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Contents
- Front matter
  - Dedication
  - Preface to the first edition
  - Preface to the second edition
  - Acknowledgements
  - Symbols and abbreviations
- Chapter 1 Thinking about psychiatry
  - Chapter 1 Thinking about psychiatry
  - First thoughts
  - What is disease?
  - The role of the psychiatrist
  - Diagnosis in psychiatry
  - Why don’t psychiatrists look at the brain?
  - Can psychotherapy change the brain?
  - Treating patients against their will
  - Perceptions of psychiatry
  - Stigma
  - Anti-psychiatry
  - A brief history of psychiatry
  - The future
- Chapter 2 Psychiatric assessment
  - Chapter 2 Psychiatric assessment
  - The clinical interview
  - Setting the scene
  - Interviewing psychiatric patients
  - Discussing management
  - History
  - Mental state examination
  - Case summary
  - Observations of appearance and behaviour
  - Speech
  - Abnormal mood
  - Asking about depressed mood
  - Asking about thoughts of self-harm
  - Asking about elevated mood
  - Anxiety symptoms
  - Asking about anxiety symptoms
  - Abnormal perceptions
  - Asking about abnormal perceptions
  - Abnormal beliefs
  - Asking about abnormal beliefs
  - Asking about the first-rank symptoms of schizophrenia
  - Disorders of the form of thought
  - Abnormal cognitive function
  - Assessing cognitive function 1
  - Assessing cognitive function 2
  - Supplementary tests of cerebral functioning
  - Insight
  - Physical examination
  - Some physical signs in psychiatric illness, and possible causes
  - Clinical investigation
  - Common assessment instruments 1
  - Common assessment instruments 2
- Chapter 3 Symptoms of psychiatric illness
  - Chapter 3 Symptoms of psychiatric illness
  - Symptoms of psychiatric illness
  - Dictionary of psychiatric symptoms
- Chapter 4 Evidence-based psychiatry
  - Chapter 4 Evidence-based psychiatry
  - Introduction
  - Finding and appraising the evidence
  - Systematic reviews (SRs) of RCTs
  - Randomized controlled trials (RCTs)
  - Case–control studies
  - Cohort studies
  - Diagnostic studies
  - Qualitative studies
  - Economic studies
  - Applying the evidence to patients
  - Measuring performance and implementing evidence-based practice
- Chapter 5 Organic illness
  - Chapter 5 Organic illness
  - Presentations of organic illness
  - Dementia: general overview
  - Alzheimer’s disease 1
  - Alzheimer’s disease 2
  - Alzheimer’s disease 3: pharmacological treatments
  - Dementia with Lewy bodies (DLB)
  - Fronto-temporal dementia (FTD) (Pick’s disease)^,
  - Vascular dementia
  - Prion diseases
  - Amnestic disorders
  - Normal pressure hydrocephalus (NPH)
  - Chronic subdural haematoma (SDH)
  - Psychiatric sequelae of CVA
  - Psychiatric aspects of head injury
  - Psychiatric aspects of epilepsy 1
  - Psychiatric aspects of epilepsy 2
  - HIV/AIDS and psychiatry 1
  - HIV/AIDS and psychiatry 2: clinical presentations
  - Neuropsychiatric aspects of CNS infections
  - Autoimmune disorders and psychiatry
  - Movement disorders in psychiatry
  - Parkinson’s disease (PD) and psychiatry
  - Huntington’s disease (HD)
  - Wilson’s disease (WD)
  - Other movement disorders
- Chapter 6 Schizophrenia and related psychoses
  - Chapter 6 Schizophrenia and related psychoses
  - Introduction
  - Historical views of schizophrenia
  - The diagnosis of schizophrenia
  - Differential diagnosis of schizophrenia
  - Aetiological theories
  - Epidemiology of schizophrenia
  - Examination of the patient with psychotic symptoms
  - Presentations of psychotic illness
  - Initial assessment of acute psychosis
  - Initial treatment of acute psychosis
  - Discharge planning
  - Outpatient treatment and follow-up
  - Conventional antipsychotics
  - Atypical antipsychotics
  - Antipsychotic side-effects
  - An approach to treatment-resistant schizophrenia (TRS)
  - Clozapine 1: general guidelines
  - Clozapine 2: starting and stopping
  - Clozapine 3: side-effects
  - Antipsychotic depot injections
  - Disorders related to schizophrenia
