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Principles and Practice of Child and Adolescent Forensic Mental Health

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When care of younger patients raises thorny legal questions, you need answers you can trust: that's why this book belongs on every clinician's reference shelf. Principles and Practice of Child and Adolescent Forensic Mental Health is a timely and authoritative source that covers issues ranging from child custody to litigation concerns as it walks clinicians through the often-confusing field of depositions and courtroom testimony.The book expands on the 2002 volume Principles and Practice of Child and Adolescent Forensic Psychiatry winner of the 2003 Manfred S. Guttmacher Award, to meet pressing twenty-first-century concerns, from telepsychiatry to the Internet, while continuing to cover basic issues, such as forensic evaluation, psychological screening, and the interviewing of children for suspected sexual abuse, that are important to both new and experienced practitioners. Many of its chapters have been entirely rewritten by new authors to provide fresh insight into such topics as child custody; juvenile law; abuse, neglect, and permanent wardship cases; transcultural, transracial, and gay/lesbian parenting and adoption; and the reliability and suggestibility of children's statements. It also includes significant material not found in the previous volume:   Two chapters on special education offer an introduction to screening instruments and help practitioners determine a child's potential need for special education programs and services. A chapter on cultural competence helps readers improve the accuracy and responsiveness of forensic evaluations and minimize the chance of an unjust outcome resulting from misguided expert opinion. The section on youth violence features three new chapters -- Taxonomy and Neurobiology of Aggression, Prevention of School Violence, and Juvenile Stalkers -- plus a newly written chapter on assessment of violence risk, offering guidance on how to confront problems such as bullying and initiate effective family interventions. A chapter on psychiatric malpractice and professional liability addresses these legal concerns with an eye toward cases involving minors. A chapter on psychological autopsy covers evaluation of the circumstances surrounding pediatric suicides, describing various types of equivocal deaths and discussing legal issues such as admissibility of the autopsy in court. A newly written chapter on the Internet expands the previous book's focus on child pornography to help practitioners deal with issues ranging from online threats to emotional and legal consequences of interactions in cyberspace. This is a valuable reference not only for practitioners in psychiatry and the mental health field but also for attorneys and judges. It opens up a field that may be too often avoided and helps professionals make their way through legal thickets with confidence.

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Peter Ash, Charles L. Scott, Elissa P. Benedek

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Clinical Manual for Management of Bipolar Disorder in Children and Adolescents

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Clinical Manual for Management of Bipolar Disorder in Children and Adolescents was written in response to the growing body of knowledge surrounding pediatric bipolar illness and the underlying biological, environmental, and psychosocial influences that exacerbate symptoms and behavior. Written to provide clinically useful information about diagnosis and management, this manual is a comprehensive collection of empirical evidence, case studies, and the growing number of evidence-based reports on pediatric bipolar disorder over the past five years.This manual also contains several chapters provided by Dr. Mary Fristad and her team at The Ohio State University -- experts in family and psychosocial aspects of pediatric bipolar disorder. Her contributions, along with vast clinical evidence and the expertise provided by Drs. Kowatch, Findling, and Post, help paint an accurate picture of everything from age onset to the effectiveness of various therapies.  In this manual, clinicians can refer to the following tools: A clinical description of childhood and adolescent bipolar disorder  Management strategies for the patient including daily mood charting Current medication strategies and tactics Ways to help patients through the educational system Resources for clinicians, parents and patients A review of the future directions for childhood and adolescent bipolar disorder The many new developments in the field of pediatric bipolar disorder are affirming what this manual emphasizes -- that a combination of family and cognitive-behavior therapy can work in tandem with medical treatments to help young bipolar disorder patients achieve a more balanced life and a greater chance of controlling this illness later in life. The manual demonstrates how the medical community has shifted from asking, "Does bipolar disorder really exist in children and adolescents" to "How can we best predict, diagnose and treat this serious medical disorder" through a review of 25 years of study and insight.

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Robert M. Post, Robert A. Kowatch, Mary A. Fristad, Robert L. Findling

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Clinical Manual of Electroconvulsive Therapy

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Increasingly, electroconvulsive therapy (ECT) is recognized as a proven, effective, and even life-saving intervention in certain mood and thought disorders when other treatments have had little or no effect. Despite the proven efficacy and safety of this standard treatment in psychiatry, its availability is variable. Part of this disparity in access is related to misunderstanding by laypersons regarding the treatment and its potential adverse effects. Adequate education and training of psychiatrists and their support staff are essential to ensuring patients' access to this vital treatment tool. The authors of Clinical Manual of Electroconvulsive Therapy offer this expansive yet reader-friendly volume to help psychiatrists successfully incorporate ECT into their clinical practices. It is also a valuable resource for medical students and psychiatric residents, as well as experienced clinicians and researchers.The book updates the 1985 original and 1998 second edition of Electroconvulsive Therapy: A Programmed Text, and provides readers with a scheduled approach to understanding the fundamental concepts of ECT while offering practical guidance for establishing and maintaining an ECT program. Topics include the history of ECT, indications for use, patient referral and evaluation, the basics of ECT, clinical applications, anesthetics and other medications, seizure monitoring and management, ictal motor and cardiovascular response, adverse effects, and maintenance ECT. Included are detailed descriptions of recent advances including ultra-brief pulse ECT, oxygenation, muscle relaxation, and other modifications that have made this very effective treatment much safer and more acceptable to patients. Currently, it is estimated that more than 100,000 people receive ECT treatments each year in the U.S. Indications for use of ECT are for mood disorders such as major depressive disorder and mania, and thought disorders including schizophrenia and schizoaffective disorder. Indications for use in other psychiatric disorders and general medical disorders such as Parkinson's disease, which appears to respond especially well to ECT, are reviewed as well. This highly-readable manual is a must-have for the library of any clinician interested in or currently practicing ECT:   Provides background information on the origins of psychiatric treatments preceding ECT, including efforts using hydrotherapy and insulin comas  Includes an algorithm for the management of ECT seizure adequacy Discusses contraindications as well as the potential adverse effects of ECT, including cognitive changes and cardiovascular complications Provides specific information about ECT device manufacturers, reprintable patient information sheets, and a written informed consent form This clinical manual comprehensively explores and explains the available knowledge regarding ECT -- based on extensive research over the past 70 years -- in order to help potential ECT clinicians make informed choices about the development and management of their ECT program.

