"Personalities are like impressionistic paintings. At a distance, each person is 'all of a piece'; up close, each is a bewildering complexity of moods, cognitions, and motives."
-Theodore Millon

Exploring the continuum from normal personality traits to the diagnosis and treatment of severe cases of personality disorders, Personality Disorders in Modern Life, Second Edition is unique in its coverage of both important historical figures and contemporary theorists in the field. Its content spans all the major disorders-Antisocial, Avoidant, Depressive, Compulsive, Histrionic, Narcissistic, Paranoid, Schizoid, and Borderline-as well as their many subtypes. Attention to detail and in-depth discussion of the subtleties involved in these debilitating personality disorders make this book an ideal companion to the DSM-IV(TM).

Fully updated with the latest research and theory, this important text features:Discussion of the distinctive clinical features and developmental roots of personality disordersBalanced coverage of the major theoretical perspectives-biological, psychodynamic, interpersonal, cognitive, and evolutionaryIndividual chapters on all DSM-IV(TM) personality disorders and their several subtypes and mixturesCase studies throughout the text that bring to life the many faces of these disorders

Including a new assessment section that singles out behavioral indicators considered to have positive predictive power for the disorders, this Second Edition also includes a special focus on developmental, gender, and cultural issues specific to each disorder. A comprehensive reference suitable for today's practitioners, Personality Disorders in Modern Life, Second Edition features a clear style that also makes it a valuable resource for advanced undergraduate and graduate students. The most thorough book of its kind, this Second Edition is a powerful, practical resource for all trainees and professionals in key mental health fields, such as psychology, social work, and nursing.

Author: Theodore Millon, Carrie M. Millon, Sarah Meagher, Seth Grossman, Rowena Ramnath
Hardcover: 624 pages
Company: Wiley (2004-08-06)
ISBN: 0471237345
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Completely revised and updated, this Second Edition spans every issue related to ADD care and treatment. New chapters focus on emerging issues, the overlap of sleep disorders, how sleep disorders mimic ADD/ADHD and/or increase the symptoms, ADHD and sleep apnea, ADHD and restless legs or periodic limb movements in sleep, sleep in children, adolescents and adults, the aged population, ADD and women, novel treatment approaches, including a new cognitive training program, methods to diagnosis ADD/ADHD and separate it from other overlapping disorders, and mis-diagnosis.

The Definitive Resource for Trauma Survivors, Their Loved Ones, and Helpers

Trauma can take many forms, from witnessing a violent crime or surviving a natural disaster to living with the effects of abuse, rape, combat, or alcoholism. Deep emotional wounds may seem like they will never heal. However, with The Post-Traumatic Stress Disorder Sourcebook, Dr. Glenn Schiraldi offers a remarkable range of treatment alternatives and self-management techniques, showing survivors that the other side of pain is recovery and growth.

Live your life more fully-without fear, pain, depression, or self-doubt Identify emotional triggers-and protect yourself from further harm Understand the link between PTSD and addiction-and how to break it Find the best treatments and techniques that are right for you

This updated edition covers new information for war veterans and survivors with substance addictions. It also explores mindfulness-based treatments, couples strategies, medical aids, and other important treatment innovations.

Author: Glenn Schiraldi
Paperback: 464 pages
Company: McGraw-Hill (2009-03-05)
ISBN: 007161494X
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This thoroughly revised and updated edition of Linda Seligman's classic book, Selecting Effective Treatments combines the latest research on evidence-based practices with practical, how-to information on implementation.

Filled with numerous illustrative case studies and helpful examples, this Fourth Edition features expanded coverage of:

Trauma and its effect across the lifespan, suicide assessment and prevention, and new treatment approaches, including mindfulness

Childhood disorders, including autism spectrum disorders, bipolar disorder, ADHD, and attachment disorder

Grief, loss, and bereavement

Diagnosis and treatment of depression, borderline personality disorder, the schizophrenia spectrum disorders, and the bipolar disorders

With a new discussion of treatment strategies for dual diagnosis, Selecting Effective Treatments, Fourth Edition provides a pathway for treatment of mental disorders based on the most recent evidence-based research, while at the same time recognizing that the diagnosis and treatment of mental disorders are part of a dynamic and evolving field that embraces individuality and personalization.

New this spring, the third edition of this Hazelden best-seller has been updated to include the latest research, information about new medications, and an explanation of new diagnostic criteria.

Key features and benefits outlines the relationship between chemical dependency and psychiatric disorders contains important resources for chemically dependent individuals and their families presents practical relapse prevention strategies

Author: Dennis C Daley Ph.D., Howard B. Moss M.D.
Paperback: 499 pages
Company: Hazelden (2002-04) (2002-03-07)
ISBN: 1568388020
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Consult the second edition of this authoritative, comprehensive, in-depth medical guide for information on more than 1,700 medical topics in language accessible to adult laypersons. Presented in a single alphabetical sequence, articles range in length from one or two paragraphs for minor topics, to several pages or more for major topics. Disease/disorder articles typically cover definition; description; causes and symptoms; diagnosis; treatments; prevention; and more. Test/treatment articles typically cover definition; purposes; precautions; preparation; risks; normal and abnormal results; and much more. This second edition includes more than 200 new entries, 300 updated entries, approximately 650 color images and illustrations, and a comprehensive subject index. New features include biographical and historical sidebars throughout the text.

