bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disorders relating to the use of ecstasy and other ‘party drugs’
Authors: Winstock Adam R. , Schifano Fabrizio 
Published: January 2013

AbstractMDMA, methamphetamine, GHB, and ketamine are all capable of producing acute adverse psychological experiences in normal users and exacerbating symptoms in those with underlying psychological disorders. They also to varying degrees pose the risk of long-term neuropsychiatric consequences. Although dependent patterns of use are not commonly seen with this group of drugs, methamphetamines certainly can result in the very rapid development of severe dependence. Most acute presentations are typically short-lived and self-limiting and are only very rarely life-threatening. The precipitation of an underlying psychiatric disorder or an exacerbation of premorbid traits may well be one of the longer term consequences of heavy use of these drugs. In those who present with acute drug-related psychological symptoms there should be an emphasis on follow-up since in some cases the symptoms will represent the onset of a persistent independent disorder which requires treatment. Users who have experienced acute psychological problems should be encouraged to make the attribution that there may be something inherent in them that makes them susceptible to experiencing the unpleasant reactions with a drug and that they are likely to remain vulnerable to those adverse experiences. This may be difficult to accept for potentially vulnerable young people who may prefer to think that the experience was not enjoyable because the drugs were not good – ‘it was a bad pill’.
Assessing need and organizing services for drug misuse problems
Authors: Marsden John , Bradbury Colin , Strang John 
Published: January 2013

AbstractIn the present decade, there has been substantial investment in drug misuse treatment thereby expanding the workforce, the capacity of the treatment system and leading to reduced waiting times and better integration of local services. In 2006–07, an in-treatment population of approximately 200 000 individuals were recorded by the National Drug Treatment Monitoring System (NDTMS). Capture-recapture estimates suggest that there are approximately 327 000 users of opioids and/or crack cocaine. About two-thirds of adults entering drug misuse treatment services are dependent on illicit heroin—a clinical presentation complicated by between 20 per cent to 50 per cent of admissions by concurrent dependence on cocaine and other substances such as the misuse of pharmaceutical medications (such as benzodiazepines). Cannabis is reported as the main problem drug for younger patients under 18 years of age. Overall, treatment services for clients of all ages are able to assess and provide interventions across all illicit drugs including amphetamine-type stimulants, sedative/hypnotics, cannabis, hallucinogens and volatile substances (solvents and inhalants). Hazardous and harmful alcohol use characterizes a significant, but priority group of drug misuse treatment seekers. In 2006, a revised national drug misuse treatment effectiveness strategy stressed the need for better local partnerships to commission and organize local services and promote reintegration of treated patients into the community. A core component of the strategy was the creation of Criminal Justice Integrated Teams (CJITS) who were given the role of treatment case coordi-nation for individuals involved in the justice system with identified drug misuse. Nevertheless, improvements to the reach, operation, and effectiveness of treatments remains a priority—particularly tackling high-risk behaviours linked to the acquisition and transmission of blood-borne infections and ensuring that all service users receive good quality assessment and care coordination.
Descriptive clinical features of schizophrenia
Authors: Liddle Peter F. 
Published: January 2013

AbstractThe clinical features of schizophrenia embrace a diverse range of disturbances of perception, thought, emotion, motivation, and motor activity. It is an illness in which episodes of florid disturbance are usually set against a background of sustained disability. The level of chronic disability ranges from a mild decrease in the ability to cope with stress, to a profound difficulty in initiating and organizing activity that can render patients unable to care for themselves.
Genetic and environmental risk factors for schizophrenia
Authors: Murray R. M. , Castle D. J. 
Published: January 2013

AbstractOne thing that is certain about the aetiology of schizophrenia is that there is no single cause. This might reflect the fact that the schizophrenia construct itself is heterogeneous, such that specific subtypes might in the future be found to have specific causes. But it is more useful at this stage of our knowledge to conclude that, like other disorders such as ischaemic heart disease and diabetes mellitus, schizophrenia results from the cumulative effects of a number of risk factors. These may be crudely divided into the familial-genetic and the environmental, though there are clearly interactions between the two.
The neurobiology of schizophrenia
Authors: Harrison Paul J. 
Published: January 2013

