The Medical Basis of Psychiatry

Foreword

Preface

Acknowledgments

Contents

Contributors

Color Plates

Part I Syndromes—Adult

The Mental Status Examination

1. The Importance of Signs and Symptoms in Psychiatry

2. Special Problems in Psychiatric Phenomenology

3. Recording Signs and Symptoms in Psychiatry

4. Conduct of the Mental Examination

5. Areas of the Mental Status

6. Common Errors in Mental Status Examination

7. Summary: Further Reading

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

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

2. Dementia

3. Mental Disorders Caused by a General Medical Condition

The Amnestic Syndrome

1. Introduction

2. Anatomy of Memory

3. Symptoms of Amnesia

4. Amnestic Syndromes

5. Etiologies for Amnesia

6. Evaluation

7. Treatment

Bipolar Illness

1. Definition

2. Etiology

3. Epidemiology

4. Risk Factors

5. Clinical Picture

6. Course

7. Differential Diagnosis

8. Treatment

Major Depressive Disorder

1. Definition

2. Epidemiology

3. Clinical Picture

4. Depressive Subtypes

5. Etiology

6. Biological Theories of Depression

7. Laboratory Studies

8. Presentation of Depression in the Primary Care Setting

9. Presentation of Depression in a Mental Health Setting

10. Principles of Treatment

11. Treatments for Depression

12. Summary

Schizophrenia

1. History

2. Current Diagnostic Criteria

3. Epidemiology

4. Genetics

5. Etiology

6. Clinical Findings

7. Pharmacological Treatments of Schizophrenia

8. Antipsychotic-Related Side Effects

9. ECT Treatment of Schizophrenia

10. Psychosocial Treatment

11. Time Course of Schizophrenia

12. Prognosis and Course of Illness

Schizoaffective and Schizophreniform Disorders

1. Definition

2. Etiology

3. Epidemiology

4. Clinical Picture

5. Clinical Course

6. Differential Diagnosis

7. Treatment

8. Schizophreniform Disorder

Delusional Disorders

1. Definition

2. Epidemiology

3. Etiology and Pathophysiology

4. Clinical Picture

5. Some Illustrative Cases

6. Course

7. Differential Diagnosis

8. Laboratory Examinations

9. Treatment

Anxiety Disorders

1. Introduction

2. Panic Disorder

3. Generalized Anxiety Disorder

4. Phobic Disorders: Specific and Social Phobia

5. ObsessiveÒCompulsive Disorder

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

Obsessive–Compulsive Disorder

1. Introduction

2. Neuroanatomical Features of OCD: The Basal Ganglia

3. Neuropsychiatric Disorders Frequently Comorbid with OCD

4. Genetics of OCD

5. Neuroimaging Studies

6. Neuropsychologic Studies

7. OCD Induced by Psychological Trauma

8. Structural Brain Etiologies of OCD

9. Autoimmune Etiologies of OCD

10. Medication-Induced OCS

11. Medical Consequences of OCD

12. Treatment

13. Conclusions

Somatoform and Dissociative Disorders

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

2. Emotional Drives and Emotional Intelligence

3. Alexithymia—Deficits in Emotional Intelligence

4. Somatization Disorder (Briquet’s Syndrome)

5. Undifferentiated Somatoform Disorder

6. Conversion Disorders

7. Other Somatoform Disorders

8. Dissociative Disorders

Anorexia Nervosa and Bulimia Nervosa

1. Etiology and Pathogenesis

2. Comorbidity

3. Epidemiology

4. Clinical Picture

5. Clinical Course

6. Medical Findings 7. Differential Diagnosis

8. Treatment

Antisocial Personality Disorder

1. Definition

2. Etiology

3. Epidemiology

