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The Medical Basis of Psychiatry

of: S. Hossein Fatemi, Paula J. Clayton

Humana Press, 2008

ISBN: 9781597452526 , 799 Pages

3. Edition

Format: PDF, Read online

Copy protection: DRM

Windows PC,Mac OSX Apple iPad, Android Tablet PC's Read Online for: Windows PC,Mac OSX,Linux

Price: 260,61 EUR



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The Medical Basis of Psychiatry


 

Foreword

7

Preface

9

Acknowledgments

11

Contents

13

Contributors

17

Color Plates

21

Part I Syndromes—Adult

24

The Mental Status Examination

25

1. The Importance of Signs and Symptoms in Psychiatry

26

2. Special Problems in Psychiatric Phenomenology

26

3. Recording Signs and Symptoms in Psychiatry

27

4. Conduct of the Mental Examination

28

5. Areas of the Mental Status

29

6. Common Errors in Mental Status Examination

35

7. Summary: Further Reading

36

Syndromes of Brain Dysfunction Presenting with Cognitive Impairment or Behavioral Disturbance: Delirium, Dementia, and Mental Disorders Caused by a General Medical Condition

39

1. Syndromes of Brain Dysfunction Presenting with Global Cognitive Impairment: Delirium

39

2. Dementia

45

3. Mental Disorders Caused by a General Medical Condition

54

The Amnestic Syndrome

61

1. Introduction

61

2. Anatomy of Memory

62

3. Symptoms of Amnesia

63

4. Amnestic Syndromes

64

5. Etiologies for Amnesia

65

6. Evaluation

66

7. Treatment

66

Bipolar Illness

69

1. Definition

70

2. Etiology

70

3. Epidemiology

75

4. Risk Factors

76

5. Clinical Picture

77

6. Course

79

7. Differential Diagnosis

81

8. Treatment

83

Major Depressive Disorder

95

1. Definition

95

2. Epidemiology

96

3. Clinical Picture

96

4. Depressive Subtypes

97

5. Etiology

97

6. Biological Theories of Depression

97

7. Laboratory Studies

98

8. Presentation of Depression in the Primary Care Setting

98

9. Presentation of Depression in a Mental Health Setting

99

10. Principles of Treatment

99

11. Treatments for Depression

99

12. Summary

103

Schizophrenia

107

1. History

107

2. Current Diagnostic Criteria

107

3. Epidemiology

108

4. Genetics

108

5. Etiology

109

6. Clinical Findings

116

7. Pharmacological Treatments of Schizophrenia

119

8. Antipsychotic-Related Side Effects

122

9. ECT Treatment of Schizophrenia

122

10. Psychosocial Treatment

123

11. Time Course of Schizophrenia

123

12. Prognosis and Course of Illness

123

Schizoaffective and Schizophreniform Disorders

131

1. Definition

131

2. Etiology

131

3. Epidemiology

135

4. Clinical Picture

135

5. Clinical Course

136

6. Differential Diagnosis

140

7. Treatment

140

8. Schizophreniform Disorder

141

Delusional Disorders

147

1. Definition

147

2. Epidemiology

148

3. Etiology and Pathophysiology

148

4. Clinical Picture

149

5. Some Illustrative Cases

150

6. Course

151

7. Differential Diagnosis

151

8. Laboratory Examinations

152

9. Treatment

152

Anxiety Disorders

155

1. Introduction

155

2. Panic Disorder

158

3. Generalized Anxiety Disorder

164

4. Phobic Disorders: Specific and Social Phobia

167

5. ObsessiveÒCompulsive Disorder

171

6. Trauma-Related Disorders: PTSD and Acute Stress Disorder

175

Obsessive–Compulsive Disorder

183

1. Introduction

183

2. Neuroanatomical Features of OCD: The Basal Ganglia

184

3. Neuropsychiatric Disorders Frequently Comorbid with OCD

184

4. Genetics of OCD

184

5. Neuroimaging Studies

186

6. Neuropsychologic Studies

187

7. OCD Induced by Psychological Trauma

187

8. Structural Brain Etiologies of OCD

187

9. Autoimmune Etiologies of OCD

189

10. Medication-Induced OCS

191

11. Medical Consequences of OCD

191

12. Treatment

191

13. Conclusions

194

Somatoform and Dissociative Disorders

203

1. Introduction: The Dualism of Psychogenic Versus Physiological Is False

203

2. Emotional Drives and Emotional Intelligence

205

3. Alexithymia—Deficits in Emotional Intelligence

206

4. Somatization Disorder (Briquet’s Syndrome)

210

5. Undifferentiated Somatoform Disorder

211

6. Conversion Disorders

212

7. Other Somatoform Disorders

213

8. Dissociative Disorders

213

Anorexia Nervosa and Bulimia Nervosa

217

1. Etiology and Pathogenesis

217

2. Comorbidity

221

3. Epidemiology

222