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Richard D. Weiner, John L. Beyer, Andrew Krystal, Mehul V. Mankad

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Handbook of Diagnosis and Treatment of Bipolar Disorders

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This readable guide to the assessment and management of patients with bipolar disorder can help physicians keep abreast of dramatic and rapid advances of recent years and integrate them into their practice. Handbook of Diagnosis and Treatment of Bipolar Disorders emphasizes recent controlled studies and FDA-approved indications and translates these data into the real world of clinical practice. The contributions of the eleven chapter authors from Stanford University reflect more than a decade of clinical research and treatment undertaken at that institution, including advances in diagnosis and interventions supported by controlled studies. They provide crucial information regarding diagnosis, pharmacotherapy, psychotherapy, and treatment of patients from special populations -- such as children, women, and older adults -- and patients with particular challenging illness course such as rapid cycling.This is the first book to provide quantitative assessment of potential benefit (number needed to treat) and risk (number needed to harm) for all approved treatments for bipolar disorder, providing clinicians with information needed to balance benefits and risks in order to render individualized state-of-the-art, evidence-based care. It describes all FDA-approved indications -- reviewing efficacy, safety, tolerability, pharmacokinetics, illness phase-specific dosing, and drug interactions. A chapter on multiphase treatment strategy explains crucial illness transition points and describes how these have been integrated with knowledge of illness phase in mood disorders. The book then demonstrates the relevance of this approach to therapeutics by providing:   An overview of pharmacotherapy that covers the emergence of evidence-based pharmacotherapy and number-needed-to-treat and -harm analyses. Guidelines to managing acute manic and mixed episodes that include evidence-based assessments of lithium, divalproex, carbamazepine, and second-generation antipsychotics. Coverage of acute major depressive episodes in bipolar disorders that outlines four tiers of treatment for this most pervasive illness phase with the fewest approved treatments. Discussion of the longer-term management of bipolar disorders, including reviews of controlled trials of recently approved pharmacotherapies such as lamotrigine, olanzapine, aripiprazole, and adjunctive quetiapine.  A review of the use of mood stabilizers and second-generation antipsychotics, often in combinations, as well as the controversial role of adjunctive antidepressants in treating patients with rapid-cycling bipolar disorders.  Description of important advances in evidence-based adjunctive psychotherapeutic interventions in bipolar depression, and bipolar maintenance treatment. Comprehensive in scope, yet readily accessible for application to clinical practice, the book includes summary tables, quick-reference lists of clinical pearls, and case studies to make its content more relevant. Handbook of Diagnosis and Treatment of Bipolar Disorders is the ideal source for integrating recent research into everyday practice.

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Acclaimed as "a tremendous contribution to the field of psychiatry" (Doody's Health Science Book Review Journal), the Textbook of Anxiety Disorders is now available in an expanded second edition. The new edition continues to offer both clinicians and researchers a single-volume resource that covers not only progress in clinical interventions but also the latest advances in theoretical knowledge. Following a comprehensive overview of anxiety disorders, the book provides detailed coverage of seven specific DSM-IV-TR diagnoses: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), mixed anxiety-depression, panic disorder, social phobia, specific phobias, and posttraumatic stress disorder (PTSD). Each section covers the latest thinking on symptomatology and pathogenesis, then provides evidence-based clinical recommendations for pharmacotherapy and psychotherapy.    All chapters have been expanded and fully updated with new research findings. Many chapters have been entirely rewritten by new authors to provide fresh insight into such topics as integrated treatment of anxiety disorders; pharmacotherapy for GAD, OCD, and panic disorder; psychotherapy for OCD and PTSD; anxiety disorders in the elderly; anxiety accompanying substance abuse; and the economic and social costs of anxiety. In addition, new chapters on anxious traits and temperaments, the neuropsychology of anxiety disorders, and anxiety and insomnia enhance this comprehensive edition.  Each chapter now includes a concise summary of key clinical points that helps readers put findings into practice -- as well as recommended readings that provide access to essential reports. Standing at the cutting edge of anxiety disorder research and clinical practice, this authoritative volume deserves a place on the reference shelf of any busy clinician, researcher, or educator. It will be invaluable to all mental health care professionals interested in the latest developments in understanding and treating these complex and costly disorders.