4. Clinical Picture

5. Pathology

6. Clinical Course

7. Differential Diagnosis

8. Treatment

Alcoholism

1. Definition

2. Epidemiology

3. Clinical Picture

4. Case History

5. Laboratory Findings

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

7. Clinical Course

8. Differential Diagnosis

9. Etiology

10. Treatment

11. Concluding Comment

Drug Addiction

1. Definition

2. Etiology and Pathogenesis

3. Epidemiology

4. Pathology

5. Clinical Picture

6. Clinical Course

7. Laboratory Findings

8. Differential Diagnosis

9. Treatment

Sexual Disorders: Dysfunction, Gender Identity, and Paraphilias

1. Introduction

2. Sexual Health Defined

3. Sexual Dysfunction Disorders ( Table 16.1)

4. Gender Identity Disorder

5. Paraphilias and Compulsive Sexual Behavior

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

1. Adjustment Disorder

2. Factitious Disorder

3. Illicit Anabolic Steroid Use

4. Eponyms and Cultural Syndromes

Part II Child Psychiatry

Disruptive Behavior Disorders

1. Description, Symptoms

2. DSM-IV ADHD Criteria

3. Epidemiology

4. Comorbidity

5. Neuropsychology

6. Pathophysiology

7. Etiology

8. Evaluation

9. Treatment

10. Prevention

11. Conduct Disorder

12. Summary

Mood Disorders in Children and Adolescents

1. Diagnosing Mood Disorders in Children and Adolescents

2. Etiology, Pathogenesis, and Neurobiological Findings

3. Psychological Theories of Mood Disorders

4. Epidemiology

5. Clinical Presentations and Phenomenology

6. Sex Differences in Mood Disorders

7. Differential Diagnoses/Comorbidities

8. Treatment

9. Summary

Autistic Disorder

1. Introduction

2. Diagnostic Criteria, Assessment, and Measures

3. Genetics

4. Comorbid Medical Disorders and Autism

5. Special Sensory Disorders and Autism

6. Neuroimaging Findings

7. Histopathology

8. Immunological Abnormalities

9. Electroencephalography

10. Epidemiology

11. Putative Causes of Increasing Prevalence of Autism

12. Treatment

Childhood Anxiety Disorders

1. Epidemiology

2. Etiology

3. Separation Anxiety Disorder

4. Fears and Specific Phobias

5. Social Phobia

6. Generalized Anxiety Disorder

7. ObsessiveÒCompulsive Disorder

8. Panic Disorder

9. Treatment

Schizophrenia in Children and Adolescents

1. Introduction

2. Diagnosis

3. Epidemiology

4. Pathophysiology

5. Treatment of Schizophrenia in Children and Adolescents

6. Conclusions

Part III Symptom Clusters

Mood Disturbances

1. Affects, Moods, and Their Disorders

2. The Depressive Syndrome

3. The Distinction Between Grief and Melancholia

4. The Distinction Between Anxiety and Depressive States

5. The Heterogeneity of Dysthymic Disorders

6. The Manic Syndrome

7. The Distinction Between Bipolar and Schizophrenic Psychoses

8. Hypomania and its Diagnostic Significance

9. Mood Disorder in Different Clinical Settings

Anxiety Symptoms

1. Introduction

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

3. Treatment

4. Alcoholism

5. Other Anxiety Syndromes

6. Depressive Disorder

7. Bipolar Disorder

8. Psychoses

Addendum

Thought Disorder

1. Introduction

2. Definition

3. What are the Boundaries of Thought Disorder?

4. What are the Common Types of Thought Disorder?

5. Diagnostic and Prognostic Significance of Thought Disorder

6. Relationship between Thought Disorders and Other Symptoms of Schizophrenia

EditorÌs Comment (From 1994 Edition)