Disease/disorder articles contain some or all of the following sections:

Test/treatment articles contain some or all of the following sections:

Published/Released: December 2001

The “Gale Encyclopedia of Mental Disorders” is a comprehensive two-volume set providing detailed information on mental disorders and conditions, in an easy-to-use format. It includes entries for all 150 disorders classified in the “Diagnostic and Statistical Manual of Mental Disorders,” and also features entries for prescription, alternative and over-the-counter drugs, as well as the various therapies used to treat mental disorders.

Avoiding hard-to-understand medical jargon, the four-volume “Gale Encyclopedia of Children’s Health” uses language that parents can understand, while still providing enough depth to benefit today's health science students. The set provides in-depth coverage of pediatric diseases and disorders, along with issues related to physical and cognitive/behavioral development.

This major professional reference and text offers an authoritative review of evidence-based treatments for the most prevalent child and adolescent problems. Leading contributors present applications for anxiety disorders, depressive disorders, ADHD, autistic spectrum disorders, learning disabilities, the effects of maltreatment, substance use, and more.

The Quick Reference to the Diagnostic Criteria From DSM-IV-TR® is a handy, low priced companion to the ultimate psychiatric reference, DSM-IV-TR®. It includes all the diagnostic criteria from DSM-IV-TR® in an easy-to-use, paperback format.

In making DSM-IV diagnosis, clinicians and researchers may find it convenient to consult the Quick Reference to the Diagnostic Criteria From DSM-IV-TR®, a pocket sized book that contains the classification, the diagnosis criteria, and a listing of the most important conditions to be considered in a differential diagnosis for each category.

Recognized as the definitive reference in the field, this book addresses a broad range of biologically based disorders that affect children's learning and development. Leading authorities review the genetics of each disorder; its course and outcome; associated developmental, cognitive, and psychosocial challenges; and what clinicians and educators need to know about effective approaches to assessment and intervention. Coverage encompasses more frequently diagnosed learning and behavior problems with a genetic component as well as numerous lower-incidence neurodevelopmental disabilities. Illustrations include 12 color plates.

Everything you need to know to record client intake, treatment, and progress—incorporating the latest managed care, accrediting agency, and government regulations

Paperwork and record keeping are day-to-day realities in your mental health practice. Records must be kept for managed care reimbursement; for accreditation agencies; for protection in the event of lawsuits; to meet federal HIPAA regulations; and to help streamline patient care in larger group practices, inpatient facilities, and hospitals.

The standard professionals and students have turned to for quick and easy, yet comprehensive, guidance to writing a wide range of mental health documents, the Third Edition of The Psychotherapy Documentation Primer continues to reflect HIPAA and accreditation agency requirements as well as offer an abundance of examples.

The new edition features:

Revised examples of a wider range of psychological concerns

New chapters on documentation ethics and the art and science of psychological assessment and psychotherapy

Study questions and answers at the end of each chapter

Greatly expanded, The Psychotherapy Documentation Primer, Third Edition continues to be the benchmark record-keeping reference for working professionals, reflecting the latest in documentation and reporting requirements.

Author: Donald E. Wiger
Paperback: 237 pages
Company: Wiley (2011-12-27)
ISBN: 0470903961
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Posttraumatic Stress Disorders in Children and Adolescents is an expert guide to the most salient issues pertaining to PTSD, stress, trauma, and the concurrent conditions that affect children and adolescents. The rich mix of clinical experience and research constitutes a thorough introduction for practitioners.

The “Gale Encyclopedia of Mental Disorders” is a comprehensive two-volume set providing detailed information on mental disorders and conditions, in an easy-to-use format. It includes entries for all 150 disorders classified in the “Diagnostic and Statistical Manual of Mental Disorders,” and also features entries for prescription, alternative and over-the-counter drugs, as well as the various therapies used to treat mental disorders.

This volume (one of two) is the first presentation of Schore's comprehensive theory in book form, as it has developed since 1994.

Also available:

Borderline Personality Disorder: The NICE Guideline on Treatment and Management - ISBN 1854334778
Dementia: The NICE-SCIE Guideline on Supporting People with Dementia and Their Carers in Health and Social Care (National Clinical Practice Guideline) - ISBN 1854334514

RCPsych Publications is the publishing arm of the Royal College of Psychiatrists (based in London, United Kingdom), which has been promoting excellence in mental health care since 1841. Produced by the same editorial team who publish The British Journal of Psychiatry, they sell books for both psychiatrists and other mental health professionals; and also many written for the general public. Their popular series include the College Seminars Series, the NICE mental health guidelines and the Books Beyond Words series for people with intellectual disabilities.

RCPsych publishes in all areas of psychiatry and mental health, including but not limited to:
Clinical psychiatric practice
Intellectual disability
Mental health services for children, adolescents, adults and the elderly
Psychopharmacology
Psychotherapy
Rehabilitation psychiatry
Family mental health
Service provision

RCPsych Publications books can help with the following disorders:
Addictions
Affective disorders
Attention deficit hyperactivity disorder (ADHD)
Bereavement
Borderline personality disorder
Cognitive-behavioral therapy (CBT)
Dementia
Depression
Eating disorders
Perinatal psychiatric disorder
Post-traumatic stress disorder (PTSD)
Psychosis
Schizophrenia
Sleep problems

Author: National Collaborating Centre for Mental Health
Paperback: 168 pages
Company: British Psychological Society and RCPsych Publications (2005-01-01)
ISBN: 190467125X
List Price: $70.00
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The authority of Harrison's in a handy, full-color paperback devoted exclusively to Nephrology and Acid-Base Disorders

A Doody's Core Title for 2011!

