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Based on sophisticated clinical descriptions and characteristic symptom patters occurring during the long-term course of psychiatric diseases, Leonhards classification requires that all the clinical features fit for a diagnosis to be made. Always using his own life-long case studies, Leonhard divided the endogenous psychoses into five main nosological groups: on the one hand, the prognostically favourable unipolar affective psychoses, bipolar affective psychoses and cycloid psychoses, and, on the other hand, the prognostically unfavourable unsystematic and systematic schizophrenia. In the meantime, the reliability and validity of this classification have been confirmed by scientific studies and early results provide guidelines for the different origins and varied therapeutic approaches for the specific disease profiles.
The study of catatonia in Autism Spectrum Disorders is a novel and controversial topic. Catatonia is a motor disorder characterized by stereotypy, rigidity, mutism, and posturing. These motor signs are also characteristic of autism. The interest in the relation between autism and catatonia stems from clinical observations that autistic and catatonic symptoms overlap, that some people with autism develop full-blown catatonia, and that anti-catatonic treatments bring relief in some of those patients. Catatonia in Autism Spectrum Disorders explores the question of if the two syndromes have a common pathophysiology. It also examines whether the successful treatment of catatonia be applied to patients with both autism and catatonia. The book concludes with blueprints for the assessment, treatment, and future study of catatonia in Autism Spectrum Disorders. These blueprints aim to increase early recognition and treatment of catatonia in patients with autism, show the urgency of controlled treatment trials and increased collaborative and interdisciplinary research into the co-occurrence of these two enigmatic disorders. - Provides a historical perspective of the concepts of catatonia and autism, as described by old European masters like Bleuler and Kalhbaum - Presents clinical-epidemiological studies that apply systematic criteria of catatonia in populations with Autism Spectrum Disorders - Includes a review of the importance of psychomotor function for normal and abnormal development
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During the 20th century, catatonia all but dropped off the agenda of mainstream psychiatric research. However, several dedicated research groups, represented in this volume, continued to report original data highlighting catatonia as a relevant and ideal subject for clinical study. This book, which exemplifies the unparalleled breadth of the knowledge gained, will benefit clinicians managing catatonic phenomena as well as researchers interested in pursuing further investigations. This book covers in great detail the psychopathology and neurobiology of catatonia, focusing on the history, epidemiology, etiology, diagnosis and treatment of the disorder. This comprehensive volume Offers a wide representation of the historical and worldwide literature on the many variants of catatonia in a single, well-organized text. Includes work presented by the original investigators, many of whom work outside the United States and have had their previous studies published only in non-English journals. Covers alternative opinions and perspectives on catatonia, contributing novel and illuminating perspectives on the syndrome. Addresses areas of controversy -- including disagreements over treatment and the nosologic status of catatonia -- head-on, in a balanced, evidence-based presentation. Balances practical clinical material with the underlying neurobiology, presenting clinical aspects in the context of history, epidemiology, cross-cultural perspectives, and neurobiological findings and highlighting the richness and intellectual attraction of the study of the disorder. Catatonia is unique in offering a diverse, international group of contributors and such a comprehensive, up-to-date review of the clinical and scientific literature, spanning the breadth of contemporary understanding about the nature, meaning, and importance of the syndrome.
It is well known that estrogen is "somehow” a protective hormone for various age-related disorders. This book provides a solid knowledge of estrogen’s neuroprotective activities in the brain with a special emphasis on neurodegenerative disorders such as Alzheimer’s Disease. The focus is (1) to describe the biochemical, molecular, and cellular basis of the protective activity of estrogen and (2) to transfer this knowledge into the hospitals by discussing preventive and therapeutic approaches such as estrogen replacement therapy for post-menopausal women. Besides up-to-date information on estrogen and the brain, this book explains in a highly understandable manner molecular and cellular techniques by which basic data have been collected. The reader, which may include the professional specialist as well as the interested non-specialist, will also gain insight into the scientific transfer process of knowledge from basic science to the clinical situation and therefore "from bench to bed”.