AbstractSignificant progress has been made in understanding the neurobiology of schizophrenia over the past decade (Table 4.3.6.2.4). In particular, there is now good evidence for a dopaminergic dysfunction, and for structural brain changes that are present at, and in part before, the onset of illness. There is also emerging evidence for several susceptibility genes, accompanied by data suggesting mechanisms by which these genes contribute to the neurodevelopmental and other pathogenic processes that are thought to lead to schizophrenia. Whilst highlighting the progress, one must also acknowledge that much remains unknown (Table 4.3.6.2.5), and it is a moot point how and when the research advances will impact on the diagnosis, treatment, or prognosis of schizophrenia.
Persistent delusional symptoms and disorders
Authors: Munro Alistair 
Published: January 2013

AbstractParanoia/delusional disorder is unique in psychiatry in that it is virtually a newly discovered illness, yet much of the fundamental descriptive work was done a century or more ago. This long hiatus means that most practitioners have little knowledge or experience of the disorder, and the few who are aware of it usually only see a small part of the fabric. The dermatologist treats a case of delusional parasitosis, the cosmetic surgeon has an impossible patient wth a dysmorphic delusion, the lawyer does not know what to do with a totally unreasonable litigant, the police officer has to deal with a jealous murderer or an erotomanic stalker, and the personnel officer has an employee who is convinced his fellow workers are persecuting him, etc. How can we draw all this scattered material together and add it to the psychiatric literature to make a whole cloth? The answer is largely by consciousness raising and education. Kendler, an authority in this field, has said, ‘The paranoid disorders may be the third great group of functional psychoses, along with affective disorder and schizophrenia’. If he is correct, it is imperative that we hone our diagnostic and treatment skills in order to improve the help we might offer to delusional disorder sufferers and to facilitate research which is so badly needed.
Diagnosis, classification, and differential diagnosis of the mood disorders
Authors: Parker Gordon 
Published: January 2013

AbstractVarying expressions of mood disorders make for difficulties in definition, diagnosis, and classification. DSMIV and ICD10 formal classifications with decision rules (see Chapter 1.9) provide a structure but their underlying models may or may not be valid. This chapter therefore considers how mood disorders can be variably conceptualized and structured—an issue of intrinsic importance but also influencing identification of causes and management. Some definitional and boundary issues are first detailed prior to considering sub-typing and differential diagnostic issues.
Recovered memories and false memories
Authors: Brewin Chris R. 
Published: January 2013

AbstractClinicians working with survivors of traumatic experiences have frequently noted the existence of memory loss with no obvious physical cause and the recovery of additional memories during clinical sessions. Indeed, amnesia is described in diagnostic manuals as a feature of post-traumatic stress disorder, although its presence is not necessary for this diagnosis. In the majority of these cases, people forget details of the traumatic event or events, or forget how they reacted at the time, although they remember that the event happened. They typically report that they have endeavoured not to think about the event, but have never forgotten that it occurred. Controversy is centred on memories of traumatic events, particularly concerning child abuse, that appear to be recovered after a long period of time in which there was complete forgetting that they had ever happened. It has sometimes been suggested that many, if not all, of these apparent recovered memories are the product of inappropriate therapeutic suggestion. This argument has been promulgated in particular by the False Memory Syndrome Foundation in the United States, by its counterpart, the British False Memory Society, and by their scientific advisors.
Obsessive–compulsive disorder
Authors: Zohar Joseph , Fostick Leah , Juven-Wetzler Elizabeth 
Published: January 2013