4 STAR DOODY'S REVIEW!
"In the Harrison's tradition, this book integrates pathophysiology with clinical management while outlining discoveries in genetics and molecular biology. It includes some important chapters that are not found in similar books: one on adaptation of the kidney to renal injury (including factors and mechanisms of renal disease progression) and one on hyperuricemia and gout. The introductory chapter on the basic biology of the kidney, covering renal development, function, and physiology, is very well written. This book meets the expected Harrison's standards and reading it is a satisfying experience."--Doody's Review Service

Featuring the chapters on Nephrology and Acid-Base Disorders that appear in the landmark Harrison's Principles of Internal Medicine, 17e, this compact clinical companion delivers all the latest knowledge in the field, backed by the scientific rigor and reliability that have defined Harrison's.

You'll find coverage that reflects the expertise of renowned editors and contributors -- presented in a carry-anywhere format that makes it ideal for the classroom, the wards, or the point of care. With its ease of use, indispensable diagnosis-speeding guidelines, and acclaimed state-of-the-art strategies, Harrison's Nephrology and Acid Base Disorders is a must for students and clinicians alike.

Harrison's Nephrology and Acid-Base Disorders delivers:
Current, complete coverage of all major renal-related presentations and diseases, as well as acid-base and electrolyte disorders 63 high-yield self-assessment Q&A for exam and board review drawn from Harrison's Principles of Internal Medicine Self-Assessment and Board Review, 17e A timely focus on the impact of scientific advances, with a look at how genetics and molecular biology are transforming the field New diagnostic and treatment strategies based on evidence from recent clinical studies Integration of pathophysiology with clinical management topics in each of the disease-oriented chapters Valuable content in print form from the acclaimed Harrison's DVD Helpful appendix that highlights laboratory values of clinical importance

The Harrison’s specialty series is written by the same world-renowned author team who brought you Harrison’s Principles of Internal Medicine, 17e:
Anthony S. Fauci, MD; Eugene Braunwald, MD; Dennis L. Kasper, MD; Stephen L. Hauser, MD; Dan L. Longo, MD; J. Larry Jameson, MD, PhD; Joseph Loscalzo, MD, PhD

The newly revised edition of this volume describes the nature of conduct disorder, incorporating the most important findings since the publication of the original. The author draws on current research and clinical work from a variety of fields to explore such topics as: psychiatric diagnosis; child-rearing practices; parent psychopathology; sex differences in development; i

Author: Alan E. Kazdin
Paperback: 191 pages
Company: Sage Publications, Inc (1995-03-27)
ISBN: 0803971818
List Price: $71.00
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This readable guide to the assessment and management of patients with bipolar disorder can help physicians keep abreast of dramatic and rapid advances of recent years and integrate them into their practice. Handbook of Diagnosis and Treatment of Bipolar Disorders emphasizes recent controlled studies and U.S. Food and Drug Administration (FDA) approved indications and translates these data into the real world of clinical practice. The contributions of the eleven chapter authors from Stanford University reflect more than a decade of clinical research and treatment undertaken at that institution, including advances in diagnosis and interventions supported by controlled studies. The manual provides crucial information regarding diagnosis, pharmacotherapy, psychotherapy, and treatment of patients from special populations such as children, women, and older adults and patients with particularly challenging illness courses such as rapid cycling.

This is the first book to provide quantitative assessment of potential benefit (number needed to treat) and risk (number needed to harm) for all approved treatments for bipolar disorder, providing clinicians with information needed to balance benefits and risks in order to render individualized state-of-the-art, evidence-based care. The manual describes all FDA-approved therapies reviewing efficacy, safety, tolerability, pharmacokinetics, illness phase specific dosing, and drug interactions and summarizes published therapeutic data, as well as results of randomized controlled clinical trials very recently presented at major scientific conferences.

J Occup Health Psychol. 2012 Feb 6;
Lagerveld SE, Blonk RW, Brenninkmeijer V, Meij LW, Schaufeli WB

The aim of this study was to compare the effectiveness of two individual-level psychotherapy interventions: (a) treatment as usual consisting of cognitive-behavioral therapy (CBT) and (b) work-focused CBT (W-CBT) that integrated work aspects early into the treatment. Both interventions were carried out by psychotherapists with employees on sick leave because of common mental disorders (depression, anxiety, or adjustment disorder). In a quasi-experimental design, 12-month follow-up data of 168 employees were collected. The CBT group consisted of 79 clients, the W-CBT group of 89. Outcome measures were duration until return to work (RTW), mental health problems, and costs to the employer. We found significant effects on duration until RTW in favor of the W-CBT group: full RTW occurred 65 days earlier. Partial RTW occurred 12 days earlier. A significant decrease in mental health problems was equally present in both conditions. The average financial advantage for the employer of an employee in the W-CBT group was estimated at $5,275 U.S. dollars compared with the CBT group. These results show that through focusing more and earlier on work-related aspects and RTW, functional recovery in work can be substantially speeded up within a regular psychotherapeutic setting. This result was achieved without negative side effects on psychological complaints over the course of 1 year. Integrating work-related aspects into CBT is, therefore, a fruitful approach with benefits for employees and employers alike. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Depress Anxiety. 2011 Dec 13;
Petkus AJ, Gum A, Wetherell JL

