People suffering from mental illnesses are among the most vulnerable of our society’s unfortunates. They deserve our support and care. While the clinical care they receive from front-line psychiatrists and other clinicians is generally good in the Western world, better understanding of mental illness is desperately needed. Every year or so sees new diagnoses added to the list of mental disorders, each with cohorts of new patients. Every year or so sees new estimates—ever swelling—of the number of those suffering from mental illness. But does this demonstrate progress? The academics and others who control the psychiatric profession have opted for what they consider an objective approach to comprehending mental illness. Tragically, they have adopted the mantra “Mental Illness is Brain Disease” and have attempted to work with this approach exclusively. Any interest in patients as individual human beings has been put aside; without that connection, we’ve achieved almost no progress in well over a century. According to Dr. Simon A. Brooks, any understanding of what constitutes a mental illness seems to be disappearing. The boundary between “normal” and “pathological” in human behaviour is increasingly blurred. Almost anything can be labelled as a disorder, and psychiatry has no clear idea of which conditions it should be addressing. Even grief can now be stigmatised as depression. Meanwhile the public is sold myths about psychiatry resting upon a secure foundation of neuroscience and that breakthroughs are just around the corner. After a century, how can they still be just around the corner? In this disturbing book, Dr. Brooks analyses the nature and causes of this dangerous divide between practise and reality, using evidence to show why our mental health crisis must be resolved.
With an increasing global ageing population, the psychiatry of old age has become increasingly important. This revised second edition remains a succinct manual on the practice of psychiatry of old age, providing an up-to-date summary of existing knowledge, best practice and future challenges for the specialty, from a global perspective. Written by four leading clinicians, teachers and researchers, the book offers a much-needed international focus and is designed for use in a wide variety of countries and settings. Chapters are presented in a clear and practical way, enhanced by current and comprehensive further reading sections as well as tables and diagrams for quick assimilation and reference. The new edition is updated to incorporate new developments in assessment, investigation, classification, treatment and care since the publication of the first edition, including the ICD-11 and DSM-5. Essential reading for practising psychiatrists and geriatricians, as well as trainees, nurses and medical students.
One in six people in the US are currently taking psychotropic drugs. In 80% of cases, the medication is taken for long-term use and predominantly involves new-generation antidepressants, such as SSRIs (e.g. paroxetine) and SNRIs (e.g. venlafaxine). When patients want to stop taking these drugs and/or their physicians decide it is time for them to stop, substantial problems often can ensue. About 50% of patients experience withdrawal symptoms that do not necessarily subside after a few days or weeks and may be severe and debilitating. Physicians often do not know what to do in these situations. As a result, patients experiencing the anguish and mental pain of withdrawal syndromes are unlikely to receive appropriate medical attention. Discontinuing antidepressants is a highly technical challenge that requires specific strategies. This handbook guides clinicians through each clinical step (assessment; what the counter-indications would be for stopping or continuing; and how discontinuation can best be achieved). It provides a detailed account of the assessment and management strategies, with many case illustrations and clinical examples, drawing from the literature that is available and the extensive personal experience of the author.
