bluuebunny/crossref_metadata_2025_split huggingface dataset:
The organization of psychiatric services for general hospital departments
Authors: Huyse Frits J. , Kathol Roger G. , Söllner Wolfgang , Wulsin Lawson 
Published: January 2013

AbstractThe organization of psychiatric services for general hospital departments might change in far-reaching ways in the coming decades. Whereas the focus was primarily on reactive services for inpatients on medical and surgical wards, the future should focus on more proactive integrated service delivery for the complex medically ill. The essential difference from other psychiatric services is that the population served is taken care of by medical specialists in the general health setting. Consequently services are delivered in the context of the medical-psychiatric interface. Consult requests are always formulated in this perspective: the patient is treated for a medical illness or physical complaints and there are signs of an interfering psychiatric disorder. Nowadays these patients are referred to as the ‘complex medically ill’. Therefore triage and treatment integrated in the medical context is the area of expertise of consultation-liaison (CL) psychiatrists. The development of this area of psychiatry has been hampered by dysfunctional splits in health care, such as between general and mental health care, both on the level of its organization as well as its reimbursement. Recent reports, such as the report of the joint working group of the United Kingdom Royal College of Physicians and the Royal College of Psychiatrists, which describe the psychological needs of the medically and surgically ill, provide guidance to counteract these dysfunctional splits. As the delivery of care-trajectories for comorbid patients becomes more and more an issue on the health care agenda, CL psychiatrists should seize this opportunity and become advocates for integrated service delivery for the complex medically ill.
Phototherapy
Authors: Cowen Philip J. 
Published: January 2013

AbstractPhototherapy or artificial bright-light treatment, has been used in the management of a number of medical disorders including psoriasis and hyperbilirubinaemia of the newborn. From the point of view of psychiatric treatment, the notion that light might help people with certain psychological symptoms has an ancient lineage. For example, Wehr and Rosenthal cite Aretaeus who suggested in the second century ad that ‘lethargics are to be laid in the light and exposed to the rays of the sun (for the disease is gloom)’. In 1898, a ship's physician named Frederick Cook recorded that the ‘languor’ which affected members of an Antarctic expedition during the winter darkness could be relieved with bright artificial light. The first systematic study of phototherapy as a psychiatric treatment was carried out in 1984 by Rosenthal et al. who used bright artificial light to treat patients with the newly identified syndrome of seasonal affective disorder. Seasonal affective disorder is a recurrent mood disorder in which patients experience regular episodes of depression in autumn and winter with remission in spring and summer. Since then phototherapy has become the mainstay of the treatment of seasonal affective disorder, particularly in patients with atypical depressive features such as hyperphagia and hypersomnia. Phototherapy has also been used as an investigational treatment in other psychiatric disorders but the evidence for its efficacy in these conditions less established.
Cognitive behaviour therapy for depressive disorders
Authors: Fennell Melanie J. V. 
Published: January 2013

Abstract
This chapter describes A.T. Beck's cognitive behaviour therapy (CBT) for depression. Beck's is probably the most fully developed, comprehensively evaluated, and widely disseminated cognitive behavioural approach to depression. Additionally, CBT is an effective treatment for a range of acute psychiatric disorders, shows promise for severe mental illness and personality disorder, and is thus helpful not only with primary depression, but also with a range of comorbid conditions.
Cognitive behaviour therapy for schizophrenia
Authors: Birchwood Max , Spencer Elizabeth 
Published: January 2013

Abstract
Cognitive behaviour therapy (CBT) for schizophrenia focuses on the core psychotic symptoms of hallucinations and delusions. Other psychosocial approaches to psychosis (e.g. intervention with families and to promote medication compliance) also frequently use CBT techniques. In this chapter, however, we focus on CBT for delusional beliefs and other psychotic phenomena and review evidence for its efficacy.
Group methods in adult psychiatry
Authors: Schlapobersky John , Pines Malcolm 
Published: January 2013