Background: Engaging in thought suppression as a coping mechanism has been associated with higher rates of anxiety and depressive disorders in younger adults. Homebound older adults are a population of elders experiencing poor health and high levels of depression and anxiety. It is unclear the extent to which psychological factors, such as thought suppression, are associated with distress, given that their health and disability status may be more salient. The aim of this study was to investigate thought suppression in relation to anxiety and depressive symptoms in homebound older adults. Methods: Participants (N = 142) were clients of home-based case management services delivered by aging service agencies in Florida. Participants were administered a research interview that included the White Bear Suppression Inventory, Structured Clinical Interview for DSM-IV Diagnosis (SCID), Brief Symptom Inventory-18 (BSI-18), and Modified Mini-Mental Status Examination (3MS). Case managers provided standard assessments containing functional and health status of the participant. Results: After controlling for physical health and cognitive functioning, thought suppression was significantly associated with higher likelihood of clinically significant somatic, depressive, and anxiety symptoms on the BSI-18. Thought suppression was also associated with meeting criteria for a SCID depressive or adjustment disorder. Engaging in thought suppression was associated with worse mental health in this sample of homebound older adults even after taking into account physical health, disability, and cognitive functioning. Conclusions: These findings suggest the need to develop and test interventions that may address thought suppression as a coping mechanism. Depression and Anxiety 0:1-7, 2011.  © 2011 Wiley Periodicals, Inc.

Int J Soc Psychiatry. 2011 Nov 2;
Viswanath B, Maroky AS, Math SB, John JP, Cherian AV, Girimaji SC, Benegal V, Hamza A, Chaturvedi SK

AIM: The aim of this observational study was to explore gender-related differences in psychiatric morbidity during the initial three months following the December 2004 earthquake and tsunami involving the Andaman and Nicobar Islands, India. METHODS: There were 12,784 survivors sheltered across 74 relief camps with 4,684 displaced survivors in Port Blair and 8,100 non-displaced survivors in Car-Nicobar Island. All persons who accessed mental health assistance within the camps constituted the study sample. Diagnoses were made by qualified psychiatrists using the ICD-10. There were 475 patients: 188 (40%) men and 287 (60%) women. RESULTS: There were significant gender differences in terms of displacement. There were significantly higher levels of panic disorder, unspecified anxiety disorder and somatic complaints in the displaced women while the non-displaced population showed more adjustment disorder. CONCLUSIONS: Displacement was a significant factor in the manifestations of observed pathology. Displaced women had greater psychiatric morbidity. In addition, the fact that adjustment disorder (a self-limiting disorder form of psychopathology) was more prevalent in the non-displaced group may be a reflection of the findings of overall lesser morbidity in non-displaced women. Hence, women may have to be rehabilitated in their own habitats after major disasters.

Encephale. 2011 Sep; 37(4): 284-92
Boudoukha AH, Hautekeete M, Abdelaoui S, Groux W, Garay D

Prison is typically considered as a dangerous setting partly because of promiscuity and violence, which leads to a whole series of suffering and frustration among prisoners. Due to their occupation, prison guards must ensure the safety of the inmates, their colleagues, as well as any other persons working in prison and in the prison setting. Thus, correctional guards are the "Bumper excitement" of prison violence and suffer from stressful and traumatic events. Indeed, inmates' sufferings and frustration are firstly expressed towards them because they share daily relationships with inmates. In addition, correctional guards are faced with the high inmate suicide risk. One potential consequence of these chronic stressful situations is burnout. Burnout is described as a three-dimensional syndrome composed of emotional exhaustion, depersonalization and sense of lack of personal accomplishment. Burnout is a severe psychological suffering, which can lead to depression. It has been initially identified among persons who are working with patients. Nevertheless, research shows that burnout is not a psychopathology of work but of the relationship with others. In other terms, burnout seems to arise when people share stressful, chronic and violent relationships with someone else. Burnout doesn't appear per se in any international classification of mental disorders: clinicians often use the diagnosis of adjustment disorder.Our aim is to assess the impact of victimization on burnout among guards in French prisons. Prison guards were chosen for two major reasons. First, the custodial role of correctional officers is typically described as a stressful occupation, sensitive to burnout. Second, prison is generally considered "dangerous". Indeed, victimizations and aggressions frequently occur. Consequently, we hypothesize that burnout levels will be high for prison guards. We also hypothesize that the intensity of the victimizations (verbal, physical or armed aggression) will heighten burnout levels.Two hundred and thirty-five prison guards were involved. Among these 235 correctional guards, there were 46 women and 188 men, ranging from 22 to 56 years old. Victimizations were very common: more than 87 % had experienced an aggression, whether verbally, physically or armed. They were asked to fill out the French form of the Maslach burnout Inventory (MBI). The MBI is a 22-item self-report measurement that assesses the three dimensions of burnout: emotional exhaustion, depersonalization and personal accomplishment. Items are rated on a 7-point scale ranging from 0 ("never") to 6 ("every day"). We have statistically created a new global level of burnout with the three dimensions. It is called "burnout level". We have assessed two sets of independent variables (VI): demographic VI (age, sex, tenure, level of studies) and correctional VI (penal status of prison, victimizations). Regarding our dependent variables, we have four levels which are (1) global burnout (GB), (2) emotional exhaustion (EE), (3) depersonalization (D), and (4) personal accomplishment (PA). For the purpose of our study, we carried out variance analyses (Anova) in order to compare the averages of our groups of subjects. Further to Anova, we chose the Bonferroni/Dunn post hoc test.The results indicate that demographic variables such as age, sex or level of studies have no significant effect on GB, EE, D and PA levels. Tenure has a significant effect on GB and D levels. Concerning correctional variables, results show that the penal status of prison has a significant effect on GB and EE. Prison guards working with inmates incarcerated for more than 5years report higher GB and EE than their counterparts working with inmates not already convicted. Victimizations have a significant effect on GB, EE, D and PA levels. Prison guards with physical or armed aggressions report higher global GB, EE, D and PA levels than prison guards without aggressions. Furthermore, prison guards with physical or armed aggressions report higher global GB and D levels than prison guards with verbal aggressions. Two major points are highlighted by our study. First, characteristics of prison and inmates are related to burnout among prison guards. Second, victimizations lead to burnout.