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Eric Hollander, Dan J. Stein, Barbara O. Rothbaum

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Despite growing awareness in the psychiatric community of the multifaceted medical needs of the severely mentally ill, statistics show that as much as 60% of all schizophrenia patients die prematurely from nonpsychiatric medical conditions -- in part because many physicians have not yet recognized how to properly treat common diseases and illnesses within this complex patient population. Medical Illness and Schizophrenia, Second Edition, is the only clinical guide to focus exclusively on the treatment of common medical comorbidities among patients with schizophrenia. Like its best-selling predecessor, the book compiles the latest research and clinical information on integrating medical and psychiatric care for the schizophrenia patient. Twenty-eight physicians and psychiatrists, including editors Jonathan M. Meyer, M.D., and Henry A. Nasrallah, M.D., lend their expertise to this new, expanded edition. In fifteen chapters, this volume covers a wide range of common medical problems -- from metabolic and heart conditions, such as cardiovascular disease, hyperlipidemia, obesity and diabetes, to substance abuse and smoking. Each chapter concludes with "Key Clinical Points" that summarize important concepts and ensure reader retention. Additionally, the second edition includes new chapters that touch on some of the most complex clinical issues in the field of schizophrenia treatment today:   Recent trends in the integration of medical and mental healthcare  Behavioral treatments for weight loss in persons with schizophrenia Treatment of sexual dysfunction among persons treated for schizophrenia Health outcomes of schizophrenia treatment in children and adolescents Health outcomes of schizophrenia treatment during pregnancy and breastfeeding As the only clinical text of its kind, Medical Illness and Schizophrenia, Second Edition, is an invaluable resource for psychiatrists, nurses, healthcare professionals, and psychiatric and clinical residents. The goal of this text has always been to help clinicians recognize schizophrenia as both a brain disorder and a systemic disease with multiple manifestations that go beyond the obvious psychiatric symptoms -- and thus take a broader approach to treatment of schizophrenia. This new edition is a comprehensive, practical manual that serves as a reference for the medical management of seriously mentally ill patients across the age spectrum in both inpatient and outpatient settings.

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Forensic psychiatry is growing in popularity, and many a practitioner feels the urge to explore this fascinating realm of endeavor. The second edition of The Psychiatrist as Expert Witness, by Thomas G. Gutheil, M.D., is a highly readable and practical guidebook for those interested in entering the field while navigating the dangers inherent in courtroom testimony. This volume is a thoroughly revised and updated edition of his highly successful first edition. The earlier edition has been used in nearly all forensic psychiatric training programs in the U.S. and Canada since its publication in 1998.A professor of psychiatry at the Beth Israel-Deaconess Medical Center-Harvard Medical School, Gutheil draws on his decades of experience in the courtroom and countless beginner's mistakes to help readers avoid the pitfalls of serving as an expert witness. While of great value to newcomers to the field, the book offers insight and guidance to early-career and seasoned expert witnesses as well.As in the first edition, this volume explores the role of the expert witness, moral issues, basic principles, depositions and trials, writing for the court, and ethical marketing. Besides the requisite updating of references and suggested readings, this latest volume features expansions and additions of particular benefit to prospective expert witnesses:   A glossary of useful terms  Expanded definitions of key concepts A lengthened discussion of bias in testimony Additional illustrative examples A model forensic consent form for examination Cases and principles that have arisen since the first edition The Psychiatrist as Expert Witness provides the practical, hands-on mentoring and guidance that were not readily available in the past. Concrete advice replaces abstract theorizing, and informal discussion in a user-friendly tone replaces scholarly discourse. These attributes combine to make this a book that is highly accessible and usable in real world courtroom settings.While some in society decry the expert witness function, the courts will continue, from all evidence, to require expert witness testimony in increasing numbers. The author seeks to help his colleagues meet the courts' needs with ethical, effective and helpful testimony through the publication of this revised volume. At the same time, Gutheil strives to make the often complex arena of forensic psychiatry more understandable to those who wish to enter the field and to seasoned experts eager to keep up with contemporary changes in forensic psychiatry.

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The American Psychiatric Publishing Textbook of Alzheimer Disease and Other Dementias

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The American Psychiatric Publishing Textbook of Alzheimer Disease and Other Dementias is an up-to-date and comprehensive overview of dementia for psychiatrists and other health care practitioners who deal with cognitively impaired adults in outpatient, inpatient, and long-term care settings. With content ranging from clinical guidance to basic research, it contains information on nearly every subject related to dementing conditions or illnesses -- not only providing extensive coverage of clinical management issues but also enabling a deeper understanding of the causes of dementia. Designed to assist the practitioner faced with everyday dilemmas, from dosages of antipsychotic drugs to legal and ethical issues, this textbook describes in detail the most common conditions and diseases leading to dementia and covers pharmacologic, behavioral, and environmental treatments. It also considers a broader range of cognitive disorders and impairment in order to help practitioners recognize and treat primary brain diseases and systemic disorders affecting the brain before they reach the stage of dementia.Building on the editors' earlier work The Dementias: Diagnosis, Treatment, and Research, this new book expands on its scope, with nearly twice the number of contributors -- all clinicians or researchers at the vanguard of the field. New to this edition are chapters on epidemiology, history of dementia, biomarkers for Alzheimer disease, care of the late-stage dementia patient, prevention of dementia, and chapters devoted to:   Vascular cognitive impairment, emphasizing the importance of early detection with development of appropriate treatments and risk factor control Dementia with Lewy bodies and other synucleinopathies, describing differences in cognitive profile between synucleinopathies and Alzheimer disease Frontotemporal dementias, including behavioral and language variants Traumatic brain injury, distinguishing between proximal and distal effects and risk factors for dementia later in life An abundance of charts and illustrations, extensive references and additional readings, and chapter-end key points make this a practical volume for learning, while appendixes include easily administered instruments useful in daily practice for grading cognition, day-to-day function, neuropsychiatric symptoms, and quality of life. Whether used as a clinical guide or as a sourcebook on technical and scientific developments, The American Psychiatric Publishing Textbook of Alzheimer Disease and Other Dementias is an important reference for psychiatrists, neurologists, geriatricians, primary care physicians, and other health professionals who deal with cognitively impaired adults.