  - Delusional disorder 1: clinical features
  - Delusional disorder 2: differential diagnosis and aetiology
  - Delusional disorder 3: assessment and management
  - Acute and transient psychotic disorders
  - Induced delusional disorder
  - Delusional misidentification syndromes
- Chapter 7 Depressive illness
  - Chapter 7 Depressive illness
  - Introduction
  - Historical perspective
  - Diagnosis 1: symptoms
  - Diagnosis 2: caseness and subtypes
  - Diagnosis 3: other clinical presentations
  - Epidemiology
  - Aetiology
  - Differential diagnosis
  - Investigations
  - Course and prognosis
  - Management principles and outpatient treatment
  - Hospital admission
  - Treating depressive illness (without psychotic features)
  - Treating depressive illness (with psychotic features)
  - An approach to treatment-resistant depression
  - Atypical depressive episode
  - Seasonal affective disorder (SAD)
  - Dysthymia (ICD-10)/dysthymic disorder (DSM-IV)
  - Antidepressants
  - Tricyclic antidepressants (TCAs)
  - Monoamine oxidase inhibitors (MAOIs) and reversible monoamine oxidase inhibitors (RIMAs)
  - Selective serotonin reuptake inhibitors (SSRIs)
  - Other antidepressants 1
  - Other antidepressants 2
  - ECT 1: background and indications
  - ECT 2: problems and treatment course
  - ECT 3: work-up and administration
  - ECT 4: notes on treatment
  - Psychosurgery/neurosurgery for mental disorder (NMD)
  - Other physical treatments
- Chapter 8 Bipolar illness
  - Chapter 8 Bipolar illness
  - Introduction
  - Historical perspective
  - Mania/manic episode
  - Hypomania/hypomanic episode
  - Bipolar spectrum disorder
  - Bipolar (affective) disorder 1: classification
  - Bipolar (affective) disorder 2
  - Bipolar affective disorder 3: management principles
  - Other issues affecting management decisions
  - Hospital admission
  - Treatment of acute manic episodes
  - Treatment of depressive episodes
  - Prophylaxis
  - Psychotherapeutic interventions
  - Cyclothymia
  - Lithium
  - Lithium: adverse effects
  - Valproate/valproic acid
  - Carbamazepine
  - Lamotrigine
- Chapter 9 Anxiety and stress-related disorders
  - Chapter 9 Anxiety and stress-related disorders
  - Introduction
  - Historical perspective
  - Hyperventilation syndrome (HVS)
  - Panic disorder 1: clinical features
  - Panic disorder 2: aetiological models
  - Panic disorder 3: management guidelines
  - Agoraphobia
  - Simple or specific phobias
  - Social phobia
  - Generalized anxiety disorder (GAD)
  - Obsessive–compulsive disorder (OCD)
  - Exceptional stressors and traumatic events
  - Acute stress reaction
  - Acute stress disorder
  - Adjustment disorders
  - Normal and abnormal grief reactions
  - Post-traumatic stress disorder 1: diagnosis
  - Post-traumatic stress disorder 2: management
  - Depersonalization (derealization) syndrome
- Chapter 10 Eating and impulse-control disorders
  - Chapter 10 Eating and impulse-control disorders
  - Anorexia nervosa 1: overview
  - Anorexia nervosa 2: physical consequences
  - Anorexia nervosa 3: assessment
  - Anorexia nervosa 4: management
  - Bulimia nervosa
  - Impulse-control disorders 1
  - Impulse-control disorders 2
- Chapter 11 Sleep disorders
  - Chapter 11 Sleep disorders
  - Introduction
  - Normal sleep: stages and cycles
  - Assessment of sleep disorders
  - Insomnia 1: overview
  - Insomnia 2: clinical syndromes
  - Insomnia 3: general management strategies
  - Hypersomnia 1: overview
  - Hypersomnia 2: Narcolepsy/recurrent hypersomnias
  - Hypersomnia 3: other intrinsic/extrinsic causes
  - Circadian rhythm sleep disorders 1: overview
  - Circadian rhythm sleep disorders 2: management
  - Parasomnias 1: overview
  - Parasomnias 2: arousal disorders (of non-REM sleep)
  - Parasomnias 3: nocturnal panic attacks (NP)
  - Parasomnias 4: sleep–wake transition disorders
  - Parasomnias 5: disorders associated with REM sleep
  - Sleep disorders related to psychiatric disorders
  - The effects of psychiatric medication on sleep
  - The effects of drugs and alcohol on sleep