Plast Reconstr Surg. 2012 Jan; 129(1): 1-7
Kinsella C, Landfair A, Rottgers SA, Cray JJ, Weidman C, Deleyiannis FW, Grunwaldt L, Losee JE

For a population of adolescents, gynecomastia is a persistent problem. Occurring during a critical period in the formation of self-image and gender identity, this gender-incongruent process may disrupt normal psychological development. This study was designed to identify the prevalence of psychological disturbances in young male patients presenting with symptomatic gynecomastia to determine whether psychological examination should be included as a routine portion of this patient population's treatment.From 2002 to 2009, patients aged between 10 and 18 presenting to our institution for idiopathic adolescent gynecomastia were recruited to participate in a retrospective cohort study. All patients underwent psychological interviews conducted by the same clinical psychologist (C.W.) and were examined using the following metrics: the Children's Depression Inventory, the Multidimensional Anxiety Scale for Children, and the Child Behavior Checklist. All patient scores were compared against population norms.Twenty-four patients between the ages of 12 and 18 were observed. Compared with the general population, measures of anxiety, depression, and social phobia were significantly elevated in patients with gynecomastia; 100 percent of patients with gynecomastia received a Diagnostic and Statistical Manual of Mental Disorders-IV diagnosis.Idiopathic adolescent gynecomastia is a psychological threat to normal self-esteem and sexual identity. Patients presenting with this condition likely suffer an adjustment disorder subsequent to this anatomic stressor. Surgeons should strongly consider referring their patients with gynecomastia for psychological evaluation and treatment as an adjunct to successful surgical management of this condition. Future studies examining the postoperative effects on psychological health both with and without psychological treatment will be of great interest to treating physicians. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Risk, IV.

Seishin Shinkeigaku Zasshi. 2011; 113(6): 537-53
Okazaki T, Kato S

The purpose of this study was to describe the clinical characteristics of patients with workplace-associated mood disorder.We conducted a clinical survey involving 84 clinical cases (regular employees suffering from mood disorder) who were hospitalized in the Psychiatry Department of Jichi Medical University Hospital, for a period over 8 years and 4 months between April 1st, 2000 and July 31st, 2008.The size of the workplace-associated group as a percentage of those patients in whom the onset of the symptom was occasioned by an evident issue at their workplace was 65%. This rate accounted for 74% of the total patients if clinical cases in which an evident issue at the workplace served as a significant trigger for the symptom were added to these patients in the case of an initial episode in the "non-workplace associated group". In the workplace-associated group, cases in which the premorbid character was a "depression-related personality" comprised only 42%, and was noticeably characterized by a perfection-oriented habit, enthusiastic character, conformity with other people, etc. Furthermore, the percentage of patients who were diagnosed with a "depression-related personality" comprised only 59% of the "overworked group", in which a heavy workload was evident in the workplace-associated group. In the workplace-associated group, the percentage of cases involving managerial workers was significantly high; their rate as initial cases was significantly high, as well the proportion of favorable outcomes. In the workplace-associated group, the percentage of patients who showed unambiguous depression at the initial stage was significantly low. Likewise, a similar result was obtained in the overworked group.Workplace-associated mood disorder today tends to have a stress-related aspect, or aspect of adjustment disorder. There was a period in many cases during which the main symptoms were insomnia, headache, panic attack, etc., prior to the onset of unambiguous depression in the workplace-associated mood disorder group. In depression associated with workplace-associated mood disorder, there are two pathological stages. The stage of adjustment disorder is the period in which such conditions are the main symptoms, and a serious or moderate stage of major depressive disorder is the period after full-scale depression develops in the wake of the former stage. What contributes to protection against depression are a proper diagnosis of depression whose pathological condition is at an early adjustment disorder stage and appropriate therapeutic measures.

Int J Gynecol Cancer. 2011 Aug; 21(6): 1143-9
Suzuki N, Ninomiya M, Maruta T, Hosonuma S, Yoshioka N, Ohara T, Nishigaya Y, Kobayashi Y, Kiguchi K, Ishizuka B