A number of studies, mostly focusing on estrogen replacement therapy in women, have reported beneficial actions of these hormones on various neurobiological and neuropathological parameters in health and disease. Recent research has focused on gender differences and there is increasing evidence that estrogens exert protective effects in schizophrenia. Hormonal fluctuations or lack of estrogen may increase the risk of depression among vulnerable women. Treatment of depression with estrogen may stabilize and restore disrupted homeostasis – as during post-partum, premenstrual, or perimenopausal conditions – and act as a psychomodulator to offset vulnerability to dysphoric mood when estrogen levels are significantly decreased, as in the case of postmenopausal women. Studies on the effect of estrogens on Alzheimer’s Disease are still rather controversial, they do, however, facilitate the hypothesis that estrogens may have a modifying effect on the onset and course of AD, at least in subgroups of patients.
This provocative history of bipolar disorder illuminates how perceptions of illness, if not the illnesses themselves, are mutable over time. Beginning with the origins of the concept of mania—and the term maniac—in ancient Greek and Roman civilizations, renowned psychiatrist David Healy examines how concepts of mental afflictions evolved as scientific breakthroughs established connections between brain function and mental illness. Healy recounts the changing definitions of mania through the centuries, explores the effects of new terminology and growing public awareness of the disease on culture and society, and examines the rise of psychotropic treatments and pharmacological marketing over the past four decades. Along the way, Healy clears much of the confusion surrounding bipolar disorder even as he raises crucial questions about how, why, and by whom the disease is diagnosed. Drawing heavily on primary sources and supplemented with interviews and insight gained over Healy's long career, this lucid and engaging overview of mania sheds new light on one of humankind's most vexing ailments.
People with mental illness are often painfully familiar with overt prejudice or more subtle forms of mistreatment. The stigma and discrimination associated with their disorders can have effects in several areas of life: in social interactions, in work and healthcare settings, in the legal system and the media. Many withdraw due to shame and do not seek help. In turn, stigma can prove to be a more serious problem than the disorder itself. Yet too little is done to reduce stigma and its impact. The Stigma of Mental Illness: Strategies Against Discrimination and Social Exclusion offers up the knowledge necessary to understand and fight against stigma and discrimination. It will be invaluable to all health professionals, social workers, healthcare managers and policy makers with an involvement or interest in mental illness. - Broad coverage of the forms and consequences of stigma - Specific treatment of stigma in relation to diagnoses such as dementia and autism - Perspectives and strategies of a service user and a relative - Up-to-date concepts regarding exclusion and discrimination - Practical strategies for service users, relatives, healthcare professionals and policy makers
Psychiatric and psychological practice and research is critically dependent on diagnosis. Yet the nature of psychiatric diagnosis and the rules by which disorders should be created and organized have been highly controversial for over 100 years. Unlike simple medical disorders (like infectious diseases), psychiatric disorders cannot be traced to one simple etiologic agent. The last two generations have seen major conceptual shifts in the approach to diagnosis with the rise of operationalized criteria and an emphasis on a descriptive rather than etiological approach to diagnosis. The interest in psychiatric diagnoses is particularly heightened now because both of the major psychiatric classifications in the world - DSM and ICD - are now undergoing major revisions. What makes psychiatric nosology so interesting is that it sits at the intersection of philosophy, empirical psychiatric/psychological research, measurement theory, historical tradition and policy. This makes the field fertile for a conceptual analysis. This book brings together established experts in the wide range of disciplines that have an interest in psychiatric nosology. The contributors include philosophers, psychologists, psychiatrists, historians and representatives of the efforts of DSM-III, DSM-IV and DSM-V. Some of the questions addressed include i) what is the nature of psychiatric illness? Can it be clearly defined and if so how? ii) What is the impact of facts versus values in psychiatric classification? iii) How have concepts of psychiatric diagnosis changed over time? iv) How can we best conceptualize the central idea of diagnostic validity? And v) Can psychiatric classification be a cumulative enterprise seeking improvements at each iteration of the diagnostic manual? Each individual chapter is introduced by the editors and is followed by a commentary, resulting in a dynamic discussion about the nature of psychiatric disorders. This book will be valuable for psychiatrists, psychologists and other mental health trainees and professionals with an interest in the questions and problems of psychiatric diagnosis, as well as philosophers and philosophy students interested in the problems posed by psychiatry, particularly those working in the philosophy of science.