- Chapter 12 Reproductive psychiatry, sexual dysfunction and sexuality
  - Chapter 12 Reproductive psychiatry, sexual dysfunction and sexuality
  - Introduction
  - Menstrual-related disorders
  - Premenstrual disorders
  - Disorders associated with pregnancy
  - Disorders related to childbirth
  - Sexual dysfunction 1: general principles
  - Sexual dysfunction 2: problems common to men and women
  - Sexual dysfunction 3: problems specific to women
  - Sexual dysfunction 4: problems specific to men
  - Disorders of sexual preference 1: general aspects
  - Disorders of sexual preference 2: assessment and management
  - Transsexualism
- Chapter 13 Personality disorders
  - Chapter 13 Personality disorders
  - The concept of personality disorder
  - ‘Normal’ personality
  - Classification of personality disorder
  - Psychopathy and ‘severe’ personality disorder
  - Aetiology of personality disorder
  - Epidemiology of personality disorder
  - Relationship between personality disorder and other mental disorders
  - Assessment of personality disorder
  - Management of personality disorder 1: general aspects
  - Management of personality disorder 2: specific treatments^,
  - Outcome of personality disorder
- Chapter 14 Old age psychiatry
  - Chapter 14 Old age psychiatry
  - Psychiatric illness in older people and psychogeriatrics
  - Normal ageing
  - Multidisciplinary assessment
  - Specific aspects of psychiatric illnesses in the elderly 1: overview and neuroses
  - Specific aspects of psychiatric illnesses in the elderly 2: mood disorders
  - Specific aspects of psychiatric illnesses in the elderly 3: psychoses
  - Other mental health problems in the elderly
  - Issues of elder abuse^,
  - Psychopharmacology in the elderly^,
  - Services for the elderly^,
  - The end of life, living wills, and withdrawal of active treatment
- Chapter 15 Substance misuse
  - Chapter 15 Substance misuse
  - The psychiatry of substance misuse
  - Substance use and misuse
  - Substance misuse disorders
  - The dependence syndrome
  - Stages of change and harm reduction
  - Alcohol misuse
  - Alcohol as a drug
  - Screening for alcohol problems
  - Assessment of the patient with alcohol problems
  - Giving drinking advice
  - Planning treatment in alcohol misuse
  - Alcohol withdrawal syndromes
  - Management of alcohol withdrawal
  - Maintenance interventions in alcohol misuse 1: psychological methods
  - Maintenance interventions in alcohol misuse 2: pharmacological methods
  - Alcohol misuse disorders 1
  - Alcohol misuse disorders 2
  - Psychiatric comorbidity
  - Wernicke–Korsakoff syndrome
  - Medical complications of alcohol misuse
  - Illegal drugs
  - Street slang associated with drug misuse
  - Opiates/Opioids
  - Depressants
  - Stimulants
  - Hallucinogens
  - Other drugs
  - Assessment of the drug user
  - Planning treatment in drug misuse
  - Substitute prescribing 1: principles
  - Substitute prescribing 2: opiates
  - Substitute prescribing 3: benzodiazepines
  - Monitoring of maintenance prescribing
  - Psychotic illnesses and substance misuse
  - Legal issues related to drug and alcohol misuse
- Chapter 16 Child and adolescent psychiatry
  - Chapter 16 Child and adolescent psychiatry
  - Introduction
  - Assessment 1: principles
  - Assessment 2: practice
  - Development
  - Resilience
  - Attachment
  - An approach to behavioural problems
  - Conduct disorders
  - Attention deficit hyperactivity disorder (ADHD)
  - Drug treatment of ADHD
  - Autism-spectrum disorders (ASD)
  - (Gilles de la) Tourette’s syndrome
  - Other tic disorders
  - Language, learning and motor coordination disorders
  - Enuresis
  - Encopresis
  - Other behavioural disorders
  - Anxiety disorders: overview
  - Separation anxiety disorder
  - Generalized anxiety disorder
  - Panic disorder/agoraphobia
  - Social phobia, simple phobias and selective mutism
  - Post-traumatic stress disorder^,
  - Obsessive–compulsive disorder (OCD)
  - Eating disorders
  - Depression in children and adolescents
