Psychiatry

IN THIS STIRRING AND BEAUTIFULLY WRITTEN WAKE-UP CALL, psychiatrist Daniel Carlat exposes deeply disturbing problems plaguing his profession, revealing the ways it has abandoned its essential purpose: to understand the mind, so that psychiatrists can heal mental illness and not just treat symptoms. As he did in his hard-hitting and widely read New York Times Magazine article "Dr. Drug Rep," and as he continues to do in his popular watchdog newsletter, The Carlat Psychiatry Report, he writes with bracing honesty about how psychiatry has so largely forsaken the practice of talk therapy for the seductive—and more lucrative—practice of simply prescribing drugs, with a host of deeply troubling consequences.

Psychiatrists have settled for treating symptoms rather than causes, embracing the apparent medical rigor of DSM diagnoses and prescription in place of learning the more challenging craft of therapeutic counseling, gaining only limited understanding of their patients’ lives. Talk therapy takes time, whereas the fifteen-minute "med check" allows for more patients and more insurance company reimbursement. Yet DSM diagnoses, he shows, are premised on a good deal less science than we would think.

Writing from an insider’s perspective, with refreshing forthrightness about his own daily struggles as a practitioner, Dr. Carlat shares a wealth of stories from his own practice and those of others that demonstrate the glaring shortcomings of the standard fifteen-minute patient visit. He also reveals the dangers of rampant diagnoses of bipolar disorder, ADHD, and other "popular" psychiatric disorders, and exposes the risks of the cocktails of medications so many patients are put on. Especially disturbing are the terrible consequences of overprescription of drugs to children of ever younger ages. Taking us on a tour of the world of pharmaceutical marketing, he also reveals the inner workings of collusion between psychiatrists and drug companies.

Concluding with a road map for exactly how the profession should be reformed, Unhinged is vital reading for all those in treatment or considering it, as well as a stirring call to action for the large community of psychiatrists themselves. As physicians and drug companies continue to work together in disquieting and harmful ways, and as diagnoses—and misdiagnoses—of mental disorders skyrocket, it’s essential that Dr. Carlat’s bold call for reform is heeded.
Depression has become the single most commonly treated mental disorder, amid claims that one out of ten Americans suffer from this disorder every year and 25% succumb at some point in their lives. Warnings that depressive disorder is a leading cause of worldwide disability have been accompanied by a massive upsurge in the consumption of antidepressant medication, widespread screening for depression in clinics and schools, and a push to diagnose depression early, on the basis of just a few symptoms, in order to prevent more severe conditions from developing. In The Loss of Sadness, Allan V. Horwitz and Jerome C. Wakefield argue that, while depressive disorder certainly exists and can be a devastating condition warranting medical attention, the apparent epidemic in fact reflects the way the psychiatric profession has understood and reclassified normal human sadness as largely an abnormal experience. With the 1980 publication of the landmark third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), mental health professionals began diagnosing depression based on symptoms--such as depressed mood, loss of appetite, and fatigue--that lasted for at least two weeks. This system is fundamentally flawed, the authors maintain, because it fails to take into account the context in which the symptoms occur. They stress the importance of distinguishing between abnormal reactions due to internal dysfunction and normal sadness brought on by external circumstances. Under the current DSM classification system, however, this distinction is impossible to make, so the expected emotional distress caused by upsetting events-for example, the loss of a job or the end of a relationship- could lead to a mistaken diagnosis of depressive disorder. Indeed, it is this very mistake that lies at the root of the presumed epidemic of major depression in our midst. In telling the story behind this phenomenon, the authors draw on the 2,500-year history of writing about depression, including studies in both the medical and social sciences, to demonstrate why the DSM's diagnosis is so flawed. They also explore why it has achieved almost unshakable currency despite its limitations. Framed within an evolutionary account of human health and disease, The Loss of Sadness presents a fascinating dissection of depression as both a normal and disordered human emotion and a sweeping critique of current psychiatric diagnostic practices. The result is a potent challenge to the diagnostic revolution that began almost thirty years ago in psychiatry and a provocative analysis of one of the most significant mental health issues today.
Its landscaped ground, chosen by Frederick Law Olmsted and dotted with Tudor mansions, could belong to a New England prep school. There are no fences, no guards, no locked gates. But McLean Hospital is a mental institution-one of the most famous, most elite, and once most luxurious in America. McLean "alumni" include Olmsted himself, Robert Lowell, Sylvia Plath, James Taylor and Ray Charles, as well as (more secretly) other notables from among the rich and famous. In its "golden age," McLean provided as genteel an environment for the treatment of mental illness as one could imagine. But the golden age is over, and a downsized, downscale McLean-despite its affiliation with Harvard University-is struggling to stay afloat. Gracefully Insane, by Boston Globe columnist Alex Beam, is a fascinating and emotional biography of McLean Hospital from its founding in 1817 through today. It is filled with stories about patients and doctors: the Ralph Waldo Emerson protégé whose brilliance disappeared along with his madness; Anne Sexton's poetry seminar, and many more. The story of McLean is also the story of the hopes and failures of psychology and psychotherapy; of the evolution of attitudes about mental illness, of approaches to treatment, and of the economic pressures that are making McLean-and other institutions like it-relics of a bygone age.

