that has continued for at least 6 months and is severe enough to seek medical or surgical treatment. In chronic pelvic pain, the pain and disability may often appear out of proportion to physical abnormalities, and this pain is often refractory to medical and surgical therapies. Significant psychiatric comorbidities and many medical comorbidities often accompany pelvic pain. Although most pelvic pain patients are female, several conditions can cause chronic pelvic pain in males. When evaluating and diagnosing various pelvic pain conditions, it is imperative to rule out malignancy and other organic causes. Pelvic floor dysfunction, sacroiliac joint instability, and other mechanical issues are often partially involved in the process of chronic pelvic pain. As a clinician, all of these variables must be taken into consideration when evaluating and treating chronic pelvic pain patient.