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1
Mazzone, Luigi, e Benedetto Vitiello, a cura di. Psychiatric Symptoms and Comorbidities in Autism Spectrum Disorder. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-29695-1.
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Buckley, Peter F., David J. Castle e Rachel Upthegrove. Schizophrenia and Psychiatric Comorbidities: Recognition Management. Oxford University Press, 2020.
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3
Yarnell, Stephanie, e Ellen Edens. Prevalence and Severity of Psychiatric Comorbidities. A cura di Ish P. Bhalla, Rajesh R. Tampi, Vinod H. Srihari e Michael E. Hochman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190625085.003.0020.
Testo completoAbstract (sommario):
Chapter 20—The Prevalence and Severity of Psychiatric Comorbidities provides a summary of a landmark study in epidemiology, the The National Comorbidity Survey Replication (NCS-R). This chapter study sought to answer some fundamental questions. How common are comorbid psychiatric conditions? What are the prevalence and severity rates for comorbid anxiety, mood, impulse control, and substance use disorders? Starting with these questions, this chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.
4
Beckman, Nancy J., e Marie B. Tobin. Psychiatric Comorbidities in Chronic Pain Syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0033.
Testo completoAbstract (sommario):
Psychiatric comorbidities are common in patients with chronic pain syndromes. Depression, anxiety, insomnia, somatic symptom disorder, substance use disorders, personality disorders, and problematic coping strategies present unique treatment challenges to pain medicine specialists. Patients with these comorbidities tend to have poorer response to treatment, higher rates of complications, and greater pain-related suffering. To reduce stigma, providers are encouraged to define pain as both a sensory and emotional experience. This intimate connection implies that optimal pain treatment requires concurrent attention to psychosocial well-being. Overlapping biological and psychologic mechanisms in the development of chronic pain and psychiatric disorders may contribute to the high rates of comorbidity. Methods for quickly identifying psychiatric disorders within busy clinic settings and brief interventions that pain specialists can deliver are described. Finally, indications for referral to specialty mental health and the benefits of multidisciplinary treatment, which can include psychiatric medications and evidence-based psychologic treatments, such as cognitive-behavioral therapy, are discussed.
5
Vitiello, Benedetto, e Luigi Mazzone. Psychiatric Symptoms and Comorbidities in Autism Spectrum Disorder. Springer, 2018.
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Halmi, Katherine A. Psychological Comorbidities of Eating Disorders. A cura di W. Stewart Agras e Athena Robinson. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780190620998.013.13.
Testo completoAbstract (sommario):
Psychological comorbidity of eating disorders may be conceptualized in varying facets including psychiatric diagnosis, specific behaviors, traits, affect regulation, and cognitive characteristics. Although the Diagnostic and Statistical Manual, fifth edition (DSM-5) modified some criteria for psychiatric diagnoses, these modifications should have little effect over the previous rates of DSM-IV comorbidities and thus do not necessitate repeat large sample comorbidity studies. This chapter presents facets of psychological comorbidities of the three major eating disorders: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). The most comprehensive comorbid psychiatric diagnosis study from the US national comorbidity survey replication revealed at least one lifetime comorbid psychiatric DSM-IV disorder was present in 56.2% AN, 94.5% BN, and 78.9% BED. Affect regulation, negative affect, perfectionism, cognitive-behavioral flexibility, and impulse control are common comorbid features present in these disorders.
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Haag, Anja, Clarissa Lin Yasuda, Britta Wandschneider e Silvia Bonelli, a cura di. Cognitive and Psychiatric Comorbidities in Epilepsy: Insights from Neuroimaging Research. Frontiers Media SA, 2020. http://dx.doi.org/10.3389/978-2-88963-898-7.
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Soffer, Jocelyn, e Harold W. Goforth. Endocrine Comorbidities in Persons with HIV. A cura di Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding e Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0045.
Testo completoAbstract (sommario):
A wide range of endocrine abnormalities commonly accompany and complicate HIV infection, many of which have implications for psychiatrists and other mental health professionals working with this population. Such abnormalities include adrenal insufficiency, hypercortisolism, hyperthyroidism, hypothyroidism, hypogonadism, decreased bone mineral density, and bone disease. Endocrinopathies are great mimickers of psychiatric disorders, manifesting in some cases as disturbances of mood, sleep, appetite, thought process, energy level, or general sense of well-being. Understanding the intricate and complex relationships between immunological, endocrinological, and psychological systems is important to improve recognition and treatment of reversible endocrinopathies, diminish suffering, and enhance quality of life and longevity in persons with HIV and AIDS. This chapter will present an overview of HIV-associated changes in the function of the hypothalamic–pituitary axes, adrenal glands, thyroid gland, gonads, and bone and mineral metabolism, and consider the psychosocial implications of such endocrinopathies.
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Hirschtritt, Matthew E., Marc N. Potenza e Linda C. Mayes. Impulsivity and Co-occurring Psychiatric Disorders. A cura di Jon E. Grant e Marc N. Potenza. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195389715.013.0033.