This is a compelling and often oddly poignant reading for fans of books like Plath's The Bell Jar and Susanna Kaysen's Girl, Interrupted (both inspired by their author's stays at McLean) and for anyone interested in the history of medicine or psychotherapy, or the social history of New England.
Does psychiatry have a future?
Assailed from many directions, under constant attack for its reliance on "a drug for all problems" and increasingly unable to attract bright new trainees, the specialty is showing every sign of terminal decline. The reason is simple: modern psychiatry has no formal model of mental disorder to guide its daily practice, teaching and research. Unfortunately, the orthodox psychiatrists who control this most conservative profession are utterly antagonistic to criticism. Despite the evidence, they maintain a blind faith that "science will deliver the goods" by a biological examination of the brain. This book argues that their faith is entirely misplaced and is contributing to the destruction of an essential part of civilized life, the fair and equitable treatment of people with mental disorders. The author offers a rational model of mental disorder within the framework of a molecular resolution of the mind-body problem. Fully developed, this model will have revolutionary consequences for psychiatry--and the mentally-afflicted.

ÿAcclaim for the writing of Niall Mclaren, M.D.

ÿ"This book is a tour de force. It demonstrates a tremendous amount of erudition, intelligence and application in the writer. It advances an interesting and plausible mechanism for many forms of human distress. It is an important work that deserves to take its place among the classics in books about psychiatry."
--Robert Rich, PhD, AnxietyAndDepression-Help.com

ÿ"Dr. McLaren brilliantly wields the sword of philosophy to refute the modern theories of psychiatry with an analysis that is sharp and deadly. His own proposed novel theory could be the dawn of a new revolution in the medicine of mental illness."
--Andrew R. Kaufman, MD, Chief Resident of Emergency Psychiatry, Duke University Medical Center

"I found Niall McLaren's book to be an incredibly well-written and thought provoking. It is not, by any means, easy reading. It is also not for someone who doesn't have some form of background in understanding the various psychological theories and mental health conditions. I think that this would make an excellent textbook for a graduate class that allows students to question the theories that we already have."
--Paige Lovitt for "Reader Views"

ÿAbout the Author
The author is a psychiatrist of some 35 years standing. He writes philosophy in the bush outside Darwin, northern Australia, with his family as critics. For six years, while working in Western Australia, he was the world's most isolated psychiatrist.

ÿFor more information please visit www.FuturePsychiatry.com
PSY018000 Psychology: Mental Illness
MED105000 Medical: Psychiatry - General
PHI015000 Philosophy: Mind & Body

Updated with bonus material, including a new foreword and afterword with new research, this New York Times bestseller is essential reading for a time when mental health is constantly in the news.

In this astonishing and startling book, award-winning science and history writer Robert Whitaker investigates a medical mystery: Why has the number of disabled mentally ill in the United States tripled over the past two decades?

Interwoven with Whitaker’s groundbreaking analysis of the merits of psychiatric medications are the personal stories of children and adults swept up in this epidemic. As Anatomy of an Epidemic reveals, other societies have begun to alter their use of psychiatric medications and are now reporting much improved outcomes . . . so why can’t such change happen here in the United States? Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?

Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

Praise for Anatomy of an Epidemic

“The timing of Robert Whitaker’s Anatomy of an Epidemic, a comprehensive and highly readable history of psychiatry in the United States, couldn’t be better.” —Salon.com

“Anatomy of an Epidemic offers some answers, charting controversial ground with mystery-novel pacing.” —TIME.com

“Lucid, pointed and important, Anatomy of an Epidemic should be required reading for anyone considering extended use of psychiatric medicine. Whitaker is at the height of his powers.” —Greg Critser, author of Generation Rx
In this instant classic of developmental psychology, a renowned psychiatrist examines the effect that trauma can have on a child, reveals how PTSD impacts the developing mind, and outlines the path to recovery.
What happens when a young brain is traumatized? How does terror, abuse, or disaster affect a child's mind -- and how can that mind recover? Child psychiatrist Dr. Bruce D. Perry has helped children faced with unimaginable horror: genocide survivors, murder witnesses, kidnapped teenagers, and victims of family violence.
In The Boy Who Was Raised as a Dog, Dr. Perry tells their stories of trauma and transformation through the lens of science, revealing the brain's astonishing capacity for healing. Deftly combining unforgettable case histories with his own compassionate, insightful strategies for rehabilitation, Perry explains what exactly happens to the brain when a child is exposed to extreme stress -- and reveals the unexpected measures that can be taken to ease a child's pain and help him grow into a healthy adult.
As a senior fellow at the Child Trauma Academy, Dr. Perry and his clinical group worked with hundreds who endured severe childhood neglect and abuse with incredible resilience and strength. Through the stories of children who recover -- physically, mentally, and emotionally -- from the most devastating circumstances, Perry shows how simple things like surroundings, affection, language, and touch can deeply impact the developing brain, for better or for worse. In this deeply informed and moving book, Bruce Perry dramatically demonstrates that only when we understand the science of the mind can we hope to heal the spirit of even the most wounded child.
Widely recognized as the standard text for trainee psychiatrists, the Shorter Oxford Textbook of Psychiatry stands head and shoulders above the competition. The text has been honed over seven editions, displaying a fluency, authority, and insight rarely found in textbooks which makes the process of assimilating information effective and enjoyable. The book provides an introduction to all the clinical topics, sub-specialties, and major psychiatric conditions required by the trainee psychiatrist. Throughout, the authors emphasize the basic clinical skills required for full assessment and understanding of the patient. Discussion of treatment includes not only scientific evidence, but also practical problems in the management of patients in a family and social context. Full attention to ethical and legal issues is given within the evidence-based approach to practice provided in the text. Introductory chapters focus on recognition of signs and symptoms, classification and diagnosis, psychiatric assessment, and aetiology. Further chapters deal with all the major psychiatric syndromes, as well as providing detailed coverage of pharmacological and psychological treatments. The book gives equal prominence to ICD and DSM classifications - often with direct comparisons - making the book relevant to the practice of psychiatry throughout the world. Boasting greater use of summary boxes, tables, and lists within a new modern design, the Shorter Oxford Textbook of Psychiatry remains the most up-to-date secondary level textbook of psychiatry available. The extensive bibliography has been brought up-to-date and there are targeted reading lists for each chapter. The Shorter Oxford Textbook of Psychiatry fulfils all the study and revision needs of psychiatric trainees, but will also prove useful to medical students, GPs, qualified psychiatrists, and those in related fields who need to be kept informed with current psychiatric practice.
The Massachusetts General Hospital is widely respected as one of the world's premier psychiatric institutions. Now, preeminent authorities from MGH present a reference that is carefully designed to simplify your access to the current clinical knowledge you need. A remarkably user-friendly organization - with abundant boxed summaries, bullet points, case histories, and algorithms - speeds you to the answers you need. In short, this brand-new reference delivers all the authoritative answers you need to overcome any clinical challenge, in a format that's easier to consult than any other source!Peerless, hands-on advice from members of the esteemed MGH Department of Psychiatry helps you put today's best approaches to work for your patients. The book's highly templated format - with abundant boxed overviews, bulleted points, case histories, algorithms, references, and suggested readings - enables you to locate essential information quickly.In-depth coverage of many unique areas, including Psychiatric and Substance Use Disorders in Transitioning Adolescents and Young Adults; Neuroanatomical Systems Relevant to Neuropsychiatric Disorders; Legal and Ethical Issues in Psychiatry; Military Psychiatry; and Approaches to Collaborative Care and Primary Care Psychiatry.Features full, new DSM-5 criteria; new art, tables, and key points; and new Alzheimer’s Disease guidelines.Highlights recent developments in the field, such as neurotherapeutics, new psychotropics, military psychiatry, collaborative care, ensuring your knowledge is thoroughly up to date.
Varcarolis' Foundations of Psychiatric-Mental Health Nursing, 8th Edition is the most comprehensive RN psychiatric nursing text on the market! Awarded second place in the 2018 AJN Book of the Year Awards in Psychiatric Mental Health Nursing category. User-friendly by design, it simplifies the often-intimidating subject of psychiatric-mental health nursing with a practical, clinical perspective. This edition was revised in conjunction with a readability expert to support clarity and ease of understanding. Chapters follow the nursing process framework and progress from theory to application, preparing your students for clinical practice with real-world examples. New to this edition are full-page illustrated explanations about the neurobiology of disorders and associated medications, criteria from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) for major disorders, completely revised Evidence-Based Practice boxes, and a fully rewritten chapter on Dying, Death, and Grieving to provide students with essential information about difficult topics.Mentor-like writing style reinforces important information and helps in applying textbook content to the clinical setting.Coverage of key topics and emerging nursing trends keep you current with best practices in the field.Considering Culture boxes discuss the importance of person-centered care in providing competent care to diverse populations in various clinical situations.Vignettes with vivid mini-stories prepare you for real-world practice with personal, descriptive characterizations of patients with specific psychiatric disorders.Health Policy Boxes introduce the role you can play in advocating for patients and the profession.Clinical chapters follow the six-step nursing process, providing consistent guidelines for comprehensive assessment and intervention.NEW! Full-page illustrated explanations about the neurobiology of disorders and associated medications. NEW! DSM-5 guidelines from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders are fully incorporated in the text, and include updated NANDA content.NEW! Completely revised Evidence-Based Practice boxes. NEW! Revised chapter on Dying, Death and Grieving gives you all the vital information you need.NEW! Ten NCLEX-style questions and answers at the end of each chapter.
A new edition of a highly successful, award winning textbook for trainee psychiatrists, covering in one volume all the subjects required for the new MRCPsych and similar exams. Written in a highly engaging manner, it will also prove invaluable to qualified psychiatrists who need to keep up-to-date with the latest developments, as well as clinical psychologists, general practitioners, psychiatric nurses and senior medical students