AbstractAfter a century of development, group therapy is today one of the most widely practised treatment methods in psychiatry with an extensive literature. There are three principles common to its wide range of applications. First, the therapist calls the ‘community’ into the consulting room where, together with the therapist, it becomes the therapeutic agent. Second, the therapist assembles a group of people who can contribute to a commonly held resource from which its members can each derive benefits. And third, the therapist does nothing for them in the context of the group, that they can do for themselves, and one another. This chapter starts by providing a conceptual framework that differentiates methods, models, and applications for the practice of group therapy in adult psychiatry. After classification of the different methods and applications we discuss the main theoretical models; explore the dynamic life of therapy groups; consider some of the key clinical issues facing practitioners; their applications to a range of patient populations and settings; their evaluation and justification and their historical evolution this century. In the conclusion we consider the planning of group services and the training of their practitioners. This revision of the chapter has brought it up-to-date with the contemporary literature in a field that has seen a great deal of innovation since the original 2000 edition. The developing evidence base for group psychotherapy is ‘Guardedly optimistic. The literature has become stronger and deeper and is capable of supporting evidence-based treatment recommendations for some patient populations.’ The evidence base for the effectiveness of group psychotherapy has been growing with the field. Some 700 studies, spanning the past three decades, have shown that the group format consistently produced positive effects with diverse disorders and treatment models. These show that both individual and group psychotherapy will effect much the same set of results. For group therapy to be effective it has to utilize those therapeutic factors originally laid out by Foulkes and later by Yalom—the group has to be the primary focus of therapy; patients need to be well selected; and therapists need to be adequately trained. The chapter will address these questions of focus, selection, and training. Although the two authors of this chapter are both group analysts, we have set out to provide a full account of the wide range of group work practice. The United Kingdom is our own working location which lends emphasis to the chapter but it is compiled with sources and references that address the international field and it gives attention to current literature in many countries including North and South America and Continental Europe.
Psychiatry in primary care
Authors: Goldberg David , Tylee André , Walters Paul 
Published: January 2013

AbstractAt one time, it was asserted that the ‘worried well’ were treated in primary care, while true mental illnesses were seen by the mental illness services. This was not true when it was asserted, and is even less true now. The great majority of patients with common mental disorders are cared for within primary care, and many of those with severe mental illnesses are only seen in primary care. ‘Stepped care’ is a model for distributing clinical problems between the services, and ‘shared care’ refers to the care of patients seen by both primary care and specialist mental health services. Many other workers in primary care now assist GPs with the treatment of mental disorders, and special administrative arrangements within primary care are necessary to ensure that clinical services are available to those with special needs. In summary, mental disorders in primary care: ♦ Are an important public health problem ♦ Frequently present with somatic symptoms ♦ Are more likely to be detected if the doctor has better communication skills ♦ Those with disabling physical illnesses are also at greater risk ♦ Are on average less severe than those seen in specialist care
The role of the voluntary sector
Authors: Pinfold Vanessa , Teasdale Mary 
Published: January 2013

Abstract
The voluntary sector is a dynamic and vital part of any mental health system. Rooted in the experiences of mental health service users and carers, voluntary sector organizations across the world ensure that the voices of ‘experts by experience’ directly influence campaigns, policy debates, service redesign, and project planning and treatment guidelines. The sector is, however, fragile and in some countries organizations are increasingly dependent on state funding which could undermine their autonomy and independence. Psychiatrists can support their local voluntary organizations by joining them—as members, as campaigners, and as educators. The sector can also support psychiatrists, helping to transform the public image of psychiatry and encouraging young people to take an interest in mental health as a career option. The alliances forged with psychiatrists and their representative bodies are crucial for improving the quality of mental health services and to effectively tackle stigma and discrimination. We do need each other in order to deliver better outcomes for mental health service users and their families.
Mental health services for ethnic minorities
Authors: Craig Tom K. J. , Bhugra Dinesh 
Published: January 2013

Abstract
The diagnosis and treatment of mental ill health among multiethnic populations is probably one of the most complex and contentious challenges in psychiatric service provision. At the heart of this complexity are problems of ignorance, attitude, and failures of communication on all sides. It is also potentially one of the most rewarding endeavours if got right. No one service model is likely to apply to every community, even if people belong to the same ethnic group. The development of specialist psychiatric services may not always be possible or even essential. Instead, the requirements are for approaches that are flexible, sensitive, accessible, and accountable to the people they serve.
Assessment of mental disorder in older patients
Authors: Jacoby Robin 
Published: January 2013