Testo completoAbstract (sommario):
Dual diagnosis, the co-occurrence of substance abuse and another psychiatric disorder, is common. There is evidence to suggest that impulsivity may serve as a common substrate for these comorbidities, despite behavioral and biochemical differences between disorders. This chapter describes common neurobiological and behavioral findings between individuals with high impulsivity and those with dual diagnosis. Specifically, we focus on the co-occurrence of substance abuse with schizophrenia, eating disorders, attention-deficit/hyperactivity disorder, antisocial and borderline personality disorders, and bipolar disorder. For each type of dual diagnosis, we review literature that provides empirical evidence for the presence of impulsivity and treatment recommendations. In this context, we propose a “bottom-up” conceptualization, in which clusters of co-occurring phenotypes are used to formulate diagnostic and clinical plans; such an approach may produce more homogeneous diagnostic groups than exist in the current system. Further, a bottom-up approach may reveal that dual-diagnosis disorders represent distinct groups that share a common factor of impulsivity.
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Fenton, Lynne, Brian Rothberg, Laura Strom, Allison M. Heru e Mesha-Gay Brown. Integrative Care Model for Neurology and Psychiatry. A cura di Robert E. Feinstein, Joseph V. Connelly e Marilyn S. Feinstein. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190276201.003.0019.
Testo completoAbstract (sommario):
Nonepileptic seizures resemble epileptic seizures but lack epileptiform activity on an electroencephalogram and presumably have psychopathologic origins. Psychiatric comorbidities are common, and effective management requires psychiatric treatment. Unfortunately, many patients fear that seeing a psychiatrist implies their episodes are not being taken seriously and that their neurologist might perceive them as producing their symptoms willfully. Patients might feel abandoned if their neurologist refers them to a psychiatrist and indicates that they no longer need to be seen by the neurologist. Consequently, patients often resist undergoing psychiatric evaluation. To help address this problem our team piloted a program integrating psychiatric and neurologic approaches, placing a therapeutic treatment group within the neurology outpatient department. This chapter reviews the clinical features of non-epileptic seizures, including diagnosis and treatment, and presents our team’s integrated treatment approach.
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Unger, Annemarie, Gabriele Fischer e Loretta P. Finnegan. Drug Dependence During Pregnancy and the Postpartum Period. A cura di Amy Wenzel. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199778072.013.27.
Testo completoAbstract (sommario):
The chaotic lives of women who are drug dependent and their frequent lack of consistent prenatal care put them at risk for many medical problems during pregnancy. Illicit drug use during pregnancy also places women at increased risk for obstetrical complications. The complexity of medical problems in the pregnant drug abuser is complicated by the attendant psychosocial problems and psychiatric comorbidities seen in this population. Psychiatric diagnoses, treatment, and patient compliance are often hindered when the main focus of attention is on drug-related problems. The stigma associated with maternal drug use and difficult life circumstances are additional burdens to successful treatment entry and adherence for women. The basis for stabilizing most opioid-dependent pregnant women is agonist maintenance therapy in the context of comprehensive services, and the treatment of psychiatric comorbidities is a key component in optimizing pregnancy and child outcomes.
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Beal, Jules C., e Emilio Perucca. Medical Management of Epilepsy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0044.
Testo completoAbstract (sommario):
Epilepsy affects approximately 65 million people worldwide, leading to significant morbidity and mortality including injuries, psychiatric comorbidities, social stress, and the risk of sudden death. The best indicator of quality of life in patients with epilepsy is seizure freedom. The chapter discusses the medical management of epilepsy, focusing on decision making, when to initiate treatment, how to choose an appropriate medication, and how to proceed when a medication fails. The treatment of epilepsy is a highly individualized process that must take into account an individual’s seizure type, risk of seizure recurrence, age, sex, medical comorbidities, and personal goals and preferences.
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Howland, Robert H. Multidisciplinary Treatments and Medications for Depressive Disorders and Comorbidity. A cura di C. Steven Richards e Michael W. O'Hara. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.008.
Testo completoAbstract (sommario):
Compared with episodic depression, chronic depression and treatment resistant depression have higher rates of comorbidity, more persistent social and vocational disability, an increased risk of suicide, greater medical morbidity and mortality, and greater health care utilization and costs. A large number of antidepressant medications and other psychotropic drugs, depression-focused psychotherapies, and neuromodulation therapies are available for the treatment of depression. Many drugs or psychotherapies are used for the treatment of other psychiatric disorders or medical conditions, and they should be considered relevant when these comorbidities exist with depression. Selecting treatments for depression must take into account the clinical implications of the presence of any comorbidities. Because comorbidity is associated with depressive chronicity and treatment resistance, various approaches to treating chronic depression or TRD have been investigated. Treating depressed patients with comorbid psychiatric, personality, or medical disorders is a clinical challenge that requires effective multidisciplinary collaboration.
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Smith, Martha J. Chronic Pelvic Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190217518.003.0020.
