Shorter Oxford Textbook of Psychiatry

Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel

This book provides an up-to-date, authoritative, and highly readable overview of psychiatry, suitable for all psychiatrists, as well as medical students, general practitioners, and other mental health professionals. Written by experienced clinicians, the new edition has been substantially rewritten and updated. The first three chapters cover the symptoms and signs of psychiatric disorders, psychiatric classification (including DSM-5), and how to conduct a psychiatric assessment. Chapters on ethics and the law (including the Mental Health Act), aetiology, and evidence-based approaches, set the scene for description of the major syndromes of adult psychiatry. In each chapter, description of the cardinal clinical features is accompanied by the latest evidence on epidemiology, aetiology, treatment, and outcome. Subsequent chapters cover child psychiatry, the psychiatry of old age, intellectual disability, forensic psychiatry, substance misuse, suicide, and self-harm, and psychiatry in medical settings. After a new chapter on global mental health, two chapters cover psychological and psychopharmacological treatments: their indications, efficacy, side effects, and mechanisms. The final chapter describes how psychiatric services are organized.

2020 ◽  
pp. 088626052090802 ◽  
Author(s):  
Samantha C. Burns ◽  
Cary S. Kogan ◽  
Richard E. Heyman ◽  
Heather M. Foran ◽  
Amy M. Smith Slep ◽  
...  

Intimate partner violence (IPV) is a global public health problem that has been shown to lead to serious mental health consequences. Due to its frequent co-occurrence with psychiatric disorders, it is important to assess for IPV in mental health settings to improve treatment planning and referral. However, lack of training in how to identify and respond to IPV has been identified as a barrier for the assessment of IPV. The present study seeks to better understand this IPV-related training gap by assessing global mental health professionals’ experiences of IPV-related training and factors that contribute to their likelihood of receiving training. Participants were French-, Spanish-, and Japanese-speaking psychologists and psychiatrists ( N = 321) from 24 nations differing on variables related to IPV, including IPV prevalence, IPV-related norms, and IPV-related laws. Participants responded to an online survey asking them to describe their experiences of IPV-related training (i.e., components and hours of training) and were asked to rate the frequency with which they encountered IPV in clinical practice and their level of knowledge and experience related to relationship problems; 53.1% of participants indicated that they had received IPV-related training. Clinicians from countries with relatively better implemented laws addressing IPV and those who encountered IPV more often in their regular practice were more likely to have received training. Participants who had received IPV-related training, relative to those without training, were more likely to report greater knowledge and experience related to relationship problems. Findings suggest that clinicians’ awareness of IPV and the institutional context in which they practice are related to training. Training, in turn, is associated with subjective appraisals of knowledge and experience related to relationship problems. Increasing institutional efforts to address IPV (e.g., implementing IPV legislation) may contribute to improved practices with regard to IPV in mental health settings.


Author(s):  
Genevra Richardson

This chapter examines the increased concern for human rights within the global mental health policy agenda and considers what value human rights might add in relation to the use of coercion in community mental health. It describes the position underlying the European Convention on Human Rights (ECHR) and compares it with the more radical approach of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). While the CRPD might be more challenging to mental health professionals, it contains within its principles that the wishes and preferences of the person be centre stage and as such deserve to be taken seriously in the provision of community mental health care.


2014 ◽  
Vol 38 (5) ◽  
pp. 216-219 ◽  
Author(s):  
Kathryn Walsh ◽  
Alex Copello

Aims and methodThe study reports findings of an investigation into the presence of severe and enduring mental health problems within the four statutory and non-statutory teams of an established substance misuse treatment partnership.ResultsOf a total of 772 clients in the four teams surveyed, 69 (8.9%) were identified as having severe and enduring mental health problems and problem substance use in the past 12 months. Alcohol was the most prevalent substance used by this predominantly male group. Different rates were found across the four teams, with higher numbers in the non-statutory teams. The clients displayed significant levels of self-harm and suicide risk and were responsible for 131 acute service contacts over the past 12 months.Clinical implicationsClients with severe and enduring mental health problems engaged with substance misuse services display high levels of complex need. It is important to identify the best and most effective service response to this group.


2016 ◽  
Vol 13 (3) ◽  
pp. 61-63 ◽  
Author(s):  
Bibilola D. Oladeji ◽  
Oye Gureje

The brain drain of medical professionals from lower-income to higher-income countries contributes to the current inequity that characterises access to mental healthcare by those in need across the world and hinders efforts to scale up mental health services in resource-constrained settings, especially in Nigeria and other West African countries. The migration of skilled workers is driven by a combination of the globalisation of the labour market and the ability of highly resourced countries to attract and retain specialists from poorer countries. If we are to ameliorate the worldwide shortage of mental health professionals, we need to find innovative ways of attracting young doctors into psychiatric training in all countries. We must also introduce measures to improve health worker retention in low- and middle-income countries.