Phenomenology of Coarse Brain Disease

1. Introduction

2. Background

3. Traumatic Brain Injury

4. Cerebrovascular Accidents

5. Coarse Brain Injury Affecting Language Functions

6. Dementias

7. Blast Injuries

8. Summary

Catatonia in Psychiatric Illnesses

1. Introduction

2. Catatonia in DSM

3. Differential Diagnosis

4. Catatonia as a Syndrome

5. LeonhardÌs Psychomotor Psychoses

6. GABA Deficit Theory of Catatonia

7. Catatonia in Children

8. Catatonia in Autism

9. Catatonia and Childhood Disintegrative Disorder

10. Catatonia in Prader ÒWilli Syndrome

11. Evaluation of Catatonia

12. Medical Treatment of Catatonia

Acknowlegment

Personality Disorders

1. Introduction: Why are Personality Disorders Important?

2. What is Personality?

3. What is a Personality Disorder?

4. Deconstructing the Components of Personality and its Disorders

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

6. Pathophysiology

7. Treatment

Part IV Special Areas

Genetics of Psychiatric Disorders

1. Methods in Psychiatric Genetics

2. Epigenetics of Psychiatric Disorders

3. Mood Disorders

4. Alcoholism

5. AlzheimerÌs Disease

6. Antisocial Personality Disorder

7. Anxiety Disorders

8. Attention-Deficit Disorder

9. Autism (Pervasive Developmental Disorder)

10. Drug Abuse

11. Eating Disorders

12. Mental Retardation

13. ObsessiveÒCompulsive Disorder

14. Schizophrenia

15. Somatization Disorder

16. TouretteÌs Syndrome

17. Genetic Counseling

Novel Mechanisms of Drug Treatment in Psychiatry

1. Introduction

2. Depression

3. Bipolar Disorder

4. Anxiety

5. Obsessive–Compulsive Disorder

6. Schizophrenia

7. Future Directions

Use of Laboratory Assessments in Psychiatry

1. Use of Laboratory in Psychiatry

2. Laboratory Use to Establish the Diagnosis

3. Minimum Laboratory Tests Needed to Establish General Health

4. Additional Tests Needed to Assess Comorbid Medical Conditions

5. Special Cases with Specific Laboratory Assessments

6. Neuroimaging

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

Epidemiology of Psychiatric Illness

1. Applications of Epidemiology

2. Key Terms and Methodologic Issues in Psychiatric Epidemiology

3. Descriptive Epidemiology: Prevalence Studies

4. Descriptive Epidemiology: Incidence Studies

5. Comorbidity

6. Use of Mental Health Services

7. Etiology of Psychiatric Disorders

Suicide and Attempted Suicide

1. Suicide and Attempted Suicide

2. Neurobiology of Suicidal Behavior

3. Heritability of Suicidal Behavior

4. Risk Factors for Suicidal Behavior

5. Prevention and Treatment

Clinical Psychopharmacology and Other Somatic Therapies

1. Schizophrenia and Other Psychoses

2. Depression

3. Mania

4. Anxiety Disorders

5. ObsessiveÒCompulsive Disorder

6. Dementia

7. Anti-Aggression

8. Hypnotics

Cognitive and Behavioral Therapies

1. Cognitive Model

2. Efficacy of CBT

3. Conclusion

Forensic Psychiatry

1. Overview

2. Assessment of Malingering

3. Assessment of Dangerousness

4. Competency

5. Criminal Responsibility (Insanity)

6. Medical Malpractice

7. The Psychiatrist as Expert Witness

8. Summary

Sleep Disorders

1. Introduction

2. Basic SleepÒWake Regulation

3. Insomnia

4. Movement Disorder: Restless Legs Syndrome

5. Obstructive Sleep Apnea

6. Hypersomnia

7. Parasomnias

Neuroimaging in Psychiatry

1. Introduction

2. X-Ray Transmission CT

3. Magnetic Resonance Imaging

4. Introduction to Molecular Imaging

Electroconvulsive Therapy: Indications, Use, and Adverse Effects

1. Introduction

2. Indications

3. Pre-ECT Evaluation

4. Concurrent Use of ECT and Psychotropic Medications

5. Method of ECT Administration

6. Number of Treatments

7. Adverse Reactions

8. Poor Treatment Response to ECT

9. Post-ECT Pharmacological Management

10. Continuation of ECT After Index Treatment

11. Maintenance of ECT

Profiles in the History of Neuroscience and Psychiatry

Normal Laboratory Values and Drug Therapeutic and Toxic Ranges

Index