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Clinical Manual of Drug Interaction Principles for Medical Practice

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Drug interactions have become a significant iatrogenic complication, with as many as 5% of hospitalizations and 7,000 deaths annually attributable to drug-drug interactions in the United States. There are several reasons these numbers have increased. First, many new medications have been brought to market in recent years. Second, advances in medical care have resulted in increased longevity and more elderly patients than ever before -- patients who are more likely to be following polypharmacy regimens. Population patterns in the U.S. have amplified this trend, with aging baby boomers swelling the patient pool and demanding treatment with medications advertised on television and in print. Fortunately, drug interactions can be prevented with access to current, comprehensive, reliable information, and the Clinical Manual of Drug Interaction Principles for Medical Practice provides just that in a user-friendly format psychiatry clinicians (including residents and nurses) and forensics experts will find indispensable. With this new edition, the book has evolved from "Concise Guide" to "Clinical Manual" and offers the expanded coverage and features healthcare providers need to keep up with this critical field. The book is well organized, with major sections on metabolism; cytochrome P450 enzymes; drug interactions by medical specialty; and practical matters, such as the medicolegal implications of drug-drug interactions and how to retrieve and review the literature. In the section on P450 enzymes, each chapter addresses what the individual enzyme does and where, its polymorphisms, and drugs that inhibit or induce activity. Each chapter also includes extensive references and study cases to help the reader understand and contextualize the information. A number of additional features enhance the book's scope and utility:   The book boasts the very latest information in the area of drug metabolism, transport, and interaction. The chapter on P-glycoprotein (a drug transporter) was expanded from the last edition to include a broader array of transport mechanisms. The highest ethical standard was adhered to in the development of this volume, which was not supported in any way by pharmaceutical makers or distributors. All eight contributors to this excellent resource are experts in the fields they have addressed, and clinicians can trust that the information contained in the Manual reflects the very latest research. This exceptionally practical manual is essential to maintaining the highest standard of care.

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Gary H. Wynn, Jessica R. Oesterheld, Kelly L. Cozza, Scott C. Armstrong

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The time is right for recovery from serious mental disorders. Mental health professionals and state and local mental health agencies are responding to a national call for action on recovery: from the President's Commission on Mental Health, the Surgeon General, the National Alliance on Mental Illness, and the Substance Abuse and Mental Health Services Administration. But how can recovery from mental disorders become a reality? Recovery From Disability describes the principles and practices of psychiatric rehabilitation to bridge the gap between what is known and what actually can be used to achieve recovery for patients in real-life mental health programs. The book draws on Dr. Robert Paul Liberman's 40 years of designing, testing, and disseminating innovative treatments for persons with mental disabilities. Illuminating up-to-date treatment techniques that reflect a consensus of experts regarding evidence-based practices, Dr. Liberman shows how recovery can be the rule rather than the exception.This practical book addresses day-to-day realities faced by practitioners who must wrestle with the individualized needs and personal goals of each patient while drawing up a rehabilitation roadmap to recovery. Written in a down-to-earth manner with minimal jargon, this clinical manual is intended for everyday use. Brimming with clear advice and ideas for effective services, the book is relevant to the work of all mental health disciplines, administrators, consumer advocates, and clinicians with all levels of experience. Practice-based evidence is highlighted by an abundance of real-life examples and a host of graphic aids. The author addresses the particular needs of Latino patients and takes up the latest developments in rehabilitation, such as illness management, social and independent living skills training, neurocognitive pharmacology, cognitive remediation, and use of computers in rehabilitation. Each chapter contains information, techniques, and treatment methods that enable clinicians to:   Help patients select realistic yet personally meaningful goals for enriching their lives Teach patients how to stabilize their symptoms and cognitive impairments Train patients in social and independent living skills for empowerment and autonomy Educate family members and other caregivers to collaborate with mental health professionals in overcoming their loved one's disability Provide access to vocational rehabilitation, including supported employment Facilitate comprehensiveness, continuity, and coordination of competency-based rehabilitation, using personal support specialists, assertive community treatment, and integrated mental health care Dr. Liberman also describes how to customize services that are effective for individuals with more than one disorder, whose disorder is refractory to customary pharmacological and psychosocial treatments, or whose adaptation to community life is marred by aggressive behavior. With its wealth of rich and immediately applicable treatment approaches, Recovery From Disability will help professionals equip mentally disabled patients to reach their personally relevant goals and progress on the road to recovery.

