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The widespread use of nonconventional treatments, or complementary and alternative medicine (CAM), and the increasing evidence supporting their therapeutic benefits call for a concerted scientific effort to integrate treatments that work into mainstream medicines.Answering that call is the groundbreaking Complementary and Alternative Treatments in Mental Health Care, a concise, practical reference that reviews the many CAM approaches used in North America and Europe to treat – or self-treat – mental health problems, and the history and rationale for a variety of CAM treatments, including the risks and benefits of their integration into mainstream mental health care. Two dozen contributors with both conventional and nonconventional expertise present current information about safe, effective mental health treatments – including herbals and other natural products, stress management, homeopathy, Ayurveda, and traditional Chinese medicine – that have not yet been fully examined or endorsed by the institutions of conventional biomedicine. This book: Covers background issues, including conceptual and historical foundations, emerging ideas and trends, safety issues, potential drug interactions and adverse effects, and medical-legal issues pertaining to use of nonconventional treatments in mental health care. Reviews the evidence and offers practical clinical guidelines for the most widely used nonconventional treatments. Twelve chapters cover specific nonconventional modalities or alternative professional systems of medicine currently used to treat mental illness, addressing historical uses of the specified modality, significant recent research findings, unresolved safety issues, and evidence supporting use of the specified approach in common psychiatric disorders, from major depressive and bipolar disorder, schizophrenia, and generalized anxiety disorder to obsessive-compulsive disorder, dementia, and sleep and substance abuse disorders. Practical clinical applications of complementary and alternative approaches are discussed throughout the book. Closes with three appendixes and a subject and author index. Appendix A ranks evidence for the various treatment modalities by major psychiatric disorder and is cross-referenced with the material in Part II. Appendix B lists important Web sites, textbooks, professional associations, and other resources. Appendix C contains a glossary of key terms used in complementary and alternative medicine. Written for both conventionally and nonconventionally trained mental health care professionals, Complementary and Alternative Treatments in Mental Health Care provides both an ideal reference for clinicians whose patients inquire about the uses of many CAM therapies and a critical, balanced review of the nonconventional modalities most widely used in Western countries to treat mental or emotional problems.

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Patients with mental and substance use disorders have shown higher rates of morbidity and mortality from medical illnesses than the general population, and physicians are also increasingly aware of adverse effects of psychiatric medications on metabolic and cardiovascular health. In light of these problems, this book addresses an important unmet need of patients with mental disorders – namely, the lack of integration of general medical care with psychiatric care and the related problem of barriers to collaboration and communication among health care providers. Managing Metabolic Abnormalities in the Psychiatrically Ill is the first book to provide a current review of the relationships among psychiatric illnesses, metabolic abnormalities, and treatment, focusing on how clinicians can tailor care to those doubly-afflicted patients. The book integrates research findings into practical clinical guidelines that spell out what psychiatrists need to know when their patients with mental illness suffer from – or are at risk of developing – obesity, diabetes, cardiovascular disease, or the metabolic syndrome. The contributors address those risks that need to be considered in the overall context of treatment, background risks of medical illnesses associated with specific psychiatric disorders themselves, and the means of applying these data to treatment recommendations, monitoring, and clinical practice. Among the specific topics addressed are: Potential effects of psychotropics on appetite, body weight, and metabolic parameters in obese patients, and the potential effects of anti-obesity agents on psychotic, manic, and depressive syndromes Increased risk of type 2 diabetes among individuals with psychotic and mood disorders due to neurobiological changes and behavioral effects associated with these disorders Greater risk for cardiovascular disease among the mentally ill, stressing the importance of mental health providers understanding cardiovascular risk classification and modification strategies An association between dysregulation of glucose and lipid metabolism and the related risk of type 2 diabetes during treatment with any of the eight second-generation antipsychotics currently available in the United States Guidance in choice of medications and appropriate monitoring strategies for hyperlipidemia, along with recognition of which antipsychotics pose the greatest risk and an understanding of the common dyslipidemia patterns seen with their use Chapters include key clinical concepts, quick-reference tables, and extensive references, and a final chapter provides an assessment tool for evaluating patients' metabolic risk. Together, the chapters in this book constitute an authoritative clinical guide that enables psychiatrists to better integrate the treatment of patients' mental disorders with their metabolic conditions.