Testo completoAbstract (sommario):
Nonmalignant chronic pelvic pain is defined as nonmenstrual pain below the level of the umbilicus that has continued for at least 6 months and is severe enough to seek medical or surgical treatment. In chronic pelvic pain, the pain and disability may often appear out of proportion to physical abnormalities, and this pain is often refractory to medical and surgical therapies. Significant psychiatric comorbidities and many medical comorbidities often accompany pelvic pain. Although most pelvic pain patients are female, several conditions can cause chronic pelvic pain in males. When evaluating and diagnosing various pelvic pain conditions, it is imperative to rule out malignancy and other organic causes. Pelvic floor dysfunction, sacroiliac joint instability, and other mechanical issues are often partially involved in the process of chronic pelvic pain. As a clinician, all of these variables must be taken into consideration when evaluating and treating chronic pelvic pain patient.
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Van Dam, Nicholas T., Brian M. Iacoviello e James W. Murrough. Diagnosis and Epidemiology of Depression. A cura di Dennis S. Charney, Eric J. Nestler, Pamela Sklar e Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0023.
Testo completoAbstract (sommario):
Depressive disorders are among the most disabling medical illnesses worldwide and limited efficacy of currently available medication and psychotherapy treatments adds to this large public health burden. In the current chapter, we consider findings from several large-scale health surveys to estimate the burden of illness, and review the current data available regarding prognosis, psychiatric and medical comorbidities, and socio-demographic factors influencing the prevalence and course of depression. We also consider emerging alternative methods of conceptualizing depression and other mental disorders that emphasize a dimensional rather than categorical approach. Increasing attention to such approaches in the design of psychiatric research related to depression may lead to an improved understanding of depression and more effective treatments.
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Martagon-Villamil, Jose, e Daniel J. Skiest. The Medical History and Physical Examination of the HIV-Infected Patient. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190493097.003.0009.
Testo completoAbstract (sommario):
Fostering a strong and empathetic patient–physician relationship is essential for the success of the HIV therapeutic plan. A comprehensive understanding of all medical and psychiatric comorbidities, medication history, exposures, risk behaviors, and current state of health is fundamental in caring for the HIV-infected individual. All patients with HIV newly in care need a complete history and physical examination. The physical exam needs to be comprehensive both for the assessment of current complaints and for baseline comparison with future findings. Providers must be aware of the cultural, social, and sexual diversity of their patient population to help foster patient–provider communication.
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Anderson, Leslie K., Stuart B. Murray e Walter H. Kaye, a cura di. Clinical Handbook of Complex and Atypical Eating Disorders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med-psych/9780190630409.001.0001.
Testo completoAbstract (sommario):
The aim of this book is to collate what is known about an array of complicating factors for patients with eating disorders, serving as an accessible introduction to each of the comorbidities and symptom presentations highlighted in the volume. The Handbook of Complex and Atypical Eating Disorders presents the available data about atypical and complex ED, in addition to what is known about treatment approaches. The first section contains chapters on the treatment of eating disorders with various psychiatric comorbidities, including trauma, borderline personality disorder, substance use, suicidality, anxiety disorders, and autism spectrum disorders, which may greatly complicate the application of standard treatment approaches. The second section contains chapters exploring treatment of eating disorders with atypical symptom presentations which (i) are not located as a specific diagnostic category in diagnostic criteria for ED’s, (ii) centrally feature ED pathology, and (iii) have emerging data suggesting the distinct nature of the syndrome, including purging disorder, muscle dysmorphia, night eating syndrome, and anorexia with a history of obesity. The final section has chapters which focus on how to adapt eating disorder treatment for atypical populations typically neglected in controlled treatment trials: LGBT, pediatric, male, ethnically diverse, and older adults.
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Quijije, Nadia. Trauma in the Medical-Surgical Patient. A cura di Frederick J. Stoddard, David M. Benedek, Mohammed R. Milad e Robert J. Ursano. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457136.003.0018.
Testo completoAbstract (sommario):
This chapter reviews psychiatric consultation for trauma and stress in medical-surgical patients. Hospitalization can induce psychologic or psychiatric disturbance and worsen the clinical condition of patients who are suffering from medical and surgical comorbidities. Some medical conditions can be related to stress related disorders indirectly, while others, such as critical illness/intensive care unit treatment or direct physical injury, are themselves traumatic stressors that can promote trauma and stressor-related disorders (TSRDs). Given the negative impact of stress-related disorders on quality of life, mental health clinicians should diagnose TSRDs to ensure patients receive appropriate care. Treatment and management can be provided in multiple forms of psychological therapies and psychopharmacology, and within a multidisciplinary team, particularly for the medical surgical patient. Psychiatrists, psychologists, and social workers must assist patients with terminal illnesses by optimizing end-of-life care, supporting patients and their families, and encouraging approaches to allow the transformative process of dying to be meaningful.
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Ross, Lisa. Electroconvulsive Therapy. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190495756.003.0029.
Testo completoAbstract (sommario):
The anesthetic management of patients who receive electroconvulsive therapy (ECT) for various psychiatric conditions in both the inpatient and the outpatient settings must take into account a number factors, such as its associated physiologic responses, existing comorbidities, medication management, monitoring, complications, and contraindications in order for it to remain a safe procedure. This chapter reviews the indications for ECT, the preprocedure anesthetic evaluation; theories regarding the therapeutic mechanism of action leading to the efficacy of ECT; cerebrovascular, cardiovascular, and neuroendocrine responses and monitoring standards. Furthermore, it discusses the selection of medications for induction, inhalational agents, and muscle relaxants as well as common drug interactions and premedication practices. The chapter culminates with an assessment of the morbidity and mortality associated with ECT both anesthetic and nonanesthetic related.