Concise yet comprehensive, Core Psychiatry relfects the latest developments in the curriculum plus all that is new and essential in clinical practice and the sciences that underpin it. It includes new information on the new Mental Capacity Act and Mental Health Act as well as enhanced sections on psychopharmacology, old age psychiatry, child and adolescent psychiatry, forensic psychiatry and rehabilitation. The book also makes refernce to the latest NICE guidelines and includes new sections on sleep medicine and trauma psychiatry.

New edition of a popular MRCPsych curriculum based text Previous edition ‘Highly Commended’ (Mental Health category) in the BMA Awards 2005 Contains useful summary boxes, lists and key points to make last minute learning easy Comprehensive and authoritative resource written by contributors to ensure complete accuracy and currency of specialist information Chapters prepared by specialists working in conjunction with trainees – content totally up-to-date and jointly written by authors who have recently been in the exam situation Contains the latest findings in sleep medicine and trauma psychiatry Expanded section on psychology – including social psychology – to reflect the latest MRCPych examination format Text updated in full to reflect the new Mental Capacity Act and Mental Health Act Relevant chapters now contain a ‘skills and competency’ section to reflect changes in MRCPsych curriculumUpdating and amendments to improve coverage of old age psychiatry, child and adolescent psychiatry, forensic psychiatry and rehabilitation Contains reference to the latest NICE guidelines in boxes and tables Enhanced discussion of the use of the best current management options, both pharmacological and psychotherapeutic, the latter including CBT, DBT, EMDR and psychodynamic group, couple and family therapy.
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