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As understanding evolves about how different brain regions are involved in carrying out everyday tasks – and in causing brain diseases when they go awry – this book describes a new technology that allows physicians to focally stimulate the brain in awake adults through a non-invasive procedure. Transcranial Magnetic Stimulation in Clinical Psychiatry is an accessible and authoritative review of TMS, a procedure that is showing promise as a treatment in several disorders. Its authors explain how the procedure works, then the latest findings in a wide range of situations – notably in depression, but also in other conditions ranging from migraine to stroke recovery.This concise overview of TMS offers practical guidance for psychiatrists and other clinicians using it as a therapy, or referring their patients to have this done, as well as updating the field for neuroscientists and neurologists. It begins with background on the physics and safety of TMS, a guide for administering the procedure, and a review of basic neurophysiological studies with TMS, showing how it can be used to measure connectivity and excitability of the cerebral cortex. The heart of book is then devoted to its clinical applications, organized by disorder: Epilepsy, movement disorders, and pain – describes the use of TMS in inducing and inhibiting seizures and investigating their pathophysiology; in treating Parkinson's disease; and in relieving pain through motor cortex stimulation Major depression – provides a critical review of research in the most-studied clinical application of TMS in psychiatry, where it is used as a therapeutic intervention and a neurophysiological probe Mania – explores the effectiveness of TMS in light of its ECT-like properties through a trial of right TMS vs. sham TMS Anxiety disorders – reports on investigations on the uses of TMS in treating obsessive-compulsive disorder and posttraumatic stress disorder Schizophrenia – reviews studies utilizing single- or paired-pulse TMS to assess cortical inhibition and those that explore effects of extended trains of repetitive TMS in altering symptoms A further chapter on TMS in brain imaging shows how integrating imaging and TMS allows one to better place the TMS coil, better understand TMS effects on the brain, and improve understanding of how the brain mediates behavior. With a concluding overview of prospects for the future of repetitive TMS, this volume offers a definitive look at this cutting-edge research and provides critical guidance on how and when clinicians might use TMS in their practice.

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This compendium of 17 articles addresses the goals set forth by the President's New Freedom Commission on Mental Health in its 2003 report, Achieving the Promise: Transforming Mental Health Care in America. The report represents the first time since the Carter Administration that such a high-level group evaluated U.S. mental health care. The report painted a dismal picture of the nation's mental health system, saying the system was so broken that it was «beyond simple repair.» The Commission said that current services focused on «managing disabilities» rather than helping patients achieve a meaningful life in their communities. It also stated that mental health service providers ignored the preferences of consumers and their families.The articles in Transforming Mental Health Services: Implementing the Federal Agenda for Change, originally published between 2006 and 2009 in Psychiatric Services (journal of the American Psychiatric Association), offer recommendations to assist adults with serious mental illness and children with serious emotional disturbances. They include a series of reforms in which the emphasis is on recovery as an achievable goal, and the need for a person-centered orientation in service delivery. There is also discussion of the reasons many service providers resist using a recovery orientation and how this can be remedied.Transforming Mental Health Services: Implementing the Federal Agenda for Change consists of updates of papers written by the Commission's subcommittees addressing issues fundamental to those living with mental illness. It is organized into four sections: The first focuses on the interface between mental health and general health, and on employment, housing, and Medicaid financing. The second continues addressing financing and Medicaid as well as issues related to school mental health, recovery, transformation of data systems, and acceleration of research. The third includes reports from four states with transformation initiatives designed to ensure that consumers have a strong voice in the development of recovery-oriented services. The final section describes progress five years after the President's Commission Report and concludes with a proposal by the current director of the Center for Mental Health Services for a public health model of mental health care for the 21st century. This compilation of well-researched and well-written articles offers an excellent resource for frontline care providers, facility administrators and advocates. It serves as an equally valuable resource for state policy makers who wish to present a convincing case that change is happening and that the recommendations can be translated into effective policies. Although consumers and their families will receive support for their perception that service providers ignore their needs, they will also be encouraged that change for the better is coming to the U.S. mental health care system.

