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Successful management of patients with treatment-resistant depression is going to require a thorough understanding of the biological basis for both the depression and its failure to respond to standard treatments. This book clearly and succinctly summarizes the latest scientific research and its applications in clinical practice. A first step is a clear definition of what constitutes treatment-resistant depression so that clinical trials and other studies are using common criteria, enabling comparison and meta-analysis of their outcomes. The opening chapter reviews definitions and predictors of originating from different fields and discusses their usefulness in clinical practice and clinical research. The next chapter proposes a new definition, adapting terminology from medicine. Biological classification requires identification of genetic risk factors: with gene variants accounting for 50% of the variance in the clinical outcomes of antidepressant treatments this is clearly a fruitful area of research. Chapter 3 describes several genes already associated with treatment-resistant depression and, while further work is needed to translate findings into clinical recommendations, predicts that genetic prediction of TRD could became a widespread clinical reality within a few years. Most patients with TRD will be treated pharmacologically and three chapters review the latest evidence for pharmacological best practice, including switching strategies for antidepressants, the role of antipsychotics and augmentation strategies to complement lithium. There are two major alternatives to pharmacotherapy: neuromodulation and psychotherapy. The brain intervention chapter summarizes clinical research and experience with electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, deep brain stimulation and magnetic seizure therapy. The final chapter reviews the literature pertaining to the effectiveness of various forms of psychotherapy in patients who have not responded to antidepressant pharmacotherapy, revealing that patients who have not responded to one or two trials of antidepressant medication have a 30%-50% chance of responding to a focused psychotherapy. It proposes indications for psychotherapy in TRD and summarizes general therapeutic principles.

Making a psychiatric diagnosis in children can be challenging: some clinicians say the incidence of some childhood disorders, such as bipolar disorder and ADHD, is over-diagnosed while others saying they are undiagnosed, undertreated, and are a large burden on society. The drug treatment of child psychiatric disorders can also be controversial in children and adolescents. This book fulfills the need for an objective, clinically relevant source to dispel this confusion. Clinical Child Psychiatry is a textbook of current clinical practice in child and adolescent psychiatry. It is designed as a reference for clinicians that is both easily usable and authoritative, a “chairside” reference for the consultation room. This book addresses a defined series of clinical entities that represent the bulk of current treatment modalities and disorders encountered in 21st century practice. It is authoritative in the areas addressed while at the same time being rapidly accessible in format. To facilitate access, it presents disorders in declining order of frequency. The authors believe that worthwhile clinical work must be informed by both evidence-based practice and by psychiatry’s traditional attention to internal and interpersonal dynamics. They are committed to an approach that is broadly biopsychosocial while based on current clinical evidence for a pragmatic, clinical focus. The book is divided into four sections. The first, Fundamentals of Child and Adolescent Psychiatric Practice, addresses assessment, treatment modalities, and planning. Common Child and Adolescent Psychiatric Disorders and Developmental Disorders cover the diagnosis and treatment of the large majority of disease entities encountered in practice. The final section, Special Problems in Child and Adolescent Psychiatry, includes a variety of topics such as foster care and adoption, loss and grief, and forensics. The book also includes: New evidence relating to the areas of depression, psychosis, trauma. New insights from genetics, genomics, and proteomics cleverly integrated into chapters on the individual disease with focus on their clinical application. New chapter on consultation and collaboration within systems of care The book addresses a need for clinicians, many of whom are beginners, non-psychiatrists, or psychiatrists entering unfamiliar territory, to come up to speed rapidly in providing more than perfunctory service to needy populations. This challenge grows ever greater. The book has a companion website with questions to facilitate learning.

As neuroimaging becomes more widespread, it is increasingly being used in the courts, even though understanding and interpreting neuroimaging methods and results can be very challenging – even without attempting to evaluate their potential applications to forensic questions. The sheer volume of available information, research results, and opinions can seem intimidating to forensic practitioners and to mental health professionals in general. This will be the first book dedicated to this important topic. Designed as a reference for forensic psychiatrists, it starts with a brief overview of the psychiatric applications of the primary neuroimaging techniques currently in most widespread use, positron emission tomography (PET), single-photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI). Subsequent chapters explore the current and potential uses of neuroimaging in civil and criminal forensic contexts. Diagnostic categories addressed include traumatic brain injury, dementia, psychopathy, paraphilias, psychoses and mood disorders. Legal concepts such as admissibility, relevance, and standards of proof are reviewed as they relate to the possible uses of neuroimaging findings in legal proceedings; prior precedents and court decisions are also reviewed. Novel potential applications of neuroimaging, including detection of deception and identification of memory or recognition, are addressed in dedicated chapters. There is a growing body of writing on the ethical implications of neuroimaging in the legal context, but this has largely been in bioethics journals that have limited readership among members of the mental health profession. Ethical questions generated by the rapidly evolving field of forensic neuroimaging are explored in detail in a dedicated chapter. This book will be of great use to practicing forensic psychiatrists, forensic psychologists and forensic neurologists as they are increasingly likely to find themselves being asked to give professional opinions regarding the impact of neuroimaging findings on medicolegal questions such as competence, criminal responsibility, personal injury and disability. The book will be an invaluable resource for forensic practitioners seeking to understand and navigate this new area.