AbstractThe efficacy of the SRIs for OCD, together with the lack of efficacy of adrenergic antidepressants, has suggested that serotonin is involved in the pathophysiology of OCD. This relationship was validated by research on serotonergic markers in OCD and by the challenge paradigm. Which type of serotonergic receptor is involved in the pathogenesis and/or the mechanism of action of anti-obsessional drugs, is still unclear. However, the possible role of 5HT1B has emerged. Further studies are crucial for elucidating the role of serotonin and other neurotransmitters (i.e. dopamine) in the pathophysiology and management of OCD.
Depersonalization disorder
Authors: Medford Nick , Sierra Mauricio , David Anthony S. 
Published: January 2013

AbstractDepersonalization, a term coined by Dugas in 1898, is defined in DSM-IV as ‘an alteration in the experience of self so that one feels detached from and as if one is an outside observer of one's outside mental processes or body’. Brief, self-limiting experiences of depersonalization commonly occur in healthy people in the context of fatigue, intense stress, or during/after intoxication with alcohol or illicit drugs. However, some people experience chronic depersonalization of a disturbing intensity, causing significant distress and impacting on quality-of-life and daily functioning. This may occur as a primary depersonalization disorder (DPD), or in the context of other psychiatric or neurological conditions. In this chapter, we consider the primary disorder, although some sections are also relevant to secondary depersonalization. The depersonalization experience is one of feeling strangely altered and unreal, in a way that sufferers often find very hard to convey. It is often accompanied by the related phenomenon of derealization, in which the person's surroundings are experienced as somehow remote and lacking immediacy and vibrancy, as if the world itself has become oddly unreal. Patients with persistent depersonalization and derealization often use the analogy of feeling as if they are on the set of a play or film, where nothing is real and they are acting out a role rather than living a real life.
Anorexia nervosa
Authors: Russell Gerald 
Published: January 2013

AbstractThe chapter begins by describing the two different approaches in the conceptualization of anorexia nervosa, before covering the epidemiology, aetiology, clinical features both of classical anorexia nervosa (postpubertal) and anorexia nervosa of early onset (premenarchal), classification, course, and prognosis. Treatment is covered in detail, and the chapter provides both a review of the evidence and advice on management. The chapter ends with a discussion of ethical and medico-legal issues and prevention.
Gender identity disorder in adults
Authors: Green Richard 
Published: January 2013

AbstractThe behavioural phenomenon of transsexualism (now gender identity disorder) is ancient. It has been recorded for centuries and in a broad range of cultures. The historic behavioural picture is comparable to that seen clinically. After a brief historical overview, this chapter covers epidemiology, diagnosis, origins, hormonal effects, treatment, surgery, sex reassignment outcome, family management, those with a transgendered identity, popularly known as ‘the third sex’, transsexual patient subgroups, gender identity as a disorder, and finally legal issues.
Diagnosis and classification of personality disorders
Authors: Reich James , de Girolamo Giovanni 
Published: January 2013

AbstractThere has been considerable interest in the study of personality and personality disorder (PD) since early times and in many different cultures. This chapter covers definitions of personality disorders, ICD and DSM classifications of personality disorders, similarities and differences between ICD-10 and DSM-IV, recent changes in the conceptualization of DSM personality disorders, categorical versus dimensional styles of classification, and assessment methods for personality disorders.
Epidemiology of personality disorders
Authors: Guzzetta Francesca , de Girolamo Giovanni 
Published: January 2013

Abstracttbegun to be scientifically investigated. This development has taken place because a number of standardized instruments to assess personality and PD in an empirical fashion have been developed, in parallel with the refinement of a valid and reliable diagnostic system based on a categorical approach. The need for the epidemiological investigation of PDs seems justified for several reasons. 1 As seen in recent epidemiological surveys, PDs are frequent and have been found in different countries and sociocultural settings. 2 PDs can seriously impair the life of the affected individual and can be highly disruptive to societies, communities, and families. 3 Personality status is often a major predictive variable in determining the outcome of Axis I mental disorders and the response to treatment. In this chapter, we review the epidemiological literature on PDs up to October 2007, focusing on studies carried out since the development of the DSM-III. First, community prevalence studies of PDs are reviewed. We then look at the prevalence of individual PDs in the community. Finally, we consider the prevalence of PDs in clinical populations, and in special settings (e.g. primary care, prisons, etc.).
Excessive sleepiness
Authors: Billiard Michel 
Published: January 2013