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Barrera, Alvaro, Caroline Attard e Rob Chaplin, a cura di. Oxford Textbook of Inpatient Psychiatry. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198794257.001.0001.
Testo completoAbstract (sommario):
Acute inpatient mental health care remains an irreplaceable part of some people’s mental health recovery pathway, either through the severity of their difficulties or the associated risks. It can often be a traumatic experience associated with distress and vulnerability both for patients and their relatives. Modern acute inpatient psychiatric care must undoubtedly be truly multidisciplinary and part of a wider community-based system. It must emphasize dignity, compassion, and well-being as well as addressing challenges such as involuntary admissions, cultural diversity, physical comorbidities, and the needs of relatives, just to name a few. The present textbook focuses on these and related issues in a way that is relevant to frontline clinicians dealing with them daily, with medical, nursing, and legal aspects going hand in hand with topics such as team leadership or multidisciplinary work. The textbook describes inpatient services as provided in England, so it describes work that takes place within a national health service free at the point of delivery, carried out by universal primary care as well as secondary mental health care services, both operating within clinical governance structures that seek quality improvement and accountability. Crucially, both the Mental Health Act and the Mental Capacity Act provide unique legal frameworks for the care of mental ill health. The editors hope that for readers in the UK and beyond, the textbook will provide a real-life system which can be questioned and problematized and, in that way, may help to orient clinical work.
21
Colameco, Stephen. Pain and Addiction in Patients with Co-Occurring Medical Disorders (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0026.
Testo completoAbstract (sommario):
Distinct from Chapter 24, on co-occurring psychiatric disorders, this chapter addresses common physical comorbidities that give rise to chronic pain and are notorious for associated substance use disorders. The concept of “pseudo-addiction” is explored as one of several contributors to common misperceptions of the analgesic needs of such patients. Examples of entities discussed are chronic low back pain, sleep apnea, chronic pancreatitis, cirrhosis, and HIV infection or AIDS-related pain. While not intrinsically painful, sleep apnea merits inclusion as it arises in conjunction with sedative-hypnotic, opioid, or nicotine use. Cirrhosis likewise creates obstacles to successful pain or addiction management resulting from altered metabolism of medications and enhanced susceptibility to potentially lethal syndromes (hepato-renal syndrome, gastric hemorrhage, etc.). The management of neuropathic pain in HIV infection (Chapter 15) is amplified here.
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Pangarkar, Sanjog S. Pain and Addiction in Patients with Traumatic Brain Injury (DRAFT). Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190265366.003.0027.
Testo completoAbstract (sommario):
Distinct from Chapter 24, on co-occurring psychiatric disorders, this chapter addresses common physical comorbidities that give rise to chronic pain and are notorious for associated substance use disorders. The concept of “pseudo-addiction” is explored as one of several contributors to common misperceptions of the analgesic needs of such patients. Examples of entities discussed are chronic low back pain, sleep apnea, chronic pancreatitis, cirrhosis, and HIV infection or AIDS-related pain. While not intrinsically painful, sleep apnea merits inclusion as it arises in conjunction with sedative-hypnotic, opioid, or nicotine use. Cirrhosis likewise creates obstacles to successful pain or addiction management resulting from altered metabolism of medications and enhanced susceptibility to potentially lethal syndromes (hepato-renal syndrome, gastric hemorrhage, etc.). The management of neuropathic pain in HIV infection (Chapter 15) is amplified here.
23
Rummell, Christina M. Support Groups and Behavioral Science. A cura di Tomasz Rogula, Philip Schauer e Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0003.
Testo completoAbstract (sommario):
While a psychological evaluation is often a required part of a weight-loss surgery workup, providers are becoming aware of the need for behavioral health services during each phase of the surgery process. Research has documented a higher prevalence of psychiatric comorbidities in severely obese patient populations, with those who receive behavioral health interventions before surgery having better outcomes than those who do not. Common recommendations and interventions for pre- and postoperative behavioral health optimization are reviewed and discussed.Statistics indicate a greater lifetime prevalence of substance use disorders in weight-loss surgery patients than in the general population. Postoperative complications have been shown to result from substance abuse, making it one of the top-cited contraindications for surgery. Preliminary recommendations for assessing and addressing substance use in bariatric surgery candidates are discussed.
24
Khusid, Marina. Meditation Techniques for Posttraumatic Stress Disorder. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190205959.003.0004.