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Deconstructing Psychosis: Refining the Research Agenda for DSM-V provides an all-important summary of the latest research about the diagnosis and pathophysiology of psychosis. This volume gives the reader an inside look at how psychotic phenomena are represented in the current diagnostic system and how DSM-V might better address the needs of patients with such disorders.The book presents a selection of papers reporting the proceedings of a conference titled «Deconstructing Psychosis» convened by the American Psychiatric Association (APA) in collaboration with the World Health Organization (WHO) and the U.S. National Institutes of Health (NIH). The conference was designed to be a key element in the multiphase research review process for the fifth revision of DSM. This book is one in a series of ten that reflects some of the most current and critical examinations of psychiatric disorders and psychotic syndromes. APA published the fourth edition of DSM in 1994 and a text revision in 2000. DSM-V is scheduled for publication in 2013.Deconstructing Psychosis: Refining the Research Agenda for DSM-V examines the current evidence regarding the diagnosis and pathophysiology of common psychotic syndromes including: Schizophrenia Bipolar disorder Major depressive psychosis Substance-induced psychosis It also addresses broad issues relating to diagnosis such as the ways in which psychosis cuts across multiple diagnostic categories. Beyond merely summarizing the current state of the science, the authors of these papers critique the current research and clinical evidence, and raise questions about gaps in our knowledge.The book provides recommendations for the most promising areas of research in psychosis, which may lead to more refined treatments based on a better understanding of what biological and environmental factors contribute to its development and symptoms.In the learned editors' selection of papers for inclusion in this volume, they have exhibited their conviction that DSM-V is a «living document» that will reflect the pace of progress in multiple areas, ranging from molecular genetics and brain imaging to social, behavioral, and anthropological science.As a book on the narrowly defined topic of linking the classification of psychotic syndromes with their underlying pathophysiology and potential etiology, there is no other writing of comparable content available today.

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Sometimes described as «the nemesis of the primary care physician,» somatoform disorders are frustrating, expensive to treat, and under-investigated. Somatic Presentations of Mental Disorders provides a fascinating and practical review of the epidemiology, diagnosis, and treatment of this ill-defined category of disease. Somatic Presentations of Mental Disorders summarizes the proceedings of a unique international conference that convened experts from across disciplines to review perspectives on somatoform disorders. The broad range of experience and specialization results in a compendium that addresses both theoretical and practical issues presented in somatoform disorders. For the researcher, the book offers a thorough and critical overview of the research landscape, surveying and synthesizing the available literature from around the world on all aspects of the disorder. Acknowledging the unique challenges presented in studying such a heterogeneous collection of disorders, the authors identify specific gaps in the research literature. Somatic Presentations of Mental Disorders also addresses controversial issues of nosology in advance of the publication of DSM-V.Despite its utility for researchers, the book primarily serves as an invaluable reference and resource for the practitioner. Organized with the clinician in mind, Somatic Presentations of Mental Disorders surveys the latest data on phenomenology; etiology and clinical course; and treatment options. Unlike other literature on this difficult topic, the authors thoroughly explore the entire range of this category of disorders, including conversion disorder, chronic pain and fatigue, and the multitude of presentations of medically unexplained symptoms. Aimed at both primary care and mental health practitioners, the book addresses crucial issues for effective diagnosis and treatment, including: Comorbidity and association with anxiety and depressive disorders Unique insights into cultural factors affecting the presentation and treatment of somatic disorders around the globe The prevalence of misdiagnosis, and contemporary diagnostic tools and techniques to help avoid a missed organic diagnosis The complicated interrelationship of somatoform disorders and substance abuse The efficacy of various treatment modalities, including pharmacology and cognitive behavioral therapy Collaboration between primary care and mental health providers to maximize treatment outcomes Comprehensive, thoughtful, and up-to-date, Somatic Presentations of Mental Disorders is a must-have both for researchers in the field and for clinicians with somatizing patients.

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As disorders in which stress or fear play major roles present an increasing need for psychiatric care around the world, this volume summarizes current research to determine whether a specific group of stress-induced and fear-based disorders form a distinct syndrome independent from other anxiety disorders such as obsessive-compulsive disorder or generalized anxiety. Intended to suggest DSM-V revisions regarding the classification of these disorders, Stress-Induced and Fear Circuitry Disorders reflects findings that may lead to more refined treatments for these specific anxiety disorders based on a better understanding of the biological and environmental factors that contribute to their development and symptoms.Thirty contributors, all international authorities on this group of mental illnesses, clarify how these disorders develop and what factors contribute to symptomatology. Focusing on posttraumatic stress disorder, panic disorder and agoraphobia, social phobias, and specific phobia, the authors explore the possibility of linking the classification and etiology of these conditions by showing that they may be closely related in terms of brain pathophysiology. In addition to assessing the stability of disorders across patient lifespans and determining whether they form a cohesive and distinct group, the authors examine shared etiologies and biopsychosocial correlates, as well as aspects unique to each disorder. Among the book's specific insights: How minority populations, particularly African Americans, are differentially affected by these disorders. The neuronal mechanisms of normal fear and anxiety, including how changes in the genetics of the serotonin system can increase the risk of anxiety. The role of cognition in symptom presentation and treatment, revealing cognitive biases that favor the processing of threat-related information. The contribution of stress and psychosocial factors, such as peer victimization and childhood sexual abuse. The use of neuroimaging to analyze neural structure and function for each of the four disorder groups. How neurochemistry and neuroendocrine markers may aid in classification of anxiety disorders. The contribution of substance abuse to the pathophysiology of these disorders. Given the importance of changes to DSM for professional education and public health, this book offers important new ways of thinking about stress-induced and fear-based disorders. It not only allows researchers to more accurately assess their diagnostic classifications, but also can help clinicians more effectively communicate with patients regarding the nature of their illness and the importance of adhering to treatment regimens.