Abstract
The assessment of older people is not fundamentally different from that of younger patients. The principles of taking history and mental-state examination are the same at any age. But if the goals are common, the routes taken to reach them are not necessarily so. For example, an assessment adequate enough to begin treatment of a 30-year-old woman presenting to an outpatient clinic with a depressive illness might take about an hour and involve speaking only to the patient and perhaps briefly to her partner, whereas the equivalent assessment of an 81-year-old woman in whom uncertainty exists as to whether the diagnosis is that of a depressive or a dementing illness may require more than one interview and necessitate enquiry from several informants. This section will not repeat what can be found in Chapter 1.8.1, but cover only those points which are specific to or need to be emphasized for older patients.
Suicide and deliberate self-harm in elderly people
Authors: Jacoby Robin 
Published: January 2013

AbstractAlthough in some countries suicide rates in young males have risen dramatically in the last decade or so, suicide in old age is important because rates in older people, especially those over 74, are still proportionately higher in most countries of the world where reasonably reliable statistics can be obtained. For example, in 2004 in Lithuania where suicide incidence is currently the highest, the overall rate in males per 100 000 total population was 70.1, but in men over 74 the rate was 80.2. In the United States, where suicide is neither especially common nor rare, in 2002 the overall rate for males per 100 000 total population was 17.9, but 40.7 in men over 74. Rates for older women are nearly always much lower than for their male counterparts. A second reason for the importance of suicide in old age is that the proportion of older people in the population is rising worldwide. Indeed, the increase in developing countries is likely to be even greater than in developed countries. Although rates vary from year to year and birth cohort to cohort, it is highly likely that unless suicide prevention becomes a great deal more effective than at present, more and more older people will kill themselves in the coming years. As with younger people, completed suicide in old age may be seen as part of a continuum from suicidal thinking through deliberate self-harm (which does not lead to death), to completed suicide. An added component within this continuum for older people is that of ‘indirect self-destructive behaviour’, such as refusal to eat and drink or ‘turning one's face to the wall’ which is clearly intended to hasten death. Finally, although this section does not deal with euthanasia and related issues, assisted suicide in people with terminal illness such Alzheimer's disease and cancer may also be seen as part of the suicide continuum.
The planning and organization of services for older adults
Authors: Melding Pamela S. 
Published: January 2013

AbstractWorldwide, population ageing is driving the development of mental health services for older adults. Finite resources, burgeoning costs, expanding therapeutic repertoires, and increasing consumer interest in involvement in health care is challenging health organizations to develop effective, efficient, and economic patient- centred services for older adults. Fundamentally, the quality of services is dependent on health personnel working with their patients and other providers, towards shared aims of improving health outcomes and quality of life. Clinicians’ adaptability, flexibility, responsiveness, availability for patients, and willingness to collaborate are the keys to success in developing future services for older adults.
Conduct disorders in childhood and adolescence
Authors: Scott Stephen 
Published: January 2013

AbstractThe term conduct disorder refers to a persistent pattern of antisocial behaviour in which the individual repeatedly breaks social rules and carries out aggressive acts which upset other people. It is the commonest psychiatric disorder of childhood across the world, and the commonest reason for referral to child and adolescent mental health services in Western countries. Antisocial behaviour has the highest continuity into adulthood of all measured human traits except intelligence. A high proportion of children and adolescents with conduct disorder grow up to be antisocial adults with impoverished and destructive lifestyles; a significant minority will develop antisocial personality disorder (psychopathy). The disorder in adolescence is becoming more frequent in Western countries and places a large personal and economic burden on individuals and society.
Suicide and attempted suicide in children and adolescents
Authors: Shaffer David , Pfeffer Cynthia R. , Gutstein Jennifer 
Published: January 2013

AbstractSuicidal behaviour is a matter of great concern for clinicians who deal with the mental health problems of children and adolescents. The incidence of suicide attempts reaches a peak during the midadolescent years, and mortality from suicide, which increases steadily through the teens, is, in many countries, one of the leading causes of death at that age. This chapter starts with a historical review, and covers clinical features, assessment, classification of associated diagnoses, epidemiology, aetiology, course and prognosis, emergency treatment, and possibilities for prevention.
The effects on child and adult mental health of adoption and foster care
Authors: Thoburn June 
Published: January 2013