  - Suicide and deliberate self-harm in young people
  - Bipolar disorder in children and adolescents
  - Psychosis
  - Substance abuse in children and adolescents
  - Child abuse 1: general issues
  - Child abuse 2: the duty of care
  - The looked-after-child (LAC)
  - Prescribing in children and adolescents^,
  - Family therapy (FT)
  - Parent management training
- Chapter 17 Forensic psychiatry
  - Chapter 17 Forensic psychiatry
  - Introduction
  - The criminal justice system^,^,
  - Crime
  - Homicide
  - Violence 1: theoretical background^,
  - Violence 2^,
  - Sexual offences 1
  - Sexual offences 2
  - Other offences
  - Mental disorder and offending 1: overview
  - Mental disorder and offending 2: specific disorders and offending^,^,
  - Assessing risk of violence^,^,
  - Secure hospitals and units
  - Police liaison 1
  - Police liaison 2^,^,
  - Court liaison
  - Prison psychiatry 1: overview
  - Prison psychiatry 2: the role of the psychiatrist^,
  - Legal provisions for transfer of prisoners to hospital
  - Court reports and giving evidence 1
  - Court reports and giving evidence 2
  - Suggested format for criminal court report
  - Overview of the pathways of mentally disordered offenders through the criminal justice and health systems
  - Legal provisions for procedures relating to mentally disordered offenders
  - Fitness to plead 1: assessment
  - Fitness to plead 2: procedures
  - Criminal responsibility 1
  - Criminal responsibility 2
  - Assessing ‘mental state at the time of the offence’
- Chapter 18 Learning disability
  - Chapter 18 Learning disability
  - Introduction
  - Historical perspective
  - Classification
  - Impairments, disabilities, and handicaps
  - Aetiology
  - Establishing the cause
  - The process of assessment
  - Considering management choices
  - Treatment methods
  - Down’s syndrome
  - Deletions and duplication syndromes
  - Autosomal dominant syndromes
  - Autosomal recessive syndromes
  - X-linked dominant syndromes
  - X-linked recessive syndromes
  - Sex chromosome disorders
  - Non-genetic causes of LD
  - Disorders of unknown aetiology
  - Pervasive developmental disorders (PDDs)
  - Autism
  - Epilepsy and LD
  - Psychiatric comorbidity in LD
  - Behavioural disorders and ‘challenging’ behaviour
  - Management of behavioural disorders
  - Transition periods
  - Family issues
- Chapter 19 Liaison psychiatry
  - Chapter 19 Liaison psychiatry
  - Introduction
  - Working in the general hospital
  - Assessment of depressive and anxiety symptoms
  - Assessment of psychotic symptoms and confusion
  - Parasuicide assessment
  - Management after parasuicide
  - Depression in physical illness
  - Acute confusional state (delirium)
  - Capacity and consent
  - Medically unexplained symptoms 1: introduction
  - Medically unexplained symptoms 2: clinical presentations
  - Medically unexplained symptoms 3: management principles
  - Somatization disorder
  - Somatoform pain disorder
  - Conversion (dissociative) disorders
  - Hypochondriasis
  - Dysmorphic disorder
  - Chronic fatigue syndrome
  - Factitious disorder (Munchausen’s syndrome)
  - Assessment prior to organ transplantation
- Chapter 20 Psychotherapy
  - Chapter 20 Psychotherapy
  - Introduction
  - Assessment for psychotherapy
  - A brief history of Sigmund Freud
  - Other pioneers of psychoanalysis
  - Basic psychoanalytical theory
  - Defence mechanisms
  - Theory of psychosexual development
  - Object relations theory
  - Psychoanalysis 1
  - Psychoanalysis 2
  - Psychodynamic psychotherapy
  - Group psychotherapy
  - Basic learning theory
  - Behaviour therapy
  - Cognitive behaviour therapy 1
  - Cognitive behavioural therapy 2
  - Interpersonal psychotherapy
  - Dialectical behaviour therapy
  - Cognitive analytic therapy
  - Solution-focused therapy
  - Counselling methods
- Chapter 21 Legal issues
  - Chapter 21 Legal issues
  - Introduction
  - The development of mental health law
  - Consent to treatment
  - Treatment without consent
  - Common law
  - Incapacity Act: England and Wales