Testo completoAbstract (sommario):
Although there is currently insufficient evidence to support meditation as a first-line treatment for posttraumatic stress disorder (PTSD), the evidence base for meditation used adjunctively in the management of PTSD and related psychiatric comorbidities is rapidly expanding. The 2010 Veterans Administration/Department of Defense (VA/DoD) clinical practice guideline (CPG) for management of PTSD states that mind–body approaches may be considered adjunctive treatment for hyperarousal symptoms. Although several reviews support the conclusions reflected in the CPG, others suggest meditation interventions may be more useful in managing PTSD than originally speculated. Meditation may help reduce intrusive memories, avoidance, and anger; and increase self-esteem, pain tolerance, energy, and ability to relax and cope with stress. One comparative effectiveness review concluded that mindfulness meditation is beneficial in reducing psychological stress consequences, such as depression, pain, and mental health-related quality of life.
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Levesque, Anna, e Edward V. Nunes. Recognizing Addiction in Older Patients. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199392063.003.0002.
Testo completoAbstract (sommario):
Alcohol and substance-use disorders in older adults can present in primary care practice in subtle or confusing ways. Screening and diagnostic tools validated in younger populations may limit their recognition. The main objective of this chapter is to differentiate signs and symptoms of alcohol or substance use disorder from other medical and psychiatric comorbidities. We review normal metabolic changes associated with aging as well as clinical features of harmful drinking. The risks of combining alcohol with psychoactive prescription medications are also considered. The relevance of DSM-5 diagnostic criteria to older patients is explored, and we review the evidence for the importance of systematic screening using validated instruments in an older population. Therapeutic vs. aberrant uses of psychoactive prescription medications in the geriatric population are discussed. Finally, we review patterns of illicit substance use in older adults.
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Allison, Kelly C., e Jennifer D. Lundgren. Emerging Syndromes. A cura di W. Stewart Agras e Athena Robinson. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780190620998.013.24.
Testo completoAbstract (sommario):
The Diagnostic and Statistical Manual, fifth edition, of the American Psychiatric Association (2013) has designated several disorders under the diagnosis of otherwise specified feeding and eating disorder (OSFED). This chapter evaluates three of these, night eating syndrome (NES), purging disorder (PD), and atypical anorexia nervosa (atypical AN). It also reviews orthorexia nervosa, which has been discussed in the clinical realm as well as the popular press. The history and definition for each is reviewed, relevant theoretical models are presented and compared, and evidence for the usefulness of the models is described. Empirical studies examining the disorders’ independence from other disorders, comorbid psychopathology, and, when available, medical comorbidities, are discussed. Distress and impairment in functioning seem comparable between at least three of these emerging disorders and threshold eating disorders. Finally, remaining questions for future research are summarized.
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Lejoyeux, Michel, e Candice Germain. Pyromania: Phenomenology and Epidemiology. A cura di Jon E. Grant e Marc N. Potenza. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195389715.013.0049.
Testo completoAbstract (sommario):
Pyromania corresponds to fire setting not done for criminal reasons, for profit or sabotage, for monetary gain, as an expression of sociopolitical ideology (an act of terrorism or protest) or anger, or for revenge. Pyromania, in the sense of arson without a separate motive, is a rare phenomenon.In the DSM-IV-TR, pyromania is classified as an impulse control disorder (ICD) not elsewhere classified. It is characterized by a failure to resist impulsive, repetitive, deliberate fire-setting urges that are unrelated to external reward.The only study of the prevalence of fire setting derived from the National Epidemiological Survey on Alcohol and Related Conditions found a lifetime prevalence of 1% for fire setting in the U.S. population. The prevalence of pyromania in adult psychiatric inpatients was 3.4% (n = 7), and the lifetime prevalence was 5.9%.Fire setting is significantly associated with a wide range of antisocial behaviors. Multivariate logistic regression analyses identified strong associations between lifetime alcohol and marijuana use disorders, conduct disorder, antisocial and obsessive-compulsive personality disorders, and a family history of antisocial behavior. Intentional illicit fire-setting behavior is associated with a broad array of antisocial behaviors and psychiatric comorbidities. The most prevalent psychiatric disorders among persons with a history of fire setting are any lifetime alcohol use disorder (71.7%), antisocial personality disorder (51.46%), marijuana use disorder (43.17%), and nicotine dependence (42.95%). A family history of antisocial behavior is also frequent (60%).
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Steinberg, Martin. Treatment of Depression. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199959549.003.0006.
Testo completoAbstract (sommario):
Most depression in the elderly can be effectively treated in the primary care setting. Psychiatric referral should be considered in the setting of severe depression, suicidal ideation, prior suicide attempts, multiple risk factors, psychotic symptoms, bipolar disorder, poor response to prior treatment, or high medical comorbidity. Combining pharmacological and psychosocial interventions is most likely to be effective. Available antidepressants include serotonin-specific reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, novel mechanism agents, tricyclic antidepressants, and monoamine oxidase inhibitors. Antidepressant selection should take into account adverse effects, medical comorbidities, potential medication interactions, and patient preferences. Additional strategies (e.g. augmentation) are available for treatment resistant depression. Available psychotherapies include supportive, cognitive-behavioral, interpersonal, and problem solving. Lifestyle interventions (e.g. exercise) may be helpful adjuncts. Given limited evidence for antidepressant treatment in cognitive impairment, for those with mild to moderate depression severity, non-pharmacological interventions should be attempted first.
