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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
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