2019 ◽  
Vol 27 (3) ◽  
pp. 156-174
Author(s):  
N.A. Polskaya ◽  
D.K. Yakubovskaya

The paper provides a review of studies on non-suicidal self-injury (NSSI) in online social networking. Content characteristics of online self-injury narrative are examined by focusing on such categories as hashtags, images, and comments. Negative and positive aspects of social networks’ impact on the risk of self-injury in adolescent are summarized. The presence of NSSI content online and the ability to communicate on issues relating to self-injury can either improve psychological well-being of the users by increasing their mood and self-acceptance, giving means to receive support from others and get information on mental health resources, or increase the person’s susceptibility to self-injuries by initiating their interest in this subject and reinforcing, and encouraging repeated self-harm. Therefore, mental health professionals are facing a global challenge: to create supportive and helpful online content, which implies the development of a new methodology, including language and terminology, that could integrate existing online discourse on self-injury and transform it from within.


This companion guide for clinicians working with oncology patients outlines clinical management of depression, demoralization and anxiety in a pragmatic format for use in everyday practice. The specific aim is to describe treatments that can be utilized by cancer clinicians and by mental health professionals training in psycho-oncology. The guide is not intended to replace national clinical guidelines and policies but gives a more generic international overview of the important factors and elements that need to be considered when dealing with clinical anxiety and depression in cancer patients at all points on the treatment trajectory. The guide covers assessment methods for clinical anxiety, demoralization and depression, psychopharmacological and psychological treatment methods, along with information on dealing with psychiatric emergencies and self-harm issues. The guide does not offer a comprehensive description of psychotherapy techniques: these can be found in the IPOS Handbook of Psychotherapy in Cancer Care. Policies, service issues, ethical, confidentiality, and communication issues are also covered. The guide is intended as a brief pocketbook manual that can be used for quick reference.


2019 ◽  
Vol 57 (1) ◽  
pp. 19-31 ◽  
Author(s):  
Frederick W. Hickling

The contentious debate on evidence-based Global Mental Health care is challenged by the primary mental health program of Jamaica. Political independence in 1962 ushered in the postcolonial Jamaican Government and the deinstitutionalization of the country’s only mental hospital along with a plethora of mental health public policy innovations. The training locally of mental health professionals catalyzed institutional change. The mental health challenge for descendants of African people enslaved in Jamaica is to reverse the psychological impact of 500 years of European racism and colonial oppression and create a blueprint for the decolonization of GMH. The core innovations were the gradual downsizing and dismantling of the colonial mental hospital and the establishment of a novel community mental health initiative. The successful management of acute psychosis in open medical wards of general hospitals and a Diversion at the Point of Arrest Programme (DAPA) resulted in the reduction of stigma and the assimilation of mental health care into medicine in Jamaica. Successful decentralization has led to unmasking underlying social psychopathology and the subsequent development of primary prevention therapeutic programs based on psychohistoriographic cultural therapy and the Dream-A-World Cultural Therapy interventions. The Jamaican experience suggests that diversity in GMH must be approached not simply as a demographic fact but with postcolonial strategies that counter the historical legacy of structural violence.


2016 ◽  
Vol 22 (2) ◽  
pp. 318-325
Author(s):  
Cristal Oxley ◽  
Jane E Roberts ◽  
Sebastian Kraemer ◽  
Giles Armstrong

Punch injuries are a form of self-harm characterised by the intentional act of striking an object with a closed fist. We aimed to describe the characteristics and trends in young people presenting with injuries sustained via the punch mechanism. A comprehensive retrospective review of medical records was completed of all young people aged 10–18 years presenting to our Central London Emergency Department over a 12-month period. A subset of the total group was identified as the punch injury subgroup. A total of 78 punch injury presentations were identified. In this subgroup, the male:female ratio is 4.57:1; 37.18% of presentations were associated with a fracture ( n = 29) and 35.90% ( n = 28) of patients re-presented following another punch injury, as a victim of violence, or by other psychiatric presentation. In conclusion, a male preponderance was observed, with frequent re-presentations, often in high-risk circumstances. An opportunity for screening, including mental health, social and substance misuse, was identified. Further research is needed to enable targeted effective interventions in this group.


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