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Tolchin, Benjamin, e Gaston Baslet. Readiness to Start Treatment and Obstacles to Adherence. A cura di Barbara A. Dworetzky e Gaston C. Baslet. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190265045.003.0013.
Testo completoAbstract (sommario):
Effective evidence-based psychotherapeutic regimens for psychogenic nonepileptic seizures (PNES) are available, but several obstacles still contribute to poor adherence to treatment. This chapter reviews the three stages at which patient dropout tends to occur in clinical practice and in studies. Patient-related, provider-related, and systemic causes of nonadherence are reviewed. Patient-related factors include a failure to accept or understand the diagnosis, psychiatric comorbidities, and ambivalence about change. Provider-related and systemic factors include a shortage of behavioral health specialists, gaps in care between neurologists and mental health providers, a lack of familiarity with the disorder, and stigmatization of patients. The chapter concludes with a review of potential interventions to address obstacles to treatment, including an integrated treatment team with joint presentation of the diagnosis, rapid and streamlined transition into psychotherapy, motivational interviewing, and engagement of patients’ family members and support systems.
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Matson, Johnny L., e Paige E. Cervantes. Intellectual Disabilities. A cura di Thomas H. Ollendick, Susan W. White e Bradley A. White. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780190634841.013.12.
Testo completoAbstract (sommario):
Intellectual disability (ID) is characterized by significant deficits in intellectual skills and adaptive behavior. ID affects approximately 1% of the population; an individual’s ID can range from mild to profound based on the level of impairment and supports needed. Individuals often present with associated challenging behaviors and medical and psychiatric comorbidities that create a complicated clinical picture. Comprehensive assessment is critical for effective treatment. Intervention for ID is focused on addressing the discrepancies between an individual’s ability and environmental demands by providing supports to improve daily functioning. A multidisciplinary approach is necessary. Evaluation and treatment procedures will likely evolve as etiological understanding of ID improves. Greater research and policy attention to several areas of clinical practice are needed to improve prognosis and quality of life. This chapter details diagnostic criteria, assessment and intervention strategies, gaps in and future directions of research and practice, and implications for clinical practice.
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Gissey, Lidia Castagneto, James R. Casella Mariolo, Geltrude Mingrone e Francesco Rubino. Metabolic surgery and depression. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198789284.003.0012.
Testo completoAbstract (sommario):
The incidence of obesity is rising worldwide and so are its comorbidities: type-2 diabetes mellitus (T2DM), dyslipidaemia, hypertension, cardiovascular disease, sleep apnoea, and depression. Bariatric/metabolic surgery has established itself over the past several years as an effective treatment not only for morbid obesity but also for its associated morbidities. The effects of bariatric/metabolic surgery on depression are controversial, with some studies showing improvement and others demonstrating a worsening. However, a major drawback of these studies is that they do not compare patients with the same baseline psychiatric disorders. In fact, mild to severe depressive symptoms are observed in most candidates for bariatric/metabolic surgery. Preoperative evaluation of the patient’s mental state would enable identification of the appropriate interventions, enhancing long-term compliance and weight maintenance. It could also leverage psychological support in case the patient’s disorder relapses postoperatively. Preoperative evaluation should detect potential psychological contraindications to surgery, such as severe eating disorders.
32
Rubia, Katya. ADHD brain function. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198739258.003.0007.
Testo completoAbstract (sommario):
ADHD patients appear to have complex multisystem impairments in several cognitive-domain dissociated inferior, dorsolateral, and medial fronto-striato-parietal and frontocerebellar neural networks during inhibition, attention, working memory, and timing functions. There is emerging evidence for abnormalities in motivation and affect control regions, most prominently in ventral striatum, but also orbital/ventromedial frontolimbic areas. Furthermore, there is an immature interrelationship between hypoengaged task-positive cognitive control networks and a poorly ‘switched off’ default mode network, both of which impact performance. Stimulant medication enhances the activation of inferior frontostriatal systems, while atomoxetine appears to have more pronounced effects on the dorsal attention network. More studies are needed to understand the neurofunctional correlates of the effects of age, gender, ADHD subtypes, and comorbidities with other psychiatric conditions. The use of pattern recognition analyses applied to imaging to make individual diagnostic or prognostic predictions are promising and will be the challenge over the next decade.
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O’Dowd, Mary Alice, e Maria Fernanda Gomez. Insomnia and HIV: A Biopsychosocial Approach. A cura di Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding e Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0023.
Testo completoAbstract (sommario):
Insomnia is a common complaint across populations and can influence health in many ways. Individuals with HIV may be at higher risk for insomnia owing to direct effects of the virus, pain, psychiatric comorbidities, and other health- and treatment-related issues and lifestyles. This chapter reviews the physiology of healthy sleep and sleep hygiene and addresses assessment and treatment of insomnia in persons with HIV. Careful interview of a patient and accompanying family or friends with the Epworth Sleepiness Scale or Pittsburg Sleep Quality Index may help define the nature of the insomnia and target interventions. Treatment for insomnia can include a form of cognitive-behavioral therapy designed specifically for insomnia as well as education aimed at restructuring bedtime habits in order to promote better sleep. Medication use, such as benzodiazepines, melatonin, orexin, and non-benzodiazepine hypnotics, in this population must take into consideration the specific risks and benefits these medications may present in persons with HIV.
