bluuebunny/crossref_metadata_2025_split huggingface dataset:
Panic disorder and agoraphobia
Authors: Ballenger James C. 
Published: January 2013

AbstractPanic disorder draws its name from the Greek god Pan, god of flocks. Pan was known for suddenly frightening animals and humans ‘out of the blue’. The spontaneous ‘out of the blue’ character of panic attacks is the principal identifying characteristic of panic disorder and central to its recognition and diagnosis. We know the syndrome that we currently call panic disorder with and without agoraphobia has probably existed since the beginning of recorded history. Hippocrates presented cases of obvious phobic avoidance around 400 bc. One of the first modern descriptions was by Benedikt around 1870, describing individuals who developed sudden anxiety and dizziness in public places. Certainly, our current modern ideas of panic disorder evolved essentially simultaneously in the United States and Europe in the early to mid-1960s. Donald Klein in the United States described in 1964 the panic syndrome and reported that it was responsive to imipramine. Isaac Marks in the United Kingdom also described panic attacks and agoraphobic avoidance, and treating the syndrome effectively with behaviour therapy. Until the last several decades, panic disorder and agoraphobia were actually thought to be rare syndromes. It is now clear that individuals with these difficulties are anything but rare. In fact, panic disorder is one of the most common presenting problems in individuals seeking mental health treatment and the fifth most common problem seen in primary care settings. It was thought to be a mild problem, but we now know that it is associated with significant dysfunction. The disability in social, occupational, and family life is in fact comparable to major depression. Although there are differences in the understandings of panic disorder and its treatments across the world, this chapter will review the current understanding about panic disorder, its characteristics, diagnosis, aetiology, and treatments.
The paraphilias
Authors: Fedoroff J. Paul 
Published: January 2013

AbstractThe characteristic essential to all paraphilias is the presence of a persistent and/or recurrent, sexually motivated interest that causes harm. This definition has several implications, discussed in this chapter. Also covered are classification of the paraphilias, diagnosis and differential diagnosis, epidemiology, aetiology and the four major explanatory perspectives that have been identified (disease, behavioural, dimensional, and life story), course and prognosis, and finally treatment and management.
Specific types of personality disorder
Authors: Carrasco José Luis , Lecic-Tosevski Dusica 
Published: January 2013

AbstractThis chapter begins by discussing the epidemiology, aetiology, clinical picture, course, differential diagnosis, and treatment of various Cluster A personality disorders (Paranoid personality disorder, paranoid personality disorder, schizotypal personality disorder), Cluster B personality disorders (antisocial personality disorder, borderline personality disorder (BPD), histrionic personality disorder, narcissistic personality disorder) and Cluster C personality disorders (avoidant personality disorder, dependent personality disorder (JLC), and obsessive–compulsive (anankastic) personality disorder). Other personality disorders (not included in DSM-IV) are also covered, including passive–aggressive (negativistic) personality disorder, self-defeating (masochistic) personality disorder, sadistic personality disorder, depressive personality disorder, and personality changes, including enduring personality changes after traumatic experiences and personality change due to a general medical condition (JLC).
Neuropsychological templates for abnormal personalities: from genes to biodevelopmental pathways
Authors: Tobeña Adolf 
Published: January 2013

AbstractTo give a broad overview of an area that may be crucial to illuminate the genesis of personality disorders, I shall discuss the studies that, during the last decade, have tried to find genetic traces for personality traits that are both behaviourally consistent and biologically well rooted. Previous work using classical (familial or twin) methods had found substantial heritability estimates for several personality traits. It was thus unsurprising that genetic tracking methods impulsed research aimed at showing that temperamental traits contribute to personality scaffolding via neuroendocrine targets specified by particular genes. I’ll be discussing the outcome of some of these efforts and I’ll explore afterwards how other basic temperamental traits, rooted within biodevelopmental processes, do mediate enduring neurocognitive organization resulting in long-lasting behavioural styles. Finally I’ll outline new avenues for the neuropsychology of personality. My approach is deliberately selective, discussing relevant evidence rather than performing a systematic assessment of the field. For reasons of convenience and possible clinical relevance, I have selected some of the traits heralding sound biological foundations, although they are not necessarily prominent in the state-of-the-art dimensional ‘solutions’ for normal and abnormal temperaments.
Special psychiatric problems relating to gambling
Authors: Moran Emanuel 
Published: January 2013

AbstractGambling is an activity with the following elements: A contract between two or more people, which is based on a forecast of the outcome of an uncertain event involving random processes; Property, referred to as the stake, is transferred between those taking part, so that some gain at the expense of others; The property transfer depends on the outcome or result of the uncertain event, which has been forecast; Participation is voluntary and not necessarily related to gaining the property, but used to obtain an experience. This chapter discusses the clinical features, classification, aetiology and epidemiology, diagnosis, predisposing factors, course and prognosis, management and treatment, and prevention.
Treatment of suicide attempters and prevention of suicide and attempted suicide
Authors: Hawton Keith , Taylor Tatiana 
Published: January 2013