Diagnosis of cancer causes psychological distress. The present study investigated the safety and efficacy of fluvoxamine therapy in gynecologic cancer patients with either adjustment disorder or major depression after cancer was diagnosed.Screening with the Hospital Anxiety and Depression Scale (HADS) was conducted at least 2 weeks after notification of the diagnosis of cancer in 214 gynecologic cancer patients hospitalized between January 2007 and December 2008. The HADS cutoff score was set at 11 points or greater. Informed consent to the study was obtained from 10 patients, and fluvoxamine was administered for 8 weeks. As primary end points, the safety and efficacy of fluvoxamine were evaluated using the HADS and the SF-36. As a secondary end point, the Clinical Global Impression was determined.The total HADS score, the anxiety score, and the depression score were significantly reduced after 6, 4, and 6 weeks of treatment, respectively. The SF-36 revealed significant improvement in vitality, mental health, and role (emotional) after 8 weeks of treatment. In the 5 patients with adjustment disorder, only the HADS anxiety score was significantly reduced after 4 weeks. In the 5 patients with major depression, the total HADS score, the anxiety score, and the depression score were significantly reduced after 6, 8, and 6 weeks, respectively. According to the SF-36, the adjustment-disorder groups showed significant improvement in mental health after 8 weeks of treatment, whereas the major-depression group showed significant improvement in vitality and role (emotional) after 8 weeks. No adverse events occurred in any subject. Assessment of the Clinical Global Impression suggested that fluvoxamine improved psychological distress in all 10 subjects.The present findings suggest that fluvoxamine is useful for alleviating psychological distress, including adjustment disorder and major depression, in gynecologic cancer patients. Management of psychological distress after diagnosis of cancer is important.

Gen Hosp Psychiatry. 2011 May-Jun; 33(3): 246-52
Kim SJ, Rha SY, Song SK, Namkoong K, Chung HC, Yoon SH, Kim GM, Kim KR

This study primarily aimed to investigate the prevalence and associated factors of psychological distress among Korean cancer patients. Its secondary objective was to classify mental illnesses among cancer patients with significant psychological distress.We administered the Modified Distress Thermometer (MDT), Hospital Anxiety and Depression Scale (HADS), and Center for Epidemiologic Studies-Depression Scale (CES-D) to consecutive, newly diagnosed cancer patients and conducted subsequent psychiatric interviews. A multiple logistic regression produced a discriminate profile of individuals with psychological distress.Among 295 participants, 85 (28.8%) were identified as patients with psychological distress. Female gender [odds ratio (OR)=1.97], low educational level (OR=2.25) and low performance status (OR=4.10) were significantly associated with this condition. Among the 38 patients with psychological distress who received psychiatric assessment, the most common mental illness was adjustment disorder (n=23, 69.7%).The results of this study showed that approximately one-third of the cancer patients suffered from psychological distress. We recommend that physicians focus on the psychological status of female cancer patients with low levels of education and poor performance status.

Chang Gung Med J. 2011 Jan-Feb; 34(1): 57-64
Lin HL, Chou HH, Liu CY, Hsu SC, Hsiao MC, Juang YY

BaCKGROUND: The purpose of this study was to investigate the consultation psychiatry service to the Obstetrics and Gynecology Department in a general hospital, focusing on referral patterns and consultation recommendations.A retrospective review of the medical charts and consultation records of obstetric and gynecological patients referred for psychiatric consultation from Dec. 2003 to Nov. 2009 was performed.One hundred and eleven patients were referred during the 6-year period, a psychiatric referral rate of 0.11% among 99,098 obstetric and gynecologic admissions. Obstetric and gynecologic consultations comprised 0.64% of all psychiatric consultations. The most common reasons for referral were depression (52.25%), past psychiatric history (31.53%), insomnia (29.73%) and confusion (24.32%). The most common DSM-IV psychiatric diagnoses were depressive disorder (37.84%), schizophrenia and other psychoses (20.72%), delirium (17.12%) and adjustment disorder (10.81%). The most frequent physical diagnoses of referred patients were neoplasms (72.97%), infectious diseases (42.34%) and complications of pregnancy and puerperium (17.12%). Recommendations included pharmacological intervention (89.19%) and psychological management (72.07%).The psychiatric referral rate of obstetric and gynecological inpatients was relatively low compared with that of other departments. More collaboration and liaison between gynecologists and consultation psychiatrists may provide better care for obstetric and gynecological inpatients.

Indian J Med Res. 2010 Oct; 132: 428-37
Khairkar P, Malhotra S, Marwaha R

It is difficult for a single investigator to study the psychosocial changes that occur over the life span of an individual affected with a chronic illness like β-thalassaemia major. Therefore, a developmental epidemiological perspective is required to understand the chain of events and problems of psychological nature. We aimed to construct the picture of developmental epidemiology for psychosocial aspects in families of β-thalassaemia major patients attending a tertiary care hospital in north India.The accelerated longitudinal design was used. The sample consisted of 100 children with β-thalassaemia and their 150 parents, both groups were subdivided further so that each group represented the continuum of longitudinal course. The sampling was done for a period of 16 months from January 2004 to April 2005.Overall 54 per cent of children had significant psychopathology. Within the parents groups, 10 per cent had adjustment disorder, 33.3 per cent depressive disorder, and 10 per cent had anxiety disorder and 11 per cent somatoform disorder; 95 per cent of the parents of newly diagnosed children expressed feeling of dazed and shock, fear of death, hopelessness, separation anxiety and problems with their memory and concentration. There was significant difference only in the domain of psychological health in all the three groups of parents with respect to the quality of life. Among children, quality of life improved with their progression of illness. Growing up with β-thalassaemic family was analyzed.The developmental epidemiological perspective was constructed in β -thalassaemic children and their family using an accelerated longitudinal design. Such a design can test the hypothesized aetiological or developmental function of a targeted risk factor within a developmental path and may be used in studying the psychological impact of even other chronic illnesses over the life span of an individual for conceptual and holistic understanding.