4. Clinical Picture

223

5. Clinical Course

224

6. Medical Findings 7. Differential Diagnosis

225

8. Treatment

227

Antisocial Personality Disorder

235

1. Definition

235

2. Etiology

236

3. Epidemiology

237

4. Clinical Picture

237

5. Pathology

239

6. Clinical Course

241

7. Differential Diagnosis

242

8. Treatment

242

Alcoholism

249

1. Definition

249

2. Epidemiology

250

3. Clinical Picture

253

4. Case History

254

5. Laboratory Findings

254

6. Sensitivity and Specificity of Rating Scales for Detecting Alcohol Dependence and Abuse

255

7. Clinical Course

255

8. Differential Diagnosis

258

9. Etiology

258

10. Treatment

260

11. Concluding Comment

267

Drug Addiction

273

1. Definition

273

2. Etiology and Pathogenesis

274

3. Epidemiology

276

4. Pathology

277

5. Clinical Picture

280

6. Clinical Course

281

7. Laboratory Findings

282

8. Differential Diagnosis

284

9. Treatment

285

Sexual Disorders: Dysfunction, Gender Identity, and Paraphilias

289

1. Introduction

289

2. Sexual Health Defined

289

3. Sexual Dysfunction Disorders ( Table 16.1)

289

4. Gender Identity Disorder

296

5. Paraphilias and Compulsive Sexual Behavior

299

Other Psychiatric Syndromes: Adjustment Disorder, Factitious Disorder, Illicit Steroid Abuse, and Cultural Syndromes

307

1. Adjustment Disorder

307

2. Factitious Disorder

311

3. Illicit Anabolic Steroid Use

314

4. Eponyms and Cultural Syndromes

318

Part II Child Psychiatry

321

Disruptive Behavior Disorders

323

1. Description, Symptoms

323

2. DSM-IV ADHD Criteria

324

3. Epidemiology

326

4. Comorbidity

330

5. Neuropsychology

331

6. Pathophysiology

333

7. Etiology

334

8. Evaluation

338

9. Treatment

339

10. Prevention

344

11. Conduct Disorder

345

12. Summary

347

Mood Disorders in Children and Adolescents

357

1. Diagnosing Mood Disorders in Children and Adolescents

357

2. Etiology, Pathogenesis, and Neurobiological Findings

358

3. Psychological Theories of Mood Disorders

361

4. Epidemiology

361

5. Clinical Presentations and Phenomenology

362

6. Sex Differences in Mood Disorders

362

7. Differential Diagnoses/Comorbidities

362

8. Treatment

363

9. Summary

369

Autistic Disorder

377

1. Introduction

377

2. Diagnostic Criteria, Assessment, and Measures

377

3. Genetics

379

4. Comorbid Medical Disorders and Autism

380

5. Special Sensory Disorders and Autism

381

6. Neuroimaging Findings

381

7. Histopathology

382

8. Immunological Abnormalities

384

9. Electroencephalography

384

10. Epidemiology

384

11. Putative Causes of Increasing Prevalence of Autism

385

12. Treatment

385

Childhood Anxiety Disorders

397

1. Epidemiology

397

2. Etiology

398

3. Separation Anxiety Disorder

399

4. Fears and Specific Phobias

400

5. Social Phobia

401

6. Generalized Anxiety Disorder

402

7. ObsessiveÒCompulsive Disorder

403

8. Panic Disorder

404

9. Treatment

405

Schizophrenia in Children and Adolescents

413

1. Introduction

413

2. Diagnosis

413

3. Epidemiology

414

4. Pathophysiology

415

5. Treatment of Schizophrenia in Children and Adolescents

417

6. Conclusions

419

Part III Symptom Clusters

423

Mood Disturbances

425

1. Affects, Moods, and Their Disorders

425

2. The Depressive Syndrome

426

3. The Distinction Between Grief and Melancholia

430

4. The Distinction Between Anxiety and Depressive States

431

5. The Heterogeneity of Dysthymic Disorders

432

6. The Manic Syndrome

432

7. The Distinction Between Bipolar and Schizophrenic Psychoses

434

8. Hypomania and its Diagnostic Significance

435

9. Mood Disorder in Different Clinical Settings

436

Anxiety Symptoms

441

1. Introduction

441

2. Organic Anxiety Syndromes: Anxiety Syndromes Associated with Medical Conditions

442

3. Treatment

446

4. Alcoholism

447

5. Other Anxiety Syndromes

448

6. Depressive Disorder

450

7. Bipolar Disorder

450

8. Psychoses

450

Addendum

450

Thought Disorder

457

1. Introduction

457

2. Definition

457

3. What are the Boundaries of Thought Disorder?

458

4. What are the Common Types of Thought Disorder?

459

5. Diagnostic and Prognostic Significance of Thought Disorder

462

6. Relationship between Thought Disorders and Other Symptoms of Schizophrenia

463

EditorÌs Comment (From 1994 Edition)

