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50 Studies Every Psychiatrist Should Know presents key studies that have shaped the practice of psychiatry. Selected using a rigorous methodology, the studies cover topics including: psychotic disorders, depressive disorders, women's mental health, child and adolescent disorders, and epidemiological studies. This book is a must-read for health care professionals and anyone who wants to learn more about the data behind clinical practice.
On March 3-4, 2016, the National Academies of Sciences, Engineering, and Medicine's Forum on Neuroscience and Nervous System Disorders held a workshop in Washington, DC, bringing together key stakeholders to discuss opportunities for improving the integrity, efficiency, and validity of clinical trials for nervous system disorders. Participants in the workshop represented a range of diverse perspectives, including individuals not normally associated with traditional clinical trials. The purpose of this workshop was to generate discussion about not only what is feasible now, but what may be possible with the implementation of cutting-edge technologies in the future.
Advances in the practice of psychiatry have occurred in "fits and starts" over the last several decades. These advances are evident to anyone long affiliated with the field and are best appreciated through direct experience of living through the times. These advances can also be gleaned from historical overviews in textbooks or the recollections of one's teachers and mentors. Returning to the original papers that have ushered in these changes is rarely done for various, mostly practical, reasons. Filtering through thousands of articles in psychiatry may prove daunting, access to the manuscripts may be limited (especially for papers not available electronically), and understanding their impact requires a broader context. Moreover, with so much active research currently occurring in various branches of psychiatry, current practitioners or trainees may find their attention focused on the present, and this is reinforced by electronic search algorithms, which return articles in reverse chronological order. Not surprisingly, citations for articles in virtually all fields decline precipitously for articles over five years old. As scholars and professionals, we are losing touch with our academic heritage. Yet navigating the future of psychiatry requires a firm understanding of its past. This resource serves as a guide for anyone seeking to understand the evolution of psychiatry as a scientific discipline. It does so by summarizing over 100 landmark papers in psychiatry and placing their scientific contributions within a historical context. An introductory section sets the stage for the major theoretical constructs within the field, with chapters devoted to ontology and nosology. Subsequent sections examine major facets of the theory and practice of psychiatry, such as pathogenesis of psychiatric illness, pharmacotherapy, psychotherapy, and somatic treatments. These sections are divided logically into chapters addressing important contributions to the understanding and treatment of specific disorders. A final section explores ethical considerations within each field. This framework echoes the complexity of psychiatry, which cannot be reduced to a single set of diagnoses or subspecialty categories. Highlighting the research trajectory of psychiatry, this resource will appeal to academics, trainees, and practitioners who desire a comprehensive, easy-to-read, up-to-date collection of psychiatry's pivotal moments. By understanding the challenges, inspirations, and insights from the past, readers will be better poised to address new and ongoing challenges within the field.
The number of psychiatric researchers does not seem to be keeping pace with the needs and opportunities that exist in brain and behavioral medicine. An Institute of Medicine committee conducted a broad review of the state of patient-oriented research training in the context of the psychiatry residency and considered the obstacles to such training and strategies for overcoming those obstacles. Careful consideration was given to the demands of clinical training. The committee concluded that barriers to research training span three categories: regulatory, institutional, and personal factors. Recommendations to address these issues are presented in the committee’s report, including calling for research literacy requirements and research training curricula tailored to psychiatry residency programs of various sizes. The roles of senior investigators and departmental leadership are emphasized in the report, as is the importance of longitudinal training (e.g., from medical school through residency and fellowship). As there appears to be great interest among numerous stakeholders and a need for better tracking data, an overarching recommendation calls for the establishment of a national body to coordinate and evaluate the progress of research training in psychiatry.