Depress Anxiety. 2010 Oct; 27(10): 977-81
Zimmerman M, Galione JN, Chelminski I, Young D, Dalrymple K, Witt CF

In previous reports from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we developed a briefer definition of major depressive disorder (MDD), and found high levels of agreement between the simplified and DSM-IV definitions of MDD. The goal of the present study was to examine the validity of the simpler definition of MDD. We hypothesized that compared to patients with adjustment disorder, patients with MDD would be more severely depressed, have poorer psychosocial functioning, have greater suicidal ideation at the time of the intake evaluation, and have an increased morbid risk for depression in their first-degree family members.We compared 1,486 patients who met the symptom criteria for current MDD according to either DSM-IV or the simpler definition to 145 patients with a current diagnosis of adjustment disorder with depressed mood or depressed and anxious mood.The patients with MDD were more severely depressed, more likely to have missed time from work due to psychiatric reasons, reported higher levels of suicidal ideation, and had a significantly higher morbid risk for depression in their first-degree family members. Both definitions of MDD were valid.The simpler definition of MDD was as valid as the DSM-IV definition. This new definition offers two advantages over the DSM-IV definition-it is briefer and therefore more likely to be recalled and applied in clinical practice, and it is free of somatic symptoms thereby making it easier to apply with medically ill patients.

Palliat Support Care. 2010 Dec; 8(4): 455-60
Gil F, Costa G, Pérez FJ

The purpose of this study was to assess the psychological care needs of cancer patients throughout the healthcare process: after diagnosis, after medical treatment (surgery, chemotherapy, radiotherapy) and during follow-up.A total of 703 ambulatory cancer patients were assessed in this study. The inclusion period was from April 1, 2005 to April 30, 2007. The first psychological scales used were the 14-item Hospital Anxiety and Depression Scales (HADS), which has two sub-scales for anxiety (7 items) and for depression (7 items). All patients with a score ≥ 14 were assessed through the Structured Clinical Interview for Psychiatric Disorder (SCID-I) of the DSM-IV. All data were compared with sociodemographic and medical characteristics.Of the 703 cancer patients in the study, 349 were men and 354 women, with a mean age of 53 years. The median time between the cancer diagnosis and our clinical interview was 6 months (range, 12 days to 190 months). Overall, the screening tools indicated that one in four patients needed psychological care. The most common psychiatric diagnosis was adjustment disorder (129 cases), whereas 10 patients were diagnosed with major depression. Using a HADS cut-off score of > 7 for anxiety and depression, 28% and 17% of patients, respectively, were classified as "possible clinical cases." Risk factors for distress included age < 65 years, asthenia, constipation, and a low performance status. However, chemotherapy treatment was found to be a protector against distress in cancer patients.Chemotherapy treatment is interpreted by the patients as a protector against cancer, thereby reducing distress levels.

Palliat Support Care. 2010 Sep; 8(3): 291-5
Asai M, Akizuki N, Akechi T, Nakano T, Shimizu K, Umezawa S, Ogawa A, Matsui Y, Uchitomi Y

The purpose of this study is to identify psychiatric disorders and stress factors experienced by staff members in cancer hospitals who were referred to psychiatric consultation service, and to investigate the association between psychiatric disorders and stress factors.A retrospective descriptive study using clinical practice data on staff members referred to psychiatric consultation service, obtained for 8 years, was conducted at two National Cancer Center Hospitals in Japan. Psychiatric disorders were identified according to DSM-IV. Stress factors were extracted from a chief complaint at the initial visit in medical charts, using a coding approach, and grouped as job stress or personal stress. The frequencies of the stress factors were determined by two coders who were unaware of the categorized procedure. Fisher's exact test was used to determine the association between psychiatric disorders and stress factors.Of 8077 psychiatric consultations, 65 (1%) staff members were referred. The most common psychiatric disorder was adjustment disorder (n = 26, 40%), followed by major depression (n = 17, 26%). Eight stress factors were identified from 76 meaning units and were grouped into five job stresses and three personal stresses. Of the five job stresses, four were most frequently experienced in adjustment disorders, and "failure to adapt to job environmental change" was significantly associated (p = 0.014). Two of the three personal stresses were most frequently experienced in psychiatric disorders other than major depressive disorder and adjustment disorders, and "suffering from mental disease" was significantly associated (p = 0.001).We found that very few staff members were provided with psychiatric consultation service. A comprehensive support system for job stress might be needed to prevent adjustment disorders, as those are suggested to be the most common psychiatric disorders among staff members in cancer hospitals.

J Clin Psychol. 2010 Dec; 66(12): 1232-41
Kramer U, Despland JN, Michel L, Drapeau M, de Roten Y

Short-term dynamic psychotherapy (STDP) has rarely been investigated with regard to its underlying mechanisms of change, even if psychoanalytic theory informs us about several potential putative mechanisms of change in patients. Change in overall defensive functioning is one. In this study, we explored the role of overall defensive functioning, by comparing it on the process level with the neighbouring concept of overall coping functioning. A total of N=32 patients, mainly presenting adjustment disorder, were included in the study. The patients underwent STDP up to 40 sessions; three sessions per psychotherapy were transcribed and analyzed by using two observer-rating scales: Defense Mechanism Rating Scales (Perry, 1990) and Coping Action Patterns (Perry, Drapeau, Dunkley, & Blake, 2005). Hierarchical linear modeling was applied to model the change over the course of therapy and relate it to outcome. Results suggest that STDP has an effect on the target variable of overall defensive functioning, which was absent for overall coping functioning. Links with outcome confirm the importance of the effect. These results are discussed from methodological and clinical viewpoints.