AbstractExcessive sleepiness is not an homogeneous concept. It can manifest itself as bouts of sleepiness, irresistible and refreshing sleep episodes, abnormal lengthening of night sleep with a major difficulty waking up in the morning or at the end of a nap or even periods of a week or so of almost continuous sleep recurring at several months’ intervals. According to the recent second edition of the International Classification of Sleep Disorders (ICSD-2), disorders of excessive sleepiness are distributed within three chapters: sleep-related breathing disorders, hypersomnias of central origin not due to a circadian rhythm sleep disorder, sleep-related breathing disorders, or other cause of disturbed nocturnal sleep, and circadian rhythm sleep disorders. However in this volume aimed at psychiatrists, the presentation of disorders of excessive sleepiness will obey another logic. Following “Generalities” including epidemiology, morbidity, clinical work-up, and laboratory tests, the various aetiologies will be presented according to the following six subchapters: ♦ Hypersomnia not due to substance or known physiological condition (non-organic hypersomnia or psychiatric hypersomnia) ♦ Hypersomnia due to drug or substance ♦ Behaviourally induced insufficient sleep syndrome ♦ Hypersomnia in the context of sleep-related breathing disorders ♦ Hypersomnias of central origin ♦ And the special case of delayed sleep phase syndrome.
Deliberate self-harm: epidemiology and risk factors
Authors: Arensman Ella , Kerkhof Ad J. F. M. 
Published: January 2013

AbstractDeliberate self-harm is a major problem in many contemporary societies. DSH seems to reflect the degree of powerlessness and hopelessness of young people with low education, low income, unemployment, and difficulties in coping with life stress. As such, non-fatal suicidal behaviour should be a major concern for politicians. There are substantial differences between communities in the prevalence of deliberate self-harm. This suggests that some communities better meet the needs of their underprivileged youngsters than others do, but we barely understand the differences between communities and nations. Preventive action therefore is difficult to design. There is a need for a better nationwide continuous registration of DSH and related socio-economic conditions. There is also a need for better mental health care management of DSH patients, and for experimental studies on the prevention of repetition. Although we know that persons who engage in DSH are at high risk for future fatal and non-fatal suicidal behaviour, development of effective intervention, and prevention programmes is a key priority.
Somatoform disorders and functional symptoms
Authors: Mayou Richard 
Published: January 2013

Abstract
Non-specific symptoms that are not explained by organic pathology are extremely frequent in the general population and in all medical settings. Most are transient, but a substantial minority is persistent, disabling, and often associated with frequent consultation. They are likely, especially when there are multiple unexplained sym-ptoms, to be associated with psychiatric disorder (see Chapter 5.2.3). They are widely regarded as difficult to treat but only a very small proportion is seen by psychiatrists and psychologists. This chapter covers general issues relating to functional symptoms and syndromes and their psychiatric associations. The following chapters provide more detail about the more specific forms of somatoform disorder and about functional syndromes (pain, chronic fatigue).
Somatization disorder and related disorders
Authors: Fink Per 
Published: January 2013

AbstractThe essential feature of somatization disorder and related disorders is that the patient presents multiple, medically unexplained symptoms or functional somatic symptoms. These physical complaints are not consistent with the clinical picture of known, verifiable, conventionally defined diseases, and are unsupported by clinical or paraclinical findings. The phenomenon of medically unexplained symptoms cannot simply be classified into one or a few diagnostic categories, but must be regarded as an expression of a basic mechanism by which people may respond to stressors as in the cases of depression and anxiety. Somatization disorder and related disorders must thus be considered to possess a spectrum of severity. In this chapter, the focus will be on the chronic and multisymptomatic forms.
Pain disorder
Authors: Benjamin Sidney , Morris Stella 
Published: January 2013