An ideal health care system relies on efficiently generating timely, accurate evidence to deliver on its promise of diminishing the divide between clinical practice and research. There are growing indications, however, that the current health care system and the clinical research that guides medical decisions in the United States falls far short of this vision. The process of generating medical evidence through clinical trials in the United States is expensive and lengthy, includes a number of regulatory hurdles, and is based on a limited infrastructure. The link between clinical research and medical progress is also frequently misunderstood or unsupported by both patients and providers. The focus of clinical research changes as diseases emerge and new treatments create cures for old conditions. As diseases evolve, the ultimate goal remains to speed new and improved medical treatments to patients throughout the world. To keep pace with rapidly changing health care demands, clinical research resources need to be organized and on hand to address the numerous health care questions that continually emerge. Improving the overall capacity of the clinical research enterprise will depend on ensuring that there is an adequate infrastructure in place to support the investigators who conduct research, the patients with real diseases who volunteer to participate in experimental research, and the institutions that organize and carry out the trials. To address these issues and better understand the current state of clinical research in the United States, the Institute of Medicine's (IOM) Forum on Drug Discovery, Development, and Translation held a 2-day workshop entitled Transforming Clinical Research in the United States. The workshop, summarized in this volume, laid the foundation for a broader initiative of the Forum addressing different aspects of clinical research. Future Forum plans include further examining regulatory, administrative, and structural barriers to the effective conduct of clinical research; developing a vision for a stable, continuously funded clinical research infrastructure in the United States; and considering strategies and collaborative activities to facilitate more robust public engagement in the clinical research enterprise.
"This is the long-awaited text on interdisciplinary treatment and assessment of, among other clinical topics, brain-derived behavioral, cognitive, and neurological disorders...." --Niels Birbaumer, PhD University of T ̧bingen, Germany Member of the German Academy of Sciences, Leopoldina "Gone is the unidimensional approach of the expert summarizing a topic from a single vantage point. Instead, the content shifts laterally, embracing not only interdisciplinary expertise, but an integrative way of thinking that transcends each discipline....What makes the Handbook so refreshing is that this cross pollination of ideas and approaches is more than novel theorizing. It offers clinicians a new way forward." --Anthony Feinstein, MD, MPhil, PhD, FRCP University of Toronto To maintain the highest standards, allied health care practitioners must keep pace with evolving trends in diagnostics, interventions, and methodologies. This book supports clinicians by disseminating important perspectives, research, and procedures. It provides an integrative roadmap that fosters interdisciplinary cooperation. Key Features: Presents reviews of research on a broad selection of clinical disorders Includes a wide range of established and emerging diagnostic and intervention approaches Discusses viable evidence-based alternative treatment methods Critiques certain approaches, paradigms, and practices that may need to be revised Includes contributions from renowned psychologists, psychiatrists, and researchers Clinicians, researchers, and students will find this book a valuable source for interdisciplinary practice and research. It facilitates a sorely needed move toward integrative practice in an era in which specialization pervades.
Personalized Psychiatry presents the first book to explore this novel field of biological psychiatry that covers both basic science research and its translational applications. The book conceptualizes personalized psychiatry and provides state-of-the-art knowledge on biological and neuroscience methodologies, all while integrating clinical phenomenology relevant to personalized psychiatry and discussing important principles and potential models. It is essential reading for advanced students and neuroscience and psychiatry researchers who are investigating the prevention and treatment of mental disorders. - Combines neurobiology with basic science methodologies in genomics, epigenomics and transcriptomics - Demonstrates how the statistical modeling of interacting biological and clinical information could transform the future of psychiatry - Addresses fundamental questions and requirements for personalized psychiatry from a basic research and translational perspective
Antipsychotic medications are a key treatment for schizophrenia and sales of antipsychotic drugs approach $20 billion per year, with fierce marketing between the makers of the drugs. The U.S. National Institute of Mental Health sponsored the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) project to provide independent information about the comparative effectiveness of medications. CATIE was the largest, longest and most comprehensive study of schizophrenia to date. Conducted under rigorous double-blind conditions, Antipsychotic Trials in Schizophrenia presents the definitive archival results of this landmark study. The core of the book consists of chapters focused on specific outcomes that set the CATIE findings in a wider context. Also included are chapters on the design, statistical analyses and implications for researchers, clinicians and policy makers. Psychiatrists, psychiatric researchers, mental health policy makers and those working in pharmaceutical companies will all find this to be essential reading.
The MacCAT-CR provides a structured format for capacity assessment that is adaptable to the particulars of any given research project. With the introduction of the MacCAT-CR, researchers enrolling human participants in their studieshave available for the first time a reliable and valid means of assessing their potential subject's capacity to consent to participation. The MacCAT-CR can typically be administered in 15-20 minutes. Beginning with project-specific disclosures to potential participants, the MacCAT-CR measures the four generally accepted components of decision-making competence: understanding, appreciation, reasoning, and the ability to express a choice. Quantification of subjects' responses permits comparisons across subjects and subject groups, and allows the MacCAT-CR to be used for not only for screening individual participants but also for conducting research on the characteristics of subject populations and for assessing the effectiveness of interventions designed to increase subjects' capacities.