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Cognitive Dysfunction in Bipolar Disorder

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A growing body of clinical and experimental evidence shows that neurocognitive dysfunction is a fundamental -- yet frequently ignored or misidentified -- component of bipolar disorder. The first comprehensive book of its kind, Cognitive Dysfunction in Bipolar Disorder: A Guide for Clinicians compiles the latest data in neuropsychology, neuroimaging, neurogenetics, and functional outcomes research to enable clinicians to more effectively utilize pharmacological and psychotherapeutic techniques in their treatment of bipolar disorder.This volume outlines and demystifies current knowledge about neuropsychological functioning in bipolar disorder in a reader-friendly, easy-to-understand guide for practitioners. Its 12 chapters, written by 23 internationally-renowned expert contributors, examine such topics as attentional and executive functioning, neuroimaging and genetic correlates of cognitive functioning, pharmacological strategies, bipolar disorder in pediatric patients, and cognition across the life span.The book also comes with the added benefit of   A review of neurocognitive domains, examples of their operation in everyday life, the neuroanatomical regions with which they are associated, and common tests used to assess their function Summarized data from large-scale clinical trials, including the National Institute of Mental Health Antipsychotic Trials of Intervention Effectiveness (CATIE) study Take-home points at the end of each chapter summarizing main concepts and "clinical pearls" Case studies and illustrative examples depicting the application of specific neurocognitive principles Using relevant applications from cognitive neuroscience, Cognitive Dysfunction in Bipolar Disorder provides clinicians with a comprehensive overview of astounding breakthroughs in the assessment and treatment of patients with bipolar disorder. It plows new ground in the mental health industry, correcting distortions and laying the foundation for future clinical research in this rapidly expanding field.

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Covering the range of clinical presentations, treatments, and levels of care, Borderline Personality Disorder: A Clinical Guide, Second Edition, provides a comprehensive guide to the diagnosis and treatment of borderline personality disorder (BPD). The second edition includes new research about BPD's relationship to other disorders and up-to-date descriptions of empirically validated treatments, including cognitive-behavioral and psychodynamic approaches. Compelling new research also indicates a much better prognosis for BPD than previously known.A pioneer in the field, author John Gunderson, M.D., director of the Borderline Personality Disorder Center at McLean Hospital, draws from nearly 40 years of research and clinical experience. The guide begins with a clear and specific definition of BPD, informed by a nuanced overview of the historical evolution of the diagnosis and a thoughtful discussion of misdiagnosis. Offering a complete evaluation of treatment approaches, Dr. Gunderson provides an authoritative overview of the treatment options and describes in-depth each modality of treatment, including pharmacotherapy, family therapy, individual and group therapy, and cognitive-behavioral therapies. Unlike other works, this book guides clinicians in using multiple modalities, including the sequence of treatments and the types of changes that can be expected from each mode. The discussion of each treatment emphasizes empirically validated therapies, helping clinicians choose modalities that work best for specific patients. In addition, Borderline Personality Disorder: A Clinical Guide, Second Edition, also outlines therapeutic approaches for multiple settings, such as hospitalization, partial hospitalization or day hospital programs, and levels of outpatient care. Complementing the well-organized treatment guide are a series of informative and intriguing sidebars, providing insight into the subjective experience of BPD, addressing myths about therapeutic alliances in BPD, and questioning the efficacy of contracting for safety. Throughout the book, Dr. Gunderson recommends specific do's and don'ts for disclosing the diagnosis, discussing medications, meeting with families, starting psychotherapy, and managing suicidality.A synthesis of theory and practical examples, Borderline Personality Disorder: A Clinical Guide, Second Edition, provides a thorough and practical manual for any clinician working with BPD patients.

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A Forensic Psychiatrist Illuminates the Darker Side of Human Behavior

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Robert Simon's Bad Men Do What Good Men Dream: A Forensic Psychiatrist Illuminates the Darker Side of Human Behavior is that rare title that is both essential reading for the mental health professional and accessible in style and content to the fascinated lay reader. In twelve powerful and provocative chapters, the author introduces readers to a psychological perspective on evil, character and destiny, as well as the making of good men and women. Simon also illuminates the psychology of psychopaths, serial killers, rapists and all manner of evil characters who appall and challenge us by their very existence. He rejects the common belief that his subjects are "monsters" with nothing in common with the more "normal" among us. Simon posits that if we deny our dark side, it can only obscure our understanding of violent offenders and impede our ability to both know ourselves and control our own, at times, unacceptable impulses.The author is among the foremost experts in forensic psychiatry. He is Director of the Program in Psychiatry and Law at Georgetown University School of Medicine. Author or co-author of more than two dozen books and editions, including the foundational Textbook of Forensic Psychiatry, Simon has made important contributions to the field of forensic psychiatry for more than 30 years. He is also an eloquent writer with a dramatic, yet nuanced, narrative style that takes the reader inside the mind of the evildoer.The first edition of this groundbreaking work garnered uniformly superlative reviews and was translated into several languages. This updated version retains Simon's engrossing portrayals and keen insight, while offering a number of key enhancements. The highlights include:    Explorations of the Internet and violence, "corporate" psychopaths, cyberstalkers, perpetrators of school violence, and a new cast of serial killers, terrorists, and other evildoers. A psychological perspective on evil, serial killers, and us. Updates on the neuroscience and genetics of deviant behaviors. Reflections on empathy, character, and destiny: the making of good men and women. A new foreword by Thomas G. Gutheil, M.D., Professor of Psychiatry and Co-Founder, Program in Psychiatry and the Law at Harvard Medical School, that illuminates Simon's thesis and grounds it in historical context. Graphic but never sensational, unsparing but never cold, Simon's writing transcends the theoretical and achieves that most difficult of aims: leading readers to discover, contain, and transform the darkness within us all, to the betterment of our human condition.