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Price, Jennifer Cohen, Priyanka Amin e Antoine Douaihy. Hepatitis C and HIV Co-Infection. A cura di Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding e Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0043.
Testo completoAbstract (sommario):
Chronic infection with hepatitis C virus (HCV) is a leading cause of end-stage liver disease and is the most common indication for liver transplantation in the United States. Because of shared risk factors, individuals living with HIV infection are disproportionately affected by HCV. Moreover, co-infection with HIV accelerates the natural history of chronic HCV infection, increasing the risk of cirrhosis, hepatocellular carcinoma, hepatic decompensation, and death. Highly effective medications such as direct-acting antivirals (DAA) to cure HCV are now available and have the potential to profoundly improve the health of HIV-HCV-co-infected individuals. However, addressing the many gaps in the HCV care cascade is necessary to fully achieve the benefits of these drugs. This chapter reviews the natural history of HIV-HCV co-infection, the psychiatric comorbidities associated with HCV infection, the evolution of HCV treatment, and the barriers to care that HIV-HCV-co-infected individuals continue to face.
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Feinstein, Robert E. Violence and Suicide. A cura di Robert E. Feinstein, Joseph V. Connelly e Marilyn S. Feinstein. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190276201.003.0018.
Testo completoAbstract (sommario):
Patients exhibiting violent or suicidal behavior have psychiatric symptoms varying along a spectrum of risk, from minimal to fatal. Evidence supports screening patients for intimate partner violence and suicide risk. Clinical care focuses on establishing a team and a working alliance, determining the “Why now?” of dangerousness, and using clinical judgments, risk assessment tools, a critical pathway, and a risk registry. Clinical care includes assessment of (1) violent or suicidal ideation, (2) recent dangerous behaviors, (3) past history of risky behaviors, (4) support system, (5) substance use, (6) cooperation with treatment, and (7) clinician reactions (8) diagnosis of medical and neurologic comorbidities. A multidisciplinary team can optimally manage these patients by deciding on the level of care needed for each problem or episode. Care can be delivered by using a practice registry and a critical pathway and focusing care on psychotherapy, with medications as needed. Steps are outlined for managing intimate partner violence.
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Liu, Timothy C. Phenomenology and Epidemiology of Problematic Internet Use. A cura di Jon E. Grant e Marc N. Potenza. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195389715.013.0065.
Testo completoAbstract (sommario):
This chapter discusses the phenomenology and epidemiology of problematic Internet se (PIU). Interest in the addictive potential of Internet activities has grown in the past two decades. Problematic Internet use can be broadly defined as uncontrolled use of the Internet that leads to significant psychosocial and functional impairments. It is currently conceptualized as an impulse control disorder that may share features with substance dependence disorders. Reliable studies have estimated the prevalence in the general population to be about 1%, but higher proportions of individuals might be at risk. Comorbidities with other psychiatric disorders are common. Concerns exist regarding the appropriateness and implications of formally recognizing PIU as a distinct disorder in current diagnostic systems. Given the ever-growing exposure to the Internet, especially in younger generations, PIU might become an emerging public health problem. Further studies are greatly needed, especially those using valid measures and longitudinal designs. Neuroimaging and genetic studies should also be explored.
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Webb, Allison M. B., Shannon C. Ford e Patcho N. Santiago. Adjustment Disorder. A cura di Frederick J. Stoddard, David M. Benedek, Mohammed R. Milad e Robert J. Ursano. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457136.003.0005.
Testo completoAbstract (sommario):
Adjustment disorder is a psychiatric diagnosis that has undergone numerous iterations within the Diagnostic and Statistical Manual of Mental Disorders and is characterized by an immediate or almost immediate maladaptive or pathologic psychological response to a stressor. When the stressor is removed, there is the expectation that the patient returns to his or her previous level of functioning. This chapter provides an overview of its historical development, diagnostic criteria, potential controversies, epidemiology, neurobiology, comorbidities, and other differential diagnostic and treatment considerations such as ruling out depression and using assessment instruments. The chapter closes with the presentation of a case illustrating application of the criteria and clinical characteristics of adjustment disorder.The views expressed in this chapter are those of the authors and do not reflect the official policy of the Department of Army/Navy/Force, Department of Defense, or U.S. Government. The identification of specific products or scientific instrumentation is considered an integral part of the scientific endeavor and does not constitute endorsement or implied endorsement on the part of the author, DoD, or any component agency.
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Kamath, Jayesh, e Ajay Shah. Mood disorders. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199360574.003.0034.