AbstractAdoption and foster care are important ‘solutions’ to identified problems or risks, but potentially they are also contributors to problem behaviours or emotional difficulties. In their problem-solving role, they are seen as potential solutions, not only to actual or future mental health problems of children, but also to the adverse effects of involuntary childlessness. This chapter concentrates on the impact of adoption and foster care on the children placed, but their role in problem solution or problem generation for adults is also touched on. Adoption is more often than not a satisfactory way of meeting the need to become parents for those childless couples who succeed in having a child placed with them (a tiny minority of the involuntary childless). It is very rarely a solution to the problems of a parent who gives up a child for adoption whether voluntarily or involuntarily. Studies of adults who relinquished children indicate that the reaction to the loss of their child may be associated with moderate distress or may lead to a long-term grief reaction, which in turn will potentially harm children subsequently born to that parent. One must also note that some parents who lose a child to adoption or foster care are themselves children, sometimes not yet in their teens, whose needs are often overlooked in the interests of providing for the infant.
Residential care for social reasons
Authors: Hicks Leslie , Sinclair Ian 
Published: January 2013

Abstract
Residential care for the young is an elusive object of study. Provided in the past by establishments as diverse as workhouses, orphanages, and reformatories, it has no clear definition marking its boundaries with foster care or boarding education; at the same time it variously aims to shelter, classify, control, and reform and it has no agreed theory or body of values. The need for residential care, and the difficulties of providing it, vary with time and place; the issues it raises are quite different in Romania than they are in California, or were in Victorian England. Given this diversity, any discussion of residential care needs to outline the context within which it was written. In the case of this chapter the context is provided by current British social policy. Although the focus is on residential care provided to young people by Children's Services in England for social reasons, the conclusions drawn are applicable to the rest of the United Kingdom. The issues raised by this provision have similarities in other parts of the developed world, in virtually all of which the use of residential care is declining. This chapter is written against the background of this decline. Its aims are as follows: ♦ to describe the current characteristics of residential child care in England, and by extension in Great Britain ♦ to outline the problems that have led to its numerical decline ♦ to identify practices that should overcome or reduce these problems ♦ to discuss the role that residential care might play in future.
Syndromes causing intellectual disability
Authors: Clarke David M. , Deb Shoumitro 
Published: January 2013

AbstractPsychiatrists working with people who have intellectual disability (mental retardation) need expertise in the diagnosis and treatment of associated neuropsychiatric disorders. This entails knowledge of the causes of intellectual disability, and especially knowledge about those syndromal (often genetic) causes that are associated with neuropsychiatric manifestations. Such manifestations include vulnerability to behavioural and emotional disorders, epilepsy, and particular patterns of cognitive strength and weakness. This chapter provides an introduction to some such disorders and a discussion of the concept of behavioural phenotypes. For a detailed account of conditions causing intellectual disability texts such as Jones should be consulted. The concept of behavioural phenotypes is discussed in detail in O’Brien. The genetic aetiologies of intellectual disability include chromosomal abnormalities (trisomy, deletion, translocation, etc), single-gene defects, and the effect of interactions between several genes. The last is thought to account for a substantial proportion of people with mild intellectual disability by setting a ceiling on possible cognitive attainment (life experiences, nutrition, education, and other factors then determining the extent to which potential is fulfilled or thwarted). This chapter discusses the concepts of syndromes and behavioural phenotypes, then describes the clinical features of a number of syndromes that cause intellectual disability. Down syndrome, fragile-X syndrome, sex chromosome anomalies, and foetalalcohol syndrome are described in some detail. This is followed by a briefer alphabetical list of less common conditions.
Psychiatric and behaviour disorders among adult persons with intellectual disability
Authors: Došen Anton 
Published: January 2013

AbstractPersons with ID are more prone to psychiatric disorders and behavioural problems than the general population. The symptoms of their biological disorders, developmental processes, and interaction patterns may give atypical clinical pictures, particularly in individuals with moderate and severe ID. It is probable that certain disorders are specifically associated with or even unique to the ID. Traditional nosological classifications do not adequately accommodate the phenomenology of psychiatric disorders in this population. A broader taxonomy, that takes account of the atypical presentation of psychopathology in this population is necessary.
General principles of law relating to people with mental disorder
Authors: Gunn Michael , Wheat Kay 
Published: January 2013

AbstractThis chapter provides a scheme for assisting in the analysis of two areas of law that provide some of the general principles which operate in relation to offenders with mental disorder. These two areas are (a) the law concerning decision-making and other action taking to which the concept of competence is crucial; and (b) the law of responsibility in relation to liability for criminal offences and the tort of negligence. Whilst the focus of the chapter is on the law of England and Wales, it is clear that there are similarities in other common law jurisdictions, and in other jurisdictions that have borrowed ideas from common law jurisdiction, such as Japan, in relation to the concept of informed consent.