AbstractSuicide attempts occur for a wide range of reasons. In many cases the primary aim is not death but some other outcome, such as demonstrating distress to other people, seeking a change in other people’s behaviour or temporary escape. This means that a broad range of treatments are required since the needs of individual patients will vary widely. Treatments for suicide attempters include both psychosocial and pharmacological approaches. While these are considered separately below, in some patients both will be appropriate. This might be the case, for example, if a patient suffers from depression with biological features in the setting of employment and financial difficulties, when treatment with an antidepressant might be combined with problem-solving therapy. Suicide prevention programmes have been established in many countries. This is to be welcomed, not only because of the potential benefits in terms of suicide prevention, but also because of the likely benefits for the broader population of individuals with mental health problems. When considering prevention strategies, it is important to be aware of and sensitive towards issues relating to culture and ethnicity.
Conversion and dissociation disorders
Authors: Bass Christopher 
Published: January 2013

AbstractOf all the disorders characterized by symptoms in the absence of disease, conversion disorders are perhaps the most difficult to explain. How, for example, can one explain functional blindness or a loss of function of both legs in the absence of conspicuous organic disease? The ancient Greeks recognized that if we suffer emotional disturbance as a result of some serious stress (such as personal injury or bereavement), this causes a change in the nervous system which leads in turn to symptoms in different parts of the body according to the underlying pathophysiology. Nineteenth century neurologists made significant advances when they identified specific ideas at the root of the symptoms. In the early nineteenth century Collie also observed that the significance of, and attention to, a symptom or set of symptoms may depend more on what they mean (or their value) to the individual than on the biological underpinnings of the symptom itself. Spence has recently argued that the problem in hysterical motor disorders is not the voluntary motor system per se: rather, it is in the way that the motor system is utilized in the performance (or non-performance) of certain willed, chosen, actions. This model invokes a consciousness that acts upon the body and the world. By contrast, the psychodynamic (‘conversion’) model, which Freud introduced and which held sway for most of the twentieth century, invokes an unconscious mechanism ‘acting’ independently of consciousness, to interfere with voluntary movement. Spence has further argued that hysterical paralyses are maintained not by unconscious mechanisms, but by conscious processes. The maintenance of these symptoms requires the patient's attention, a characteristic of higher motor acts; the paralyses break down when the subject is distracted, consciousness is obtunded, or when it (the ‘paralyses’) is circumvented by reflexive motor routines. Hysterical paralyses, Spence avers, are quintessentially disorders of action (or inactions), which the patient disavows, when faced with some overwhelming situation, which threatens the identity of the self. One regrettable development of psychiatry's adoption of Freudian theory was the fracture in communication between the disciplines of psychiatry and neurology, which has only recently been restored by the sort of collaborative research currently being carried out by neurologists and psychiatrists. In the last decade there have also been exciting advances in neuroimaging, which have stimulated research into the neurophysiology of hysteria, and these will be described later. This chapter will also emphasize contemporary approaches to management of these difficult clinical problems.
Factitious disorder and malingering
Authors: Bass Christopher , Gill David 
Published: January 2013

AbstractPatients with factitious disorder feign or simulate illness, are considered not to be aware of the motives that drive them to carry out this behaviour, and keep their simulation or induction of illness secret. In official psychiatric nomenclature, factitious disorder has replaced the eponym Munchausen syndrome, introduced by Asher to describe patients with chronic factitious behaviour. Asher borrowed the term from Raspe's 1785 fictional German cavalry officer, Baron Karl von Munchausen, who always lied, albeit harmlessly, about his extraordinary military exploits. The criteria for factitious disorder in DSM-IV are (a) the intentional production or feigning of physical or psychological signs or symptoms; (b) motivation to assume the sick role; and (c) lack of external incentives for the behaviour (e.g. economic gain, avoidance of legal responsibility, or improved physical well-being, as in malingering) and lack of a better classification for the disorders. In the last 10 years there has been increased interest in deception in medical practice, with specific focus on pathological lying and the diagnostic dilemmas in this field: specifically, how to differentiate between hysteria, factitious disorders, and malingering. Some of these topics will be discussed in the next section. This chapter concentrates on factitious physical complaints; fabricated psychological symptoms are considered under malingering. The DSM-IV criteria have recently come under attack. Turner has argued that criterion B (motivation to assume the sick role) has no empirical content and fulfils no diagnostic function. He also argues that criterion A, the intentional production of physical or psychological signs or symptoms, emphasizes symptoms and cannot accommodate pseudologia fantastica (PF), voluntary false confessions, and impersonations. He concludes that the two criteria need reformulating in terms of lies and self-harm, respectively. Bass and Halligan have also suggested that because the conceptual justification for factitious disorders is ‘empirically unsubstantiated’ and the motivation for diagnostic purposes (conscious versus unconscious; voluntary versus involuntary) essentially unknowable, it seems reasonable to question the clinical status and legitimacy of factitious disorder. More recently there has been a resurgence of interest in pathological lying, because this is often easier to identify than, for example, the degree of ‘voluntariness’ or ‘motivation’ to attain the sick role (however that is defined).
General principles of drug therapy in psychiatry
Authors: Aronson J. K. 
Published: January 2013