Testo completoAbstract (sommario):
Depression and Bipolar Disorder comprise a substantial percentage of all psychiatric care in the community. This is also the case in correctional settings. Diagnosis and treatment may vary in multiple ways, given the context and characteristics of jails and prisons. Reassessment of symptomatology at every visit, especially in the first few months of incarceration, enhances accurate diagnosis. The clinical presentation of many individuals at the time of incarceration is frequently confounded by substance withdrawal, adjustment issues, and other comorbidities. The clinical picture frequently evolves and allows improved accuracy over weeks to months. Decades of research conducted in the community and correctional settings have shown a close but controversial relationship between mood disorders, aggression, and criminality. This may be reflected in a substantially increased risk of multiple incarcerations as with the observation that inmates with bipolar disorders are 3.3 times more likely to have had four or more previous incarcerations compared with inmates who had no major psychiatric disorders. In terms of management risks, studies conducted with both genders in the correctional setting have shown a strong association between depression and near-lethal suicide attempts. Data reflect the importance of both psychotherapy and targeted, thoughtful medication management in the effective treatment of mood disorders. This chapter discusses the data and those characteristics, as well as core management, best-practice, and evidence based therapeutic approaches to the treatment of major depressive disorders and bipolar disorders in jails and prisons.
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Attention-Deficit Disorders and Comorbidities in Children, Adolescents, and Adults. American Psychiatric Publishing, Inc., 2000.
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Clark, Caroline, Jeffrey Cole, Christine Winter e Geoffrey Grammer. Transcranial Magnetic Stimulation Treatment of Posttraumatic Stress Disorder. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190205959.003.0005.
Testo completoAbstract (sommario):
Symptoms of post-traumatic stress disorder (PTSD) often fail to resolve with psychotherapy, pharmacotherapy, or integrative medicine treatments. Given these limitations, there is a continued push to discover treatment methods utilizing novel mechanisms of action. Transcranial magnetic stimulation (TMS) offers a non-invasive and safe method of brain stimulation that modulates neuronal activity in a focal area to achieve excitation or inhibition, and may have utility for patients suffering from PTSD, although, to date, evidence of efficacy is limited. The TMS treatment can be varied to suit the needs of the patient by altering the selection of the specific treatment parameters, such as pulse frequency or stimulation intensity. The weight of evidence to date supports treatment of either the right dorsolateral prefrontal cortex or the medical prefrontal cortex. Coupling treatment with script based exposure therapies may also assist with potentiation of the extinction response. Ultimately, stimulation parameters may be related to secondary downstream effects, and thus current targets may indirectly reverse the underlying neuronal pathophysiology. Given that PTSD is a complex illness with a poorly understood pathophysiology, it often exists with other psychiatric comorbidities or TBI. As such, TMS could be an effective part of a comprehensive treatment program.
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Post, Robert M. Depression as a Recurrent, Progressive Illness. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190603342.003.0003.
Testo completoAbstract (sommario):
Clinical Highlights and summary of Chapter• Episodes of depression and bipolar illness progress in two ways:faster recurrences as a function of number of prior episodes, andgreater autonomy (decreased need for precipitation by stressors(Episode Sensitization)• Recurrent stressors result in increased reactivity to subsequent stressors(Stress sensitization) and bouts of stimulant abuse increase in severity with repetition(Stimulant-induced behavioral sensitization)• Each type of sensitization cross-sensitizes to the others and drives illness progression• Each type of sensitization involves specific memory-like epigenetic processes as well as nonspecific cellular toxicities• Childhood onset depression and bipolar illness have a more adverse course than adult onset illness and are increasing in incidence via a cohort (year of birth) effect• As opposed to genetic vulnerability, each type of sensitization can be prevented with appropriate clinical intervention and prevention, which should lessen illness severity and progression• Seeing depression and bipolar disorder as progressive illnesses changes the therapeutic emphasis away from acute treatment and instead to long term prophylaxis• Preventing recurrent depressions will likely protect the brain, the body, and the personWord count with Named refs = 6,417>Depression and bipolar disorder are illnesses which tend to progress with each new recurrence. Stressors, mood episodes, and bouts of substance abuse each sensitize (show increased reactivity) upon their repetition and cross-sensitization to the others. These sensitization processes appear to have a memory-like and epigenetic basis, in some instances conveying lifelong increased vulnerability to illness recurrence and progression. Greater numbers of episodes are associated with faster recurrences, lesser need for stress precipitation, cognitive dysfunction, pathological changes in brain, treatment refractoriness, and loss of many years of life expectancy, predominantly from cardiovascular disease. Such a perspective emphasizes the need for greater awareness of higher incidence of psychiatric and medical comorbidities in the United States compared to many European countries, and the need for earlier intervention and more sustained long term prophylaxis to prevent illness progression and its adverse consequences on brain and body.
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Brugha, Traolach S. Approaches to treatment and care. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198796343.003.0012.
Testo completoAbstract (sommario):
Sharing with the patient and their carers the results of an assessment in autism and of what that means and the principles of post diagnostic support is covered. Conventional medically orientated ways of thinking about the treatment of autism including considerations of approaches to evaluating treatments are discussed. Also covered are the sought after targets of treatment, the role of patients, carers, and the public in choosing what their wishes and objectives are, uses of medication, structured psychological interventions including those focusing on adaptive and social skills, the limited role of genetic counselling, the role of guidelines and recent systematic reviews of the evidence base, and the treatment of comorbidities. Future prospects for treatment development are also touched on. Armed with a complete assessment and treatment recommendations, duties in relation to legal aspects of the psychiatry of autism are introduced.