  - Incapacity Act: Scotland
  - Mental Health Act: England and Wales 1
  - Mental Health Act: England and Wales 2
  - Mental Health Act: England and Wales 3
  - Mental Health Act: Scotland 1
  - Mental Health Act: Scotland 2
  - Mental Health Act: Northern Ireland 1
  - Mental Health Act: Northern Ireland 2
  - Mental Health Act: Republic of Ireland 1
  - Mental Health Act: Republic of Ireland 2
  - Issues of confidentiality
  - Breaking confidentiality
  - Fitness to drive
  - DVLA requirements for specific psychiatric conditions
- Chapter 22 Transcultural psychiatry
  - Chapter 22 Transcultural psychiatry
  - Introduction
  - Cultural context and the presentation of psychiatric disorders
  - Cultural formulation of psychiatric disorders
  - Culture-bound syndromes
  - Glossary of culture-bound syndromes
- Chapter 23 Therapeutic issues
  - Chapter 23 Therapeutic issues
  - Medication adherence
  - Weight gain with psychiatric medication
  - Antipsychotics and diabetes
  - Hyperprolactinaemia with antipsychotics
  - Sexual dysfunction and psychiatric medication
  - Priapism
  - Antipsychotic-induced Parkinsonism
  - Akathisia
  - Tardive dyskinesia (TD)
  - Acute dystonic reaction
  - Neuroleptic malignant syndrome
  - Serotonin syndrome (SS)
  - SSRI withdrawal (discontinuation) syndrome
  - Hyponatraemia and antidepressants
  - Paradoxical reactions to benzodiazepines
  - Prescribing in pregnancy
  - Prescribing in lactation
  - Prescribing for patients with cardiovascular disease
  - Prescribing for patients with liver disease
  - Prescribing for patients with renal impairment
  - Prescribing for patients with epilepsy
  - Plasma level monitoring
- Chapter 24 Difficult and urgent situations
  - Chapter 24 Difficult and urgent situations
  - Dealing with psychiatric emergencies
  - What to do if summoned to a crisis situation/negotiation principles
  - Managing suicide attempts in hospital
  - Severe behavioural disturbance
  - Pharmacological approach to severe behavioural disturbance
  - The catatonic patient
  - The manipulative patient 1
  - The manipulative patient 2
  - Issues of child protection
  - Patients acting against medical advice 1: guiding principles
  - Patients acting against medical advice 2: clinical scenarios
  - The mental health of doctors
  - Looking after your own mental health
- Chapter 25 Useful resources
  - Chapter 25 Useful resources
  - Resources for patients
  - Online clinical resources
  - Online professional resources
  - Online MRCPsych exam preparation
- Chapter 26 ICD-10/DSM-IV index
  - Chapter 26 ICD-10/DSM-IV index
  - F00–F09 Organic, including symptomatic, mental disorders
  - F10–F19 Mental and behavioural disorders due to psychoactive substance abuse
  - F20–F29 Schizophrenia, schizotypal, and delusional disorders
  - F30–F39 Mood (affective) disorders
  - F40–F49 Neurotic, stress-related, and somatoform disorders
  - F50–F59 Behavioural syndromes associated with physiological disturbance and physical factors
  - F60–F69 Disorders of adult personality and behaviour
  - F70–F79 Mental retardation
  - F80–F89 Disorders of psychological development
  - F90–F98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
  - The ICD-10 multi-axial system

2nd edition

The Oxford Handbook of Psychiatry is a new book directed at medical students, doctors coming to psychiatry for the first time, psychiatric trainees, and other professionals who may have to deal with patients with psychiatric problems. It is written by a group of experienced psychiatrists and is designed to provide easy access to the information required by psychiatry trainees on the wards or on-call.

About the Editors

David Semple Consultant Psychiatrist, Hairmyres Hospital, East Kilbride and Honorary Fellow, Division of Psychiatry, University of Edinburgh.

Roger Smyth Consultant Psychiatrist, Department of Psychological Medicine, Royal Infirmary of Edinburgh.

Disclaimer: Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.

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