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Psychiatrists, psychoanalysts, other mental health workers, behavioral scientists, and university medical and neuroscience professionals will benefit from this articulate insider's view of post-World War II psychiatry in Changing American Psychiatry: A Personal Perspective by Melvin Sabshin, M.D. Dr. Sabshin served as Medical Director of the American Psychiatric Association (APA) for 23 years, from 1974 to 1997, during a period of perhaps the greatest change in psychiatry since the World War II produced a dramatic modification of practice.The author describes in detail two extraordinary periods of change, the first stimulated by laudatory efforts to understand the high rate of psychiatric casualties among World War II veterans and to provide treatment for them. Psychiatry grew quickly during the postwar years, considerably influenced by the immigration of many Central European psychoanalysts. Gradually, however, psychiatry began to weaken its ties to medicine and lost much of its public respect. By the 1970s, postwar optimism had been replaced by widespread concern that psychiatric practice was being dominated by unsubstantiated formulations rather than reliable evidence. Psychiatry was dramatically impacted by enormous pressure for therapeutic accountability exerted by a managed care reimbursement system. The profession recognized the need for a new direction and resolved to change.In the foreword to the book, current APA Medical Director James H. Scully Jr., M.D., notes that Dr. Sabshin has woven a personal journey of the history of the intellectual conflicts and changes in the field of psychiatry in the post-war era, culminating in the remedicalization of psychiatry and the development of the DSM-III.Dr. Sabshin encourages psychiatric professionals to change the field so it can employ an empirically based "bio-psycho-social" model that has the potential to revitalize the next phase of American psychiatry. He details how the potential for the future of psychiatry can be enhanced by today's practicing professionals, stressing the:   Need to incorporate the rapid developments of neuroscience into a professional practice that is increasingly integrated with empirically demonstrated psychological and social influences upon mental illness. Importance on continued research that is fed back into practice and keeps the professional evidence-based. Need of psychoanalysis to make its beliefs explicit, formulating hypotheses that can be tested scientifically in order to be employed reliably in evidence-based practice. This well-crafted historical account describes how the profession has become a more respected and accountable part of medicine and how it scientific credentials have risen as a result. Dr. Sabshin concludes that the use of psychological understanding and psychotherapies must play a major role combined with psychopharmacology in the treatment of psychiatric patients.

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Textbook of Violence Assessment and Management

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Evaluating and treating patients with violent ideations and behaviors can be frustrating, anxiety-provoking, and even dangerous, as errors in judgment can lead to disastrous consequences. Fortunately, there is the Textbook of Violence Assessment and Management, the first and only comprehensive textbook on assessing the potentially violent patient for mental health clinicians on the front lines of patient care. Uniquely qualified to produce this comprehensive volume, the editors have assembled a distinguished roster of contributors who, in 28 practical chapters, combine evidence-based medicine with expert opinion to address the topic of patient violence in all its diversity of presentation and expression. Dr. Simon is Director of the Program in Psychiatry and Law at Georgetown University School of Medicine, as well as the author or co-author of more than two dozen books. Dr. Tardiff, Professor of Psychiatry and Public Health at the Payne Whitney Clinic, The New York Hospital -- Cornell Medical Center, is the author of The Concise Guide to Assessment and Management of Violent Patients, an introduction to aggression management now in its second edition.Violence is both endemic to our society and epidemic in our age. Skilled assessment and management of violence is therefore critical for mental health professionals involved in patient care. The Textbook of Violence Assessment and Management includes many features designed to instruct and support these clinicians. For example:   It is the first comprehensive textbook to take the mental health professional from evaluation and assessment to treatment and management of patients who are or may become violent.  The 28 chapters address the diversity of clinical settings, patient demographics, psychopathology and treatment modalities, making this work useful as both a textbook and a reference that clinicians can consult as needed for particular cases. End-of-chapter "Key Points" highlight the most important concepts and conclusions, allowing students to review and consolidate their learning and practicing professionals to locate critical information quickly. Clinical case examples abound, providing rich and nuanced perspectives on patient behavior, evaluation and management. The textbook includes a separate chapter on evaluating patients from different cultures, a competency that becomes more crucial as patient populations become more diverse. Increasing numbers of veterans are diagnosed with PTSD and traumatic brain injury. Campus tragedies such as Virginia Tech are fresh in our collective memory. This text is both timely and necessary -- not just for mental health professionals and their patients, but for the families and communities whose safety depends upon competent professional judgment.