AbstractThe successful use of psychotropic drugs demands an understanding of their pharmaceutical, pharmacokinetic, and pharmacodynamic properties. ♦ Pharmaceutical properties: Pharmaceutical formulations can be manipulated to produce different durations of action, for example the use of oily emulsions of antipsychotic drugs in depot formulations. ♦ Pharmacokinetic properties: Pharmacokinetics is the mathe-matical description of the disposition of drugs in the body by absorption, distribution (to plasma proteins and tissues), and elimination (usually by hepatic metabolism and renal excretion). Differences in drug disposition determine differences in dosage regimens and are important for drug interactions. ♦ Pharmacodynamic properties: Pharmacodynamics is the study of the pharmacological actions of drugs and how actions at the molecular level are translated, via actions at cellular, tissue, and organ levels, into therapeutic or adverse effects. The known pharmacological actions of psychotropic drugs are not necessarily the actions that produce their therapeutic or adverse effects.
Antidepressants
Authors: Bhagwagar Zubin , Heninger George R. 
Published: January 2013

AbstractMajor depressive disorder is a serious, recurrent illness which levies a crippling toll on individuals, families, and society in general. The importance of depression as a major public health problem is emphasized by findings from the World Health Organization Global Burden of Disease survey in showing that in 1990 it was the fourth largest cause of burden of disease (i.e. years of life lost due either to premature mortality or to years lived with a disability). It has been estimated that by the year 2020 it is expected to be the second largest cause of burden of disease. Depression is underdiagnosed and frequently under-treated, and depressed individuals have a much higher risk for suicide. The primary treatment for depression involves the use of antidepressant drugs, and it is therefore important that clinicians become familiar with and adept in utilizing this important group of compounds. Although primarily used for the treatment of depression, drugs within this category also have a number of other important uses. A thorough understanding of the pharmacology of antidepressants will aid the clinician in the selective use of these drugs for patients with depression as well as patients with a number of other disorders.
Antiepileptic drugs
Authors: Brennan Brian P. , Pope Jr. Harrison G. 
Published: January 2013

AbstractSeveral drugs originally developed to treat epilepsy have been found effective in certain psychiatric disorders. This chapter reviews the antiepileptic drugs most extensively studied in psychiatric disorders: valproate, carbamazepine, lamotrigine, and topiramate. We then briefly mention six other antiepileptics currently under investigation in various psychiatric disorders, but not yet extensively studied: gabapentin, oxcarbazepine, levetiracetam, tiagabine, zonisamide, and pregabalin. The antiepileptic drug phenytoin is rarely used in psychiatric disorders, and is therefore not included in this chapter. The benzodiazepines, which have antiepileptic properties, are also omitted here, as they are discussed in Chapter 6.2.2. We briefly list studies documenting the efficacy of these various agents in psychiatric disorders, but the reader is referred to the individual chapters on specific disorders for a more detailed discussion of treatment strategies.
Interpersonal psychotherapy for depression and other disorders
Authors: Blanco Carlos , Markowitz John C. , Weissman Myrna M. 
Published: January 2013