In this issue of Psychiatric Clinics, guest editors Drs. Louis J. Marino, Jr. and George Zubenko bring their considerable expertise to the topic of Geriatric Psychiatry. Top experts in the field cover key topics such as insomnia and sleep disorders in older adults; substance use disorders in the elderly; comorbidity and management of concurrent psychiatric and medical disorders; mood disorders in the elderly; cognitive impairment in the elderly; and more. Contains 13 relevant, practice-oriented topics including psychopharmacology in the elderly: why does age matter?; the impact of SARS-CoV-2 infection and pandemic on mental health and brain function in the elderly; COVID-19: brain effects; epidemiology of psychiatric illness in the elderly; and more. Provides in-depth clinical reviews on current topics in geriatric psychiatry, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
Based on years of teaching psychiatry to medical students and residents, this single-authored textbook offers a conversational yet detailed guide to modern psychiatric theory and practice. Exploring various approaches to psychiatric disorders - including neurobiology, dimensional personality assessment, behavioral science, and psychodynamic and cognitive theories - it lucidly illustrates each approach's strengths and weaknesses and suggests how clinicians can interweave them in working with patients. Using clinical vignettes and recent research findings to illustrate the connections between phenomenology, pathophysiology, and treatment, it covers all of the major psychiatric disorders and includes tables listing their DSM-IV-TR diagnostic criteria. The book offers balanced coverage of subjects that receive scant attention in other introductory textbooks, including the limitations of the DSM-IV categorical approach to psychiatric diagnosis, controversies surrounding the dissociative disorders and "recovered memories," and the prescription of stimulant medications to children with suspected attention-deficit hyperactivity disorder. Later chapters provide practical guidelines for estimating a patient's risk of suicide and violence and for assessing competence to consent to medical or psychiatric treatment. In eschewing a dry recitation of clinical syndromes for an engaging discussion aimed at teaching the reader how to "think psychiatrically," the book will appeal to medical students, psychiatric residents, mental health clinicians, and primary care physicians.
The first comprehensive psychiatry review textbook, designed expressly for the Canadian market, Psychiatry Review and Canadian Certification Exam Preparation Guide is the resource residents and psychiatrists need to master the qualifying examinations in psychiatry of the Royal College of Physicians and Surgeons of Canada. These exams are required for certification both for graduating residents and most foreign-trained psychiatrists seeking to practice in Canada. This new volume, based on The American Psychiatric Publishing Board Review Guide for Psychiatry, has been carefully edited to include only material relevant to the Canadian exam. References have been taken from both the U.S. and Canadian psychiatric literature, and laboratory units, medication names and doses, and the language used have been edited to be consistent with Canadian psychiatry. The volume takes the reader from the basic sciences comprising the foundation of psychiatry, through the psychiatric interview and other diagnostic topics, to syndrome-specific chapters paralleling DSM-IV-TR, and finally to current treatment options. Rounding out the review is a 200-question practice exam that reflects the structure of the actual board examinations. Although no substitute for quality medical and residency training, Psychiatry Review and Canadian Certification Exam Preparation Guide will help the prospective exam-taker ameliorate weaknesses and enhance strengths in preparation for a successful exam experience.
Designed to provide both scholar and clinician with the current state of scientific understanding and the practical skills and knowledge base required for dealing with mental disorders in late life. This volume's 54 scholars represent an eclectic mix of distinguished psychiatrists and colleagues from relevant biomedical and behavioral disciplines. Covering both important psychiatric disorders and normal aging changes, all the chapters of this compendium have been scientifically reviewed and updated. Divided into five major parts, the Textbook's topics begin with the basic science of geriatric psychiatry, continue with the diagnostic interview and psychiatric disorders and treatment, and conclude with coverage of legal, ethical, and policy issues and the past and future of geriatric psychatry.
In the course of the study, we have used the methodological approach to the scientific substantiation of the comprehensiveness of expert assessments of the mental state of patients-offenders suffering from cerebral-organic pathology. As a result, we have formulated the following general points: The forensic-psychiatric expert procedure is comprehensive in nature due to the participation of medical doctors, medical psychiatrists, and medical psychologists. Medical-social examination, which is carried out for the purposes of determining the social status of patients (disabled or not disabled) and their need for social protection, is a processthat is comprehensive due to participation of medical doctors, medical clinicians, and medical psychologists. The comprehensiveness of expert assessmentsthe forensic psychiatric and the medical social onesis made more complex due to the comprehensiveness of each one of these expert assessments. The methodological approach to the comprehensiveness of expert assessments is based on taking into account the following three principles: the principle of continuity, the principle of cooperation, and the principle of psychological support for patients-offenders, provided to them over the entire length of their medical-social route.
Revisioning Psychiatry brings together new perspectives on the causes and treatment of mental health problems. The contributors emphasize the importance of understanding experience and explore how the brain, the person, and the social world interact to give rise to mental health problems as well as resilience and recovery.