This is a book of psychiatry at its most practical level. It aims to answer the sorts of questions psychiatrists ask on a daily basis. What treatments are available for the condition that I think this patient has? What is the relative value of each of these treatments? Are there any other treatments that I should be considering if a first approach has failed? Is there any value in combinations of treatment? And, can I be sure that the evidence and recommendations I read are free from bias? The content is organised into three sections covering disease classification, the major treatment modalities and the application of these treatments to the wide range of psychiatric diagnoses. All professionals in mental health want to give the best treatments for their patients. This book provides clinicians with the knowledge and guidance to achieve this aim.

A practical pocket reference to effective treatments for a wide range of psychiatric disorders.

Why do some psychiatric patients fail to get better, even when in the care of competent clinicians? Treatment-refractory conditions are all too common in everyday clinical practice. Treatment resistance occurs across the full spectrum of psychiatric disorders, incurring enormous emotional, economic, and social costs. In the United States, treatment of depression alone costs more than $40 billion annually, and as many as 40% of patients with depression have a treatment-refractory form of the illness. This groundbreaking clinical guide starts where standard textbooks end, focusing on clinical strategies to be used after all basic treatment options, such as medication and psychotherapy, have failed. In this book expert contributors address the sequential clinical steps in treating difficult-to-treat psychiatric patients by offering a blend of evidence-based clinical recommendations, detailed case vignettes, treatment algorithms, and -- when necessary to go beyond the reach of evidence -- the clinical wisdom of leaders in the field. The chapters in this user-friendly, practical guide are organized by major disorder. Each chapter offers concrete recommendations on what to do when the usual first steps in therapy are ineffective, including evidence for biopsychosocial treatments alone versus in combination, generic versus specific therapies, and literature reviews and the latest expert wisdom. A sampling includes The management of the complex and often refractory bipolar disorder, which involves replacing or combining lithium treatment with anticonvulsants or atypical antipsychotic agents with adjuncts such as benzodiazepines, thyroid hormone, and electroconvulsive therapy, but also -- above all -- with careful attention to the therapeutic alliance. The importance of combined therapeutic modalities for patients with schizophrenia -- especially given managed care's cost-cutting strategies, which deprive many schizophrenic patients of effective treatment modalities such as family therapy or early use of an atypical antipsychotic. Combination treatments for anxiety, with medications adjusted over time as symptoms wax and wane, and early and appropriate interventions to mitigate internal and external environmental stressors. The emphasis on common sense, optimism, a sense of humor, and an iron constitution as the most important tools for clinicians wishing to work with the most severely ill patients with borderline personality disorder. The importance of individual differences in biological vulnerability, emotionality and expressiveness, cognitive schemas and beliefs, prior traumatic experience, resilience, and coping strategies for successful treatment of posttraumatic stress disorder. Packed with up-to-date information of immediate relevance, this volume will prove invaluable in both classroom and clinical practice, for everyone from beginning interns and residents to experienced psychiatric and medical practitioners and social workers.

Use of psychotropic drugs has come to dominate clinical practice in psychiatry worldwide—perhaps owing largely to perceived simplicity, ease of use, and apparent efficiency, as well as apparent cost-effectiveness of such treatments. Nevertheless, medicinal treatments for patients with psychiatric disorders are but one component of comprehensive clinical care of complex human problems. Extensively updated since its second edition in 1985, Chemotherapy in Psychiatry, Third Edition, again addresses basic aspects of modern psychopharmacology and clinical applications of drugs used in the treatment of major psychiatric disorders, with major emphasis on psychotic, bipolar, and depressive disorders. The presentation covers descriptions of the main classes of psychotropic drugs, selected information concerning their known action mechanisms and metabolic disposition, and their clinical applications for acute illnesses and to prevent recurrences and long-term morbidity. Also covered are limitations and adverse effects of each type of agent, with emphasis on the fact that all psychotropic medicines have adverse effects that range from annoying to potentially lethal. Chemotherapy in Psychiatry, Third Edition, outlines the need to balance benefits and risks at the level of individual persons. Authoritative, and an important contribution to the literature, Chemotherapy in Psychiatry, Third Edition is an invaluable resource for physicians, scientists, trainees, and policymakers.

An in-depth look at a much misunderstood practice, offering a fresh viewpoint on how this science can be a universally effective route to our better selves.

Personalized Psychiatry presents the first book to explore this novel field of biological psychiatry that covers both basic science research and its translational applications. The book conceptualizes personalized psychiatry and provides state-of-the-art knowledge on biological and neuroscience methodologies, all while integrating clinical phenomenology relevant to personalized psychiatry and discussing important principles and potential models. It is essential reading for advanced students and neuroscience and psychiatry researchers who are investigating the prevention and treatment of mental disorders. - Combines neurobiology with basic science methodologies in genomics, epigenomics and transcriptomics - Demonstrates how the statistical modeling of interacting biological and clinical information could transform the future of psychiatry - Addresses fundamental questions and requirements for personalized psychiatry from a basic research and translational perspective

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.