464

Phenomenology of Coarse Brain Disease

467

1. Introduction

467

2. Background

467

3. Traumatic Brain Injury

468

4. Cerebrovascular Accidents

471

5. Coarse Brain Injury Affecting Language Functions

472

6. Dementias

472

7. Blast Injuries

473

8. Summary

473

Catatonia in Psychiatric Illnesses

477

1. Introduction

477

2. Catatonia in DSM

477

3. Differential Diagnosis

479

4. Catatonia as a Syndrome

482

5. LeonhardÌs Psychomotor Psychoses

483

6. GABA Deficit Theory of Catatonia

483

7. Catatonia in Children

484

8. Catatonia in Autism

485

9. Catatonia and Childhood Disintegrative Disorder

486

10. Catatonia in Prader ÒWilli Syndrome

486

11. Evaluation of Catatonia

487

12. Medical Treatment of Catatonia

488

Acknowlegment

489

Personality Disorders

493

1. Introduction: Why are Personality Disorders Important?

493

2. What is Personality?

494

3. What is a Personality Disorder?

494

4. Deconstructing the Components of Personality and its Disorders

495

5. Stages in the Development of Self- Awareness and Well- Being

496

6. Pathophysiology

498

7. Treatment

499

Part IV Special Areas

507

Genetics of Psychiatric Disorders

509

1. Methods in Psychiatric Genetics

509

2. Epigenetics of Psychiatric Disorders

512

3. Mood Disorders

512

4. Alcoholism

515

5. AlzheimerÌs Disease

518

6. Antisocial Personality Disorder

518

7. Anxiety Disorders

519

8. Attention-Deficit Disorder

520

9. Autism (Pervasive Developmental Disorder)

520

10. Drug Abuse

521

11. Eating Disorders

521

12. Mental Retardation

523

13. ObsessiveÒCompulsive Disorder

524

14. Schizophrenia

524

15. Somatization Disorder

528

16. TouretteÌs Syndrome

528

17. Genetic Counseling

529

Novel Mechanisms of Drug Treatment in Psychiatry

541

1. Introduction

541

2. Depression

541

3. Bipolar Disorder

547

4. Anxiety

548

5. Obsessive–Compulsive Disorder

550

6. Schizophrenia

550

7. Future Directions

552

Use of Laboratory Assessments in Psychiatry

557

1. Use of Laboratory in Psychiatry

557

2. Laboratory Use to Establish the Diagnosis

558

3. Minimum Laboratory Tests Needed to Establish General Health

558

4. Additional Tests Needed to Assess Comorbid Medical Conditions

559

5. Special Cases with Specific Laboratory Assessments

560

6. Neuroimaging

561

7. Laboratory Use to Monitor Treatment Adequacy and Safety of Antidepressant and Antipsychotic Drugs

562

Epidemiology of Psychiatric Illness

569

1. Applications of Epidemiology

569

2. Key Terms and Methodologic Issues in Psychiatric Epidemiology

570

3. Descriptive Epidemiology: Prevalence Studies

573

4. Descriptive Epidemiology: Incidence Studies

576

5. Comorbidity

576

6. Use of Mental Health Services

577

7. Etiology of Psychiatric Disorders

577

Suicide and Attempted Suicide

583

1. Suicide and Attempted Suicide

583

2. Neurobiology of Suicidal Behavior

584

3. Heritability of Suicidal Behavior

585

4. Risk Factors for Suicidal Behavior

586

5. Prevention and Treatment

590

Clinical Psychopharmacology and Other Somatic Therapies

599

1. Schizophrenia and Other Psychoses

599

2. Depression

614

3. Mania

626

4. Anxiety Disorders

635

5. ObsessiveÒCompulsive Disorder

640

6. Dementia

641

7. Anti-Aggression

642

8. Hypnotics

642

Cognitive and Behavioral Therapies

657

1. Cognitive Model

657

2. Efficacy of CBT

662

3. Conclusion

666

Forensic Psychiatry

673

1. Overview

673

2. Assessment of Malingering

673

3. Assessment of Dangerousness

674

4. Competency

676

5. Criminal Responsibility (Insanity)

677

6. Medical Malpractice

677

7. The Psychiatrist as Expert Witness

678

8. Summary

679

Sleep Disorders

683

1. Introduction

683

2. Basic SleepÒWake Regulation

685

3. Insomnia

686

4. Movement Disorder: Restless Legs Syndrome

691

5. Obstructive Sleep Apnea

693

6. Hypersomnia

697

7. Parasomnias

700

Neuroimaging in Psychiatry

717

1. Introduction

717

2. X-Ray Transmission CT

725

3. Magnetic Resonance Imaging

726

4. Introduction to Molecular Imaging

731

Electroconvulsive Therapy: Indications, Use, and Adverse Effects

747

1. Introduction

747

2. Indications

748

3. Pre-ECT Evaluation

748

4. Concurrent Use of ECT and Psychotropic Medications

748

5. Method of ECT Administration

749

6. Number of Treatments

749

7. Adverse Reactions

749

8. Poor Treatment Response to ECT

750

9. Post-ECT Pharmacological Management

750

10. Continuation of ECT After Index Treatment

750

11. Maintenance of ECT

750

Profiles in the History of Neuroscience and Psychiatry

753

Normal Laboratory Values and Drug Therapeutic and Toxic Ranges

775

Index

785