AbstractPersistent somatoform pain disorder is an ICD-10 diagnosis, which is included in the group of somatoform disorders. The term pain disorder is used in DSM-IV, and for convenience that is the term used here to refer to both classifications, unless a distinction needs to be made. This chapter aims to clarify the relationship of pain to mental disorders, the diagnosis of pain disorder and its differential diagnosis, and then considers how psychosocial factors contribute to pain, the treatments that stem from them, and the psychiatrist's potential contribution. Pain has been defined by the International Association for the Study of Pain (IASP) as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage’. ‘Pain’ is used here in this sense; it is not used primarily to indicate mental distress or anguish. As a perception, pain is essentially a subjective experience, and is directly accessible only to the patient. By contrast, tissue damage can be assessed by others, and its relationship with the subjective characteristics of pain have been shown to be variable, modulated by social and cultural experience, as well as within the central and peripheral nervous system.
Body dysmorphic disorder
Authors: Phillips Katharine A. 
Published: January 2013

AbstractBody dysmorphic disorder (BDD), also known as dysmorphophobia, is a relatively common, severe, and sometimes difficult-to-treat condition that has been described for more than a century. BDD consists of a distressing or impairing preoccupation with an imagined or slight defect in one's physical appearance. BDD is classified as a separate disorder in DSM-IV and a type of hypochondriasis in ICD-10. This disorder can cause severe distress and notably impaired functioning. In addition, risk behaviours—suicidality, violence, problematic substance use, and compulsive tanning—appear common in BDD. Despite its severity, BDD is underrecognized in clinical settings.
Neurasthenia
Authors: Mak Felice Lieh 
Published: January 2013

AbstractThe term neurasthenia has had a variegated history, and although retained as a diagnostic entity in the ICD-10 it does not appear in the DSM-IV. In cultures where neurasthenia still enjoys popular professional and lay acceptance it has a variety of usages: ♦ a nosological entity ♦ an idiom for expressing distress ♦ a culturally sanctioned illness behaviour ♦ an explanatory model for a constellation of somatic symptoms ♦ an euphemism for avoiding the stigma of mental disorder. Therefore, in diagnosing, understanding, and managing neurasthenia the clinician has to be aware of the context in which the term is used.
Psychiatric aspects of surgery (including transplantation)
Authors: Hales S. A. , Abbey S. E. , Rodin G. M. 
Published: January 2013

AbstractAttention to psychiatric disturbances and to emotional distress is important in the surgical setting, from the time of the initial diagnostic assessment, to the perioperative period and the phase of subsequent recovery and rehabilitation. Psychiatric illness and psychological factors, which are not taken into account prior to surgery, may contribute to inaccurate diagnoses, unrealistic assessment of the surgical risk, unnecessary surgery, and complications that could have been avoided or minimized. This chapter will address these factors and provide an approach to the consideration of psychiatric factors and interventions in this setting.
Management of psychiatric disorders in medically ill patients, including emergencies
Authors: Furlan Pier Maria , Ostacoli Luca 
Published: January 2013

AbstractThe coexistence of psychiatric disorders in patients with medical illnesses may influence both the diagnosis and the course of the illness by their effects on pathophysiological, diagnostic, and therapeutic processes. There may also be effects on patients’ collaboration with treatment and on their relationships with health care staff. Several factors change the management of, medical illnesses and psychiatric disorders, and their inter-relation ♦ increased life-expectancy and increasing survival of people with-severe illness alter the risk of other medical and psychiatric disorders; ♦ social changes affecting family structure can affect care giving. Other social factors include changes in the role of women (work, delayed maternity); increased immigration with consequent cultural diversity including different concepts of medical and psychiatric disorders (see Chapter 1.3.2); ♦ increased use of medication in medical and in psychiatric treatment, and changes in the organization of health care and social assistance from hospital-based to community-based. This chapter describes how to recognize, treat and manage psychiatric disorders in medical illnesses.