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Solomon Snyder has been instrumental in the establishment of modern psychopharmacology -- as a pioneer in the identification of receptors for neurotransmitters and drugs and in the explanation of the actions of psychotropic agents. Science and Psychiatry is a collection of some of his best scientific papers, publications ranging over forty years that represent important advances in psychopharmacology and molecular biology. Audacious and unanticipated when they first appeared, these papers opened up new areas of understanding and revolutionized the modern study of the brain. Republished here, they show why fundamental research into the "messengers of the mind" is as essential for clinicians as for researchers.Many of these papers have clear clinical relevance, offering insight into modern neuroscience to help make sense of the bewildering array of available psychotropic medications and point the way toward more effective and safer agents. Others describe the underpinnings of psychopharmacology that practitioners need to know, especially regarding the role of receptors in drug action. Each of the nine groups of research articles is accompanied by a commentary by a well-known authority, putting the discoveries in perspective and providing a broad overview of subjects ranging from characterization of the enkephalins to serotonin receptor subtypes. The final set of papers focuses on apoptosis, the general process of cell suicide, where Snyder's work with bilirubin holds promise for treating neurodegenerative disorders. And in a closing piece, "The Audacity Principle in Science," Snyder speculates about factors conducive to creativity and efficacy in scientific discovery.The articles particularly describe four groups of extraordinary discoveries for which Snyder is widely recognized:   Identification of opiate receptors, providing keys to understanding pain perception Characterization of the IP3 receptor, exploring its role as a target for lithium treatment in manic-depressive disorders Establishment of nitric oxide as a transmitter in the brain, radically transforming conceptualizations of neurotransmission Discovery that D-serine is the normal stimulus for the glycine site of the NMDA receptor, providing new insight into the regulation of the receptor important for learning and memory Hailed as one of the preeminent scientists of the past twenty years, Snyder is a consummate researcher who confesses to remaining obsessed with the need to "think thoughts no one else has thought before." Science and Psychiatry clearly shows how that urge accounts for the diversity of challenges he has taken on as it conveys the origins of modern psychopharmacologic practice.

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Windows to the Brain is the only book to synthesize neuroanatomical and imaging research as it pertains to selected neuropsychiatric diseases, containing all of the "Windows to the Brain" papers published from 1999-2006 in the Journal of Neuropsychiatry and Clinical Neurosciences. These reader-friendly summaries by more than sixty contributors present modern imaging techniques that assist in the diagnosis of neuropsychiatric illness, enhanced by easily understood color graphics of the neuroanatomical circuits of behavior, memory, and emotion. They provide a basic understanding of how to apply a variety of imaging techniques to the study of adult neuropsychiatric disease and how to use neuroimaging to assist in diagnostic work-ups for conditions ranging from sleep disorders to epilepsy to borderline personality.Integrated, color-coded graphics present functional anatomical information in a manner that promotes understanding and use in clinical practice, while the text encompasses a wide range of diseases and injuries across the adult lifespan. The book is organized into four sections that will help readers increase their appreciation of the wide range of research and clinical applications for imaging in neuropsychiatry: chapters on imaging techniques discuss underlying principles, strengths and weaknesses, and applications; chapters on specific diseases demonstrate a range of investigative techniques; anatomy/circuit chapters focus on particular brain structures or functional neuropsychiatric circuits; and final chapters present image-based approaches to understanding or selecting treatment options. Some of the applications described are:   Use of fMRI in posttraumatic stress disorder to reveal the delicate balance between the structures of the emotion and memory tracks; Use of high-resolution MRI and nuclear imaging to distinguish between panic disorder and simple partial seizure disorder; Use of functional imaging studies to detect corticobasal degeneration, as a means of better understanding dementia; Use of newer imaging techniques in identifying progressive multifocal leukoencephalopathy, to enable more rapid and reliable tailoring of individual therapy for HIV; Use of functional neuroimaging in the study of fear, in order to better understand and treat anxiety-based psychiatric disorders; Use of neuroimaging studies in conversion disorder, showing implications for the disruption of selfhood in dissociative identity disorder and schizophrenia; Use of FDG-PET scans to look for predictors of treatment response in childhood-onset obsessive-compulsive disorder. Windows to the Brain can help bring less-experienced readers up to speed on advanced imaging and anatomical details that pertain to the modern practice of neuropsychiatry. It is must-reading for specialists in neuropsychiatry and cognitive/behavioral neurology, or for general psychiatrists with an interest in neuroimaging.

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A major benchmark in the understanding of psychiatric illness in children and adolescents, Developmental Psychopathology and Wellness reports on progress in identifying genetic and environmental influences on emotional-behavioral disorders. A team of 22 international authorities presents work that changes the way child psychiatry and clinical psychology are conceptualized, debunking misconceptions about depression, antisocial behavior, and other conditions to enhance our understanding of the causes of child psychopathology -- and improve the ways we treat these disorders. Coverage of basic principles describes the influence of genomic medicine, as explained by trailblazers in the field who demonstrate the importance of the developmental perspective. Chapters on gene-environment interaction review the important concepts of personality and temperament, cognition, and sex -- including findings from molecular genetic investigations on adolescent cognition, temperament, and brain function. Disorder-based examples show how emotional-behavioral illness and wellness attest to the interaction of genetic and environmental factors over time, providing new insight into the study of anxious depression, ADHD, autism, and antisocial personality disorders. And in considering how we can bridge the gap between research and clinical applications, Dr. Hudziak describes his family-based gene-environment approach as a means of better understanding etiopathology and treatment. Among the other significant contributions:   Thomas Achenbach focuses on the importance of culture in understanding the genetic and environmental impact on children, with insights into measuring these sources of influence. Joan Kaufman reports on her seminal work on the genetic and environmental modifiers of risk and resilience in child abuse, relating maltreatment to other forms of environmental risk, genetic mediation, and reactivity. D. I. Boomsma describes the genetic architecture of childhood worry, presenting data from an extraordinary sample of 30,000 twin pairs. Frank Verhulst draws on a 14-year study to detail the advantages of the developmental perspective in understanding antisocial behavior. Stephen Faraone offers guidelines for moving beyond statistics to document the functional significance of DNA variants associated with psychopathology. As the contributors ably demonstrate, these new approaches to the care and treatment of at-risk children are applicable to daily practice, teaching, and research. Developmental Psychopathology and Wellness shows that these psychopathologies are not a matter of nature versus nurture or genes versus environment, but rather an intertwining web of them all.

