Psichiatria

This book is the first practical manual describing a new and successful short-term treatment for traumatic stress and PTSD called Narrative Exposure Therapy (NET). The manual provides both experienced clinicians and trainees with all the knowledge and skills needed to treat trauma survivors using this approach, which is especially useful in crisis regions where longer-term interventions are not possible. NET has been field tested in post-war societies such as Kosova, Sri Lanka, Uganda, and Somaliland. Its effectiveness was demonstrated in controlled trials in Uganda and Germany. Single case studies have also been reported for adults and children. Three to six sessions can be sufficient to afford considerable relief. Part I of this manual describes the theoretical background. Part II covers the therapeutic approach in detail, with practical advice and tools. Part III then focuses on special issues such as dealing with challenging moments during therapy, defense mechanisms for the therapist, and ethical issues.

The single most important public health problem facing physicians today may be the failure of patients to follow their prescribed treatment regimens, a phenomenon that results in treatment failures, increased morbidity and mortality, and enormous burdens to society and the economy. This book focuses on the many factors that influence adherence behavior and discusses how this behavior can be improved. Drawing on data from social, personality, clinical, and health psychology, a leading authority on the subject examines the psychosocial, demographic, contextual, and provider determinants of patient compliance with physician recommendations and stresses their multiplicative influence. Alan J. Christensen presents several theories to account for this behavior and then offers his own new interactional framework, one that applies broader fundamental theorizing about psychological and behavior change to the problem and thereby sheds new light on efforts to promote adherence.

Recognized as the "gold standard" in consultation psychiatry, the newest edition of this handbook is an authoritative, compact, and affordable resource for psychiatrists, residents, and non-psychiatric medical staff. Written by members of the prestigious MGH Department of Psychiatry, it contains practical advice and strategies for diagnosing and treating the most common psychiatric problems seen in the general hospital setting. For the psychiatrist, it remains a practical guide to cognitive, behavioural, and psychopharmacological tools needed to diagnose patients and to advise non-psychiatrists. For the primary care provider, it provides basic psychiatric information to assist in care of medical patients under psychiatric care or who have a psychiatric dimension to their illness.

Patient suicide is an unavoidable occupational hazard of psychiatric practice. Indeed, it is the rare clinician who does not struggle, even agonize, over the complex task of assessing and managing the risk of suicide in patients. Patient suicides account for the greatest number of malpractice suits filed against psychiatrists and for the greatest number of settlements and verdicts covered by professional liability insurers. In this book, written by a clinician for clinicians, Dr. Simon, an established expert in psychiatry and law, offers -A solid, easy-to-understand review of how medical malpractice law applies to patient suicides. He discusses the standards of care physicians must meet, the conditions associated with malpractice liability, and how best to minimize risks of litigation. -Extensive references to peer-reviewed literature on suicide and recent malpractice cases, including those triggered by patient suicides, which give insight into the latest developments in both the scientific community and the courts. -Much-needed practical advice, including advice on working with suicide risk assessments and suicide prevention contracts, on treating suicidal patients in various settings (outpatient, inpatient, collaborative, and emergency), and on coping with issues arising in the aftermath of a patient's suicide (documentation, confidentiality, and survivor care). -Clearly defined risk management guidelines that will help clinicians avoid litigation or establish a sound legal defense if sued for malpractice. -Numerous case examples that make the theoretical discussions and clinically based risk management guidelines that follow come alive. Rich in advice that draws on the author's more than 40 years of clinical experience, this book serves as an essential aid to clinicians.

Unipolar major depression is one of the most prevalent and serious of the mental health disorders. It can result in chronic mental and physical ill health, social difficulties and suicide. The disorder occurs across the lifespan; however, its characteristics and outcomes vary with the age of the sufferer. Children, adolescents, adults and the elderly may all present with a depressive illness but the characteristics, response to treatment and final outcome show considerable variations between age groups. The extent to which genetic and environmental factors and processes contribute to the onset may be influenced by the developmental components of human growth and ageing. Equally, the social context within which depressions occur are not the same at different points in life. There are also known to be differences in relative responses to psychological and pharmacological treatments across the lifespan. Unipolar Depression: A Lifespan Perspective examines these, and other, issues, focusing on the continuities and discontinuities that arise in the nature of the disorder and how genetic, hormonal, psychological and social processes operate differentially throughout life. The chapters are written by major figures from the field of clinical research into depressive illness.