Troublesome Disguises examines psychiatric conditions which are not necessarily uncommon, rare or exotic but are challenging for the clinician who may struggle to reach a diagnosis and to set up management strategies. However, with familiarity, these conditions can and should be recognised. This new edition is an exercise in consciousness-raising as well as a warning to beware of diagnostic systems which, despite their many virtues, may become too influential and may perpetuate errors which are to the detriment of patients. For the clinician struggling to understand and treat patients who fail to fit the usual diagnostic categories, Troublesome Disguises provides wise instruction in the virtue of entertaining doubts, as well as practical advice for the assessment and management of atypical cases.

Neuroimaging in Addiction presents an up-to-date, comprehensive review of the functional and structural imaging human studies that have greatly advanced our understanding of this complex disorder. Approaching addiction from a conceptual rather than a substance-specific perspective, this book integrates broad neuropsychological constructs that consider addiction as a neuroplastic process with genetic, developmental, and substance-induced contributions. The internationally recognized contributors to this volume are leaders in clinical imaging with expertise that spans the addiction spectrum. Following a general introduction, an overview of neural circuitry and modern non-invasive imaging techniques provides the framework for subsequent chapters on reward salience, craving, stress, impulsivity and cognition. Additional topics include the use of neuroimaging for the assessment of acute drug effects, drug-induced neurotoxicity, non-substance addictive behaviors, and the application of imaging genetics to identify unique intermediate phenotypes. The book concludes with an exploration of the future promise for functional imaging as guide to the diagnosis and treatment of addictive disorders. Scientists and clinicians will find the material in this volume invaluable in their work towards understanding the addicted brain, with the overall goal of improved prevention and treatment outcomes for patients. Features a Foreword by Edythe London, Director of the Center for Addictive Behaviors, University of California at Los Angeles.

The renowned Principles and Practice of Geriatric Psychiatry, now in its third edition, addresses the social and biological concepts of geriatric mental health from an international perspective. Featuring contributions by distinguished authors from around the world, the book offers a distinctive angle on issues in this continually developing discipline. Principles and Practice of Geriatric Psychiatry provides a comprehensive review of: geriatric psychiatry spanning both psychiatric and non-psychiatric disorders scientific advances in service development specific clinical dilemmas New chapters on: genetics of aging somatoform disorders epidemiology of substance abuse somatoform disorders care of the dying patient Continuing the practice of earlier editions, the major sections of the book address aging, diagnosis and assessment and clinical conditions, incorporating an engaging discussion on substance abuse and schizophrenic disorders. Shorter sections include the presentation of mental illness in elderly people from different cultures—one of the most popular sections in previous editions. Learning and behavioural studies, as well as models of geriatric psychiatry practice, are covered extensively. This book provides a detailed overview of the entire range of mental illness in old age, presented within an accessible format. Principles and Practice of Geriatric Psychiatry is an essential read for psychiatrists, geriatricians, neurologists and psychologists. It is of particular use for instructors of general psychiatry programs and their residents.

Handbook for the Assessment of Children’s Behaviours with Wiley Desktop Edition This ground-breaking book takes a new approach to the assessment of behaviour in children and adolescents. Written by an expert author team, combining one (Jonathan Williams) with higher qualifications in general practice, child neuropsychiatry, and child and adolescent psychiatry, with one (Peter Hill) with higher qualifications in medicine, paediatrics and child and adolescent psychiatry, the book draws on many thousands of multidisciplinary case discussions, at Great Ormond Street Hospital, in the Children’s Multispecialty Assessment Clinic in North London, and in private practice. The book is ideal for the busy mental health professional working in a small team. Organised to allow rapid look-up of behaviours with comprehensive lists of their possible causes, it synthesizes research evidence and clinical experience. The authors interpret behaviour broadly, including not just voluntary actions, but also actions whose voluntary nature is questionable (such as drop attacks, personal preferences, and pseudobehaviours). They also include problems that lead to referral through their behavioural manifestations (e.g. aggression, anxiety, or a poor relationship with mother). Overall, the book spans the behavioural, cognitive, social and emotional problems of children and adolescents. With the child and family in the room, and with detailed school reports and psychometric results available, it is usually possible to identify causes of symptoms that are specific to the child and his environment, and which can guide behavioural, cognitive, social, and family interventions. Purchasers of the book will also be entitled to a Wiley Desktop Edition—an interactive digital version featuring downloadable text and images, highlighting and note taking facilities, in-text searching, and linking to references and glossary terms.