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In Psychotherapy Is Worth It: A Comprehensive Review of Its Cost-Effectiveness, edited by Susan G. Lazar, M.D., and co-authored with members of the Committee on Psychotherapy of the Group for the Advancement of Psychiatry, surveys the medical, psychiatric and psychological literature from 1984 to 2007 that is relevant to the cost-effectiveness of all kinds of psychotherapy. The volume explores the cost of providing psychotherapy in relation to its impact both on health and on the costs to society of psychiatric illness and related conditions.Written for psychotherapists, psychiatric benefit providers, policy makers, and others interested in the cost-effectiveness of providing psychotherapeutic treatments, this book analyzes the burden of mental illness, particularly in the United States, and the enormous associated costs to society that constitute a chronic, insufficiently recognized crisis in the health of our nation. The authors point out that in the United States nearly 30% of the population over the age of 18 has a diagnosable psychiatric disorder and yet only about 33% of those treated receive minimally adequate care. In fact, most people with mental disorders in the United States remain untreated or poorly treated, leading to loss in productivity, higher rates of absenteeism, increased costs, morbidity and mortality from medical illnesses, and loss of life through suicide.This book provides a systematic and comprehensive review of 25 years of medical literature on the cost-effectiveness of psychotherapy and discusses the: Epidemiology of mental illness, including prevalence and treatment rates Misconceptions and stigmas associated with psychiatric illness and the provision of psychotherapy and how they affect those most in need of care Cost-effectiveness of psychotherapy for the major psychiatric disorders as well as savings that psychotherapy can yield in increased health, work productivity, lives saved, and medical and hospital related costs For instance, in a review of 18 studies conducted from 1984 to 1994, psychotherapy was found to be cost-effective in treating patients with severe disorders, including schizophrenia, bipolar disorder, and borderline personality disorder, and led to improved work functioning and decreased hospitalization. Likewise, studies point to the enhancement of outcomes when psychotherapy is used in conjunction with medical therapies in the treatment of cancer, heart disease, and other prevalent, chronic diseases. Psychotherapy Is Worth It: A Comprehensive Review of Its Cost-Effectiveness concludes that studies confirm psychotherapy works for many conditions, is cost-effective, and is not over-used by those persons not truly in need. A treatment that is cost-effective is not «cheap»; rather, it can provide effective medical help at a cost acceptable to society, in comparison both to other effective treatments for the same condition and to medical treatments for other classes of mental disorder.

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Мир людей, не джунглей. Не плохой и не хороший. А какой? И почему так трудно человеку в нём? Этот вопрос в художественном ключе освещает врач-психотерапевт, автор этой книги. В ваших руках более ста психологических эссе с правдивой констатацией бытия реальных людей. Они открывают вам дверь внутрь себя… Держитесь, чтобы не упасть: из тени вашей личности выступит разное… Не убегайте от него, а вместе с героями это проживайте. И расширяйте свои знания о себе. И делайте выбор, и собой уже осознанно управляйте, и через себя этот мир преображайте…

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Psychotherapists have an ethical requirement to inform clients about their treatment methods, alternative treatment options, and alternative conceptions of their problem. While accepting the basis for this «informed consent» requirement, therapists have traditionally resisted giving too much information, arguing that exposure to alternative therapies could cause confusion and distress. The raging debates over false/recovered memory syndrome and the larger move towards medical disclosure have pushed the question to the fore: how much information therapists should provide to their clients? In Negotiating Consent in Psychotherapy , Patrick O'Neill provides an in-depth study of the ways in which therapists and clients negotiate consent. Based on interviews with 100 therapists and clients in the areas of eating disorders and sexual abuse, the book explores the tangle of issues that make informed consent so difficult for therapists, including what therapists believe should be part of consent and why; how they decide when consent should be renegotiated; and how clients experience this process of negotiation and renegotiation.

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