AbstractInterpersonal psychotherapy (IPT) is a time-limited, diagnosis-focused therapy. IPT was defined in a manual. Research has established its efficacy as an acute and chronic treatment for patients with major depressive disorder (MDD) of all ages, as an acute treatment for bulimia nervosa, and as adjunct maintenance treatment for bipolar disorder. The research findings have led to its inclusion in treatment guidelines and increasing dissemination into clinical practice. Demonstration of efficacy in research trials for patients with major depressive episodes (MDEs) has led to its adaptation and testing for other mood and non-mood disorders. This has included modification for adolescent and geriatric depressed patients patients with bipolar and dysthymic disorders; depressed HIV-positive and depressed pregnant and postpartum patients; depressed primary care patients; and as a maintenance treatment to prevent relapse of the depression. Most of the modifications have been relatively minor and have retained the general principles and techniques of IPT for major depression. Non-mood targets have included anorexia, bulimia, substance abuse, borderline personality disorder, and several anxiety disorders. In general, outcome studies of IPT have suggested its promise for most psychiatric diagnoses in which it has been studied, with the exceptions of anorexia, dysthymic disorder, and substance use disorders.IPT has two complementary basic premises. First, depression is a medical illness, which is treatable and not the patient's fault. Second, depression does not occur in a vacuum, but rather is influenced by and itself affects the patient's psychosocial environment. Changes in relationships or other life events may precipitate depressive episodes; conversely, depressive episodes strain relationships and may lead to negative life events. The goal of treatment is to help the patient solve a crisis in his or her role functioning or social environment. Achieving this helps the patient to gain a sense of mastery over his or her functioning and relieves depressive symptoms.Begun as a research intervention, IPT has only lately started to be disseminated among clinicians and in residency training programmes. The publication of efficacy data, the promulgation of practice guidelines that embrace IPT among antidepressant treatments, and economic pressures on length of treatment have led to increasing interest in IPT. This chapter describes the concepts and techniques of IPT and its current status of adaptation, efficacy data, and training. The chapter provides a guide to developments and a reference list, but not a comprehensive review.
Family therapy in the adult psychiatric setting
Authors: Bloch Sidney , Harari Edwin 
Published: January 2013

AbstractThe term ‘family therapy’ covers a range of approaches. At one extreme, it is a method which seeks to help an individual patient. At the other extreme, the focus is on the relationships between people; according to this view psychopathology reflects recurring, problematic interactive patterns among family members. Midway between the two positions is one that views the family as acting potentially either as a resource or a liability for an identified patient. In this chapter, we cover the spectrum but confine ourselves to the adult psychiatric setting.
Psychiatric nursing techniques
Authors: Gournay Kevin 
Published: January 2013

AbstractPsychiatric nursing as an entity has really only evolved since the Second World War. Psychiatric nurses (now often referred to as mental health nurses in the United Kingdom and Australasia) can now be found in most countries of the developed world, although in the developing world, psychiatric nursing is still not defined as a specific discipline. In many countries, psychiatric hospitals are still staffed by untrained ‘Attendants’ who may have some supervision from general trained nurses. Nevertheless, a number of initiatives, notably those of the Geneva Initiative in Psychiatry in Eastern Europe and the former Soviet Union and the World Health Organization in African countries, have provided specific training in psychiatric nursing techniques. The development of psychiatric nursing across the world needs to be seen in the context of changing and evolving patterns of mental health care. De-institutionalization, with the attendant setting up of community mental health teams, has prompted a range of innovations in psychiatric nursing and the psychiatric nurse of today, who in the United States and Europe is likely to be a university graduate, is a very different person to that of the nurse working in the post-Second World War asylums of 40 years ago. In this chapter, we examine the development of psychiatric nursing in some detail and particularly emphasize the role of psychiatric nurses working in the community. Community psychiatric nursing first developed in the United Kingdom nearly 50 years ago and this model has been followed in countries such as Australia and New Zealand. However, this community role has not developed to any great extent in the United States, where the main presence of psychiatric nursing remains in hospital-based care. Furthermore, in the United Kingdom and Australasia, the development of community initiatives has seen the role of the psychiatric nurse blurring with that of other mental health professionals. Chapters such as this cannot really do justice to the whole range of techniques used by psychiatric nurses; neither can it examine in any detail the differences between psychiatric nursing practices across the world. However, a description of psychiatric nursing in six important areas will provide the reader with an appreciation of the range and diversity of psychiatric nursing skills:♦ Inpatient care ♦ Psychosocial interventions in the community ♦ Prescribing and medication management ♦ Cognitive behaviour therapy ♦ Primary care ♦ Psychiatric nursing in the developing world.
Service needs of individuals and populations
Authors: Slade Mike , Tansella Michele , Thornicroft Graham 
Published: January 2013

AbstractIn this chapter we have emphasized that it is of central importance when planning mental health service for populations, to do so on the basis of (i) the occurrence of mental disorders in that particular population, (ii) the impairments caused by these disorders that require interventions, (iii) the nature and level of needs among these people, (iv) identifying from among these needs those which are unmet, and then (v) prioritizing new service development on the basis of these unmet needs, including a range of social supports and services (such as housing or employment opportunities, outside the mental health system), the requirements for enhanced physical/general health care, as well as improvements in the provision of specific mental health services. For all of these sectors there is an increasingly clear call from service user/consumer groups for involvement in these priority-setting planning exercises. At the level of individuals with mental illness, there is a similar trend to increasingly involve service users/consumers in assessing needs, with emerging evidence that this produces a more comprehensive basis for care planning. Indeed in the last decade there has been an important conceptual shift away from the view that professionals defined ‘needs’ while consumers stated ‘demands’, to a better appreciation of the many advantages to be gained from identifying, as far as possible, unmet needs in a joint and consensual way as a basis for action.