This book is very different from any medical textbook you've ever read… its greatest merit is to have single-handedly transformed the perception of psychiatry from that of Cinderella speciality to that of hottest speciality on offer. Following in the footsteps of the groundbreaking first edition, this second edition of Psychiatry is a comprehensive textbook of mental health that brings its subject alive with numerous case studies, images and photographs, and short references from the arts, history, and philosophy. These not only facilitate learning and memorisation, but also highlight the subjective experience of mental illness, and stimulate thought into the nature of the human experience. Based on extensive feedback from students and lecturers, this second edition places greater emphasis on psychological treatments, clinical skills, and exam success, and integrates more than 350 self-assessment questions. Other important features include: A clear and attractive layout with colour coding and colour images and photographs Learning objectives, boxed summaries, and self-assessment questions in every chapter Step-by-step coverage of the psychiatric history, mental state examination, and formulation, with an integrated account of the signs and symptoms of mental disorders and a model case history Clinical skills/OSCE boxes on competencies such as enquiring about delusions and hallucinations, assessing suicidal risk, and assessing capacity Greater coverage of psychiatric subspecialties An expanded chapter on the history of psychiatry with introductions to Freud and Jung Psychiatry is the perfect textbook for medical students, junior doctors, GPs, and all healthcare professionals needing a thorough account of mental disorders.

Since 1960, the burden of adolescent illness has shifted from the traditional causes of disease to the more behavior-related problems, such as drinking, smoking and drug abuse (nearly half of American adolescents have used an illicit drug sometime during their life). Instilling in adolescents the knowledge, skills, and values that foster physical and mental health will require substantial changes in the way health professionals work and the way they connect with families, schools, and community organizations. At the same time, the major textbooks on addiction medicine and addiction psychiatry devote relatively little attention to the special problems of diagnosing and treating adolescent addicts. Similarly, the major textbooks on general and child and adolescent psychiatry direct relatively little attention to the issues surrounding adolescent addiction. The Clinical Handbook of Adolescent Addiction is one response to the challenge of meeting the mental health needs and behavior-related problems of addicted teenagers. The work has been edited as an independent project by members of the American Society for Adolescent Psychiatry, the oldest professional organization of psychiatrists devoted solely to the mental health care and treatment of teenagers in the USA. The forensic psychiatry perspective permeates the entire book. It will help to produce health providers with a deep and sensitive understanding of the developmental needs and behavior-related problems of adolescents. The Clinical Handbook of Adolescent Addiction is a practical tool for all those who help adolescents: practitioners of family medicine, general psychiatrists, child/adolescent psychiatrists, adolescent psychiatrists, addiction psychiatrists, non-psychiatric physicians specializing in addiction medicine, forensic psychiatrists, psychologists, clinical social workers, mental health administrators, Court/Probation/ Parole/Correctional health workers. The book is organized in a user-friendly format so that readers can easily locate the chapters that provide the information that is required. In some instances, topics of special importance deliberately have been addressed in more than one chapter, to illuminate the topics from a variety of vantage points. One aim of the editors is to move the topic from being a specialist area to a generalist one by providing tools for generalist to use.

The work of French Philosopher Luce Irigaray has exerted a profound influence on feminist thinking of recent decades and provides a far-reaching challenge to western philosophy's entrenched patriarchal norms. This book guides the reader through Irigaray's critical and creative transformation of western thought. Through detailed analysis of her most important text, Speculum of the Other Woman, Rachel Jones carefully examines Irigaray's transformative readings of such icons of the western tradition as Plato, Descartes, Kant and Hegel. She shows that these readings underpin Irigaray's claim that western philosophy has been dependent on the forgetting of both sexual difference and of our singular beginnings in birth. In response, Irigaray seeks to recover a positive account of sexual difference which would release woman from her traditional position as the 'other' of the subject and allow her to speak as a subject in her own right. In a sensitive reading of Irigaray's work, Jones shows why this distinctively feminist project necessarily involves the transformation of the fundamental terms of western metaphysics. By foregrounding Irigaray's approach to questions of otherness and alterity, she concludes that, for Irigaray, cultivating an ethics of sexuate difference is the condition of ethical relations in general. Lucidly and persuasively written, this book will be an invaluable resource for students and scholars seeking to understand Irigaray's original contribution to philosophical and feminist thought.