Synopsis of Psychiatry [antikvár]

Preface This is the sixth edition of Synopsis of Psychiatry to appear within a span of almost 20 years. The timing of its publication represents a departure from previous editions in that only three years instead of the usual tour years have elapsed since the last edition. The reasons for this change are several: New advances in the neural sciences have occurred at an especially rapid pace, particularly in the areas of neurochemistry, neurophysiology, psychoimmunology, and psychoendocrinology; significant data about the nosology, diagnosis, and treatment of mental illness have emerged; and the number of therapeutic methods, particularly in the area of psychopharmacology, have grown rapidly. Because of these changes and advances, a new edition of Synopsis was deemed necessary at this time. An eclectic and multidisciplinary approach is the hallmark of this book and all other books by the authors and shall remain so. Accordingly, biological, psychological, and sociological factors are integrated and presented as they affect the person in health and disease. Modern psychiatry must emphasize the humane and compassionate aspects of medicine; this textbook is dedicated to the humanism that is unfortunately often lost in technically based modern medical education, training, and practice. Of equal importance, the interactions between medical school faculty and students require a high level of mutual empathie concern if America is to avoid producing computerlike robotic physicians. In the United States psychiatry is one of the few medical school courses consistently included throughout the four years of the curriculum. If taught property, with quality and sensitivity, psychiatry should be a dramatic and continuing reminder to all in medicine of their mission—the diagnosis, treatment, and elimination of pain, suffering, and disease through the treatment of the whole patient. The authors believe that textbooks of medicine have an obligation to provide a forum for a discussion of some of the sociopolitical forces that affect medical practice. Some doctors in today's complex society wear many hats— for example, physician and administrator and politician. In those roles controversy may arise regarding decisions in which they participate: managed care; third-party insurance reimbursement for medical and psychiatric care; Medicare and Medicaid; the use and classification of the boundaries and the definition of controlled substances; the use of triplicate prescriptions; poverty, homelessness, and deinstitutionalization; and the working conditions and number of hours on duty of medical house staff are but a few. The authors believe that the time has arrived when medical educators should make observations about these and other controversial areas, and the reader will find such comments in this book. Psychiatrists, who are involved in the humane and psychological aspect of medical care, have a special obligation to discuss all issues that affect the physical and psychological well-being of their patients and their own freedom to exercise their best medical judgment in their work. CHANGES IN THIS EDITION New and updated sections. The chapter "The Brain and Behavior" has been updated to provide thorough coverage of the fields of neurochemistry, neurophysiology, and psychoendocrinology, which represent the cutting edge of psychiatry. Other new and extensively changed areas include geriatric psychiatry, the doctor-patient relationship, psychiatric interviewing techniques, history taking and mental status examination, brain-imaging techniques, ethics, neuropsychiatrie tests and rating scales, the role of laboratory tests in psychiatry, psychiatry and acquired immune deficiency syndrome (AIDS), neuropsychiatry, behavioral medicine, and the psychiatric aspects of immunology. The chapters on child psychiatry have been heavily rewritten. The chapter on the life cycle has been greatly expanded, with a new discussion of pregnancy and childbirth, among other issues. In addition, the authors have included many clinical case vignettes to illustrate the various psychiatric disorders. These cases have been adapted from the revised third edition of DSM-III-R Case Book, published by the American Psychiatric Press, Inc., from which permission was obtained. Biological therapies. A major change has been introduced in the organization of the chapter on biological therapies. The authors discuss drugs used in the treatment of psychiairic illness in a unique and novel manner through the use of a new pharmacological classification. This represents a departure from the discussion of psychiatric drug therapy under the rubrics of antidepressants, antipsychotics, and the like. This was done to provide the student with a deeper and more comprehensive understanding not only of the general principles of psychopharmacology but also of the use of psychotherapeutic drugs according to their pharmacological activity as discrete drugs, rather than as one of a family of drugs. This edition has expanded information about the uses, caution, interactions, and dosages of drugs, including color illustrations of ail the major