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A Clinical Handbook for Mental Health Professionals

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Because physicians are shaped by the expectations and responsibilities of their profession and are especially susceptible to stress and illness, professionals treating them need to be attuned to a host of demands and considerations not applicable to other patients. The Physician as Patient meets that need by combining the perspectives of two seasoned psychiatrists who have been assessing and treating physicians for more than 30 years. Drs. Myers and Gabbard pool their career-long dedication to physician health, counseling, and risk management to demonstrate that, through accurate diagnosis and state-of-the-art treatment, most impaired physicians can recover and return to practice.As the most current sourcebook available on this subject, The Physician as Patient not only discusses common illnesses and problems seen in doctors but also outlines the many biopsychosocial treatments that are indicated -- always with an emphasis on integrated care. It considers such issues as the reluctance of physicians to assume the role of patient and the uniqueness of the physician's psychological makeup that facilitates or impedes diagnosis and treatment. It describes the most common medical and psychiatric illnesses in physicians -- including addictions -- and addresses personality disorders and the increasingly important subject of boundary violations. And it helps readers determine what can be done about doctors behaving badly or out-of-character, or what strategies are useful in treating physicians to assure accuracy while also diminishing morbidity and relieving suffering. Among other key issues raised are:   The importance of considering sociocultural customs and values when treating the increasing number of minority and International Medical Graduate physicians  Addressing the many clinical, humanistic, ethical, and legal dimensions of the psychiatric evaluation of physicians Distinguishing between long-standing patterns of personality disorders that manifest as disruptive behaviors and those patterns that lead to burnout and depression Assessing amenability to rehabilitation in cases of sexual boundary violation, including an awareness of alcohol or drug abuse as contributing factors Utilizing a physician's predisposition as a learner and pragmatist to enter into cognitive behavior therapy The success of early diagnosis and treatment in lowering the occurrence of suicide, for which physicians are notoriously at risk Brimming with case examples, The Physician as Patient adopts a reader-friendly style that facilitates quick grasp of concepts, while an extensive list of references and websites provides an entree for additional support. This book is an indispensable resource for all mental health professionals who take caregivers into their care.

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As more patients seek information about family risks of psychiatric illness -- an interest likely to increase as gene-identification studies are publicized -- most psychiatrists agree it is their role to discuss these issues but admit they are ill-prepared to do so. Psychiatric Genetics addresses that need as the first book to focus on clinical applications of genetics in psychiatry. It covers issues involved in genetic counseling, the interpretation of familial and genetic information for clinical use, information regarding risks associated with specific psychiatric disorders, risk/benefit considerations related to medication use during pregnancy, and the ethical and social implications of psychiatric genetic knowledge and research -- including the prospects for genetic testing.While other books have been written for the genetics community, this volume is addressed to practitioners: a clinically relevant resource that can help them understand the often bewildering flood of information about genetics -- information difficult to interpret, let alone integrate into practice -- and enable them to respond to patients' requests to predict the risk of recurrence of psychiatric illness or provide information about reproductive and pregnancy-related issues. Experts from psychiatry, genetic epidemiology, molecular genetics, genetic counseling, cognitive psychology, and ethics focus on issues that have received little attention elsewhere yet are of increasing importance to clinicians. Written at a level that assumes no particular expertise in genetics, the book features these immediately applicable benefits:   It offers a framework for understanding and critically evaluating the psychiatric genetic research literature, enabling clinicians to better understand the meaning and limitations of genetic discoveries when patients raise questions about media reports.  It provides a resource for clinicians who would like more information about the role and content of genetic counseling, outlining a typical counseling session while demonstrating how risks are estimated and discussed. It summarizes genetic aspects of major psychiatric conditions -- from childhood-onset disorders through psychotic, mood, and anxiety disorders to dementia -- as well as neuropsychiatric manifestations of other genetic disorders. It alerts clinicians to risk/benefit considerations related to medication use during pregnancy. It covers the ethical, legal, and social implications of genetic research and counseling, illustrating the dilemmas that arise with new advances. Whether used as a clinical guide, reference, or ancillary text, this book sets the standard for the application of psychiatric genetic knowledge in everyday practice. Psychiatrists, mental health clinicians, and genetic counselors will find it an essential resource for all patient encounters in which genetic issues arise.

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Ming T. Tsuang, Jordan W. Smoller, Beth Rosen Sheidley