Psychiatry Clin Neurosci. 2010 Oct; 64(5): 514-9
Hoshiai M, Matsumoto Y, Sato T, Ohnishi M, Okabe N, Kishimoto Y, Terada S, Kuroda S

Psychiatric comorbidity and mental instability seem to be important unfavorable prognostic factors for long-term psychosocial adjustment in gender identity disorder (GID). However, psychiatric comorbidity in patients with GID has rarely been assessed. In this study, we investigated the psychiatric comorbidity and life events of patients with GID in Japan.A total of 603 consecutive patients were evaluated independently by at least two senior psychiatrists at the GID clinic using clinical information and results of examinations.Using DSM-IV criteria, 579 patients (96.0%) were diagnosed with GID. Among the GID patients, 349 (60.3%) were the female-to-male (FTM) type, and 230 (39.7%) were the male-to-female (MTF) type. Current psychiatric comorbidity was 19.1% (44/230) among MTF patients and 12.0% (42/349) among FTM patients. The lifetime positive history of suicidal ideation and self mutilation was 76.1% and 31.7% among MTF patients, and 71.9% and 32.7% among FTM patients. Among current psychiatric diagnoses, adjustment disorder (6.7%, 38/579) and anxiety disorder (3.6%, 21/579) were relatively frequent. Mood disorder was the third most frequent (1.4%, 8/579).Comparison with previous reports on the psychiatric comorbidity among GID patients revealed that the majority of GID patients had no psychiatric comorbidity. GID is a diagnostic entity in its own right, not necessarily associated with severe comorbid psychological findings.

Pol Merkur Lekarski. 2010 May; 28(167): 387-94
Golinowska D, Florkowski A, Juszczak D

In everyday life there are many obstacles that prevent the creation of many important needs. They require a skillful adaptation and may be the cause of stress. Stress of considerable intensity can receive the joy of life and even lead to a temporary mental disorder.To present the main causes and frequency of disturbance determined according to the ICD-10 as a reaction to severe stress and adaptive disorders among patients in psychiatric and psychological counseling and to establish whether the causes of the disorder are dependent on factors such as age, sex or level of education.Analysis was done on a separate group of 754 persons from among patients seeking psychiatric counseling--Psychological Outpatient Mental Health in the 10th Military Clinical Hospital in Bydgoszcz, in 2005. This group were qualified person, who according to the criteria of ICD-10 were found to respond to severe stress and abnormal adaptation. In addition, during the interview determines whether they are long-term somatic illness. They have not been included in the study group. Also excluded persons who were found difficulties in operation prior to the stressful situation and those that have already been treated with psychiatric or psychological benefit from therapy. The collected data were statistically analyzed.The analysis identifies three main causes of adjustment disorder. The first group of reasons is related to difficulties in the workplace, which represents 59% of all patients with the disorder described. In this group identifies three major stressful situations: bullying, job loss, unemployment. Another reason relates to family problems. They are the reason for the emergence of abnormalities in 23% of patients analyzed group. Among these difficulties was divided into four main types of situation causing disorder presented. There are family conflicts, death of spouse, parent death, divorce. The last group of factors are stressful events or incidents which contributed to the disorder in 16% of patients in the group described. In this category were observed four major groups analyzed the causes of the disorder. This is due to the difficulty of adapting to the compulsory military service, traffic accidents, participation in missions abroad, the situation of rape. Making a detailed analysis by category of difficulty is shown that in this group of subjects, age, educational level and gender are significant factors in influencing the formation of these disorders.The main causes of this disorder are closely related to everyday human activity and especially on employment. Harassment and bad relationships in the workplace, job loss, unemployment are the factors most often causing disorder in question. The analysis made also clear that the situations of family conflict is also a frequent cause of severe reactions to stress and adjustment disorder. Not without significance is the impact of factors such as level of education, age and sex. Analysis by specific categories of causes of reactions to stress and adjustment disorder indicates that these factors significantly correlate with the formation of these disorders in the group of people.

Psychiatr Hung. 2010; 25(1): 62-73
Kovács I, Vargha A, Ali I, Bódizs R

In adjustment disorder (ICD: F43.2) the danger of suicide is greater, and specific dream quality may be characteristic of this state, too. Moreover adjustment disorder, suicide and quality of dream can be related to different types of trauma the patient had during life. Considering these aspects we examined with questionnaires 41 patients with adjustment disorder and 41 control persons with no diagnosed psychiatric disorder. Our results suggest that in adjustment disorder the danger of suicide is significant, nightmare and dreams with negative affect often occur. If these patients went through physical agression, it proved to be more serious than with members of the control panel. Besides, suicide attempt, dream quality, recurring dreams and different traumas also are in relation with each other. From the point of view of clinical practice the result is very important that the risk of suicide and the occurance of nightmares--in accordance with results of other researches--go together strongly. Our study's conclusion is--agreeing with hypothesis of Tanansken et al. 2001--this correlation can occur with the trauma the patient went through.

J Pain Palliat Care Pharmacother. 2010 Mar; 24(1): 39-47
Kirsh KL

Pain patients often have comorbid psychiatric disorders that can complicate their management. Failure to recognize and address psychological comorbidities often limits pain treatment success. This paper describes some of the more commonly seen psychiatric comorbidities in pain patients, briefly discusses how the diagnoses are made, and provides some initial treatment guidelines. The multiaxial diagnostic system of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is described. Three common psychiatric issues seen in pain patients: anxiety, depression, and adjustment disorder, are discussed. A brief history of the DSM is also discussed.

Appl Neuropsychol. 2010 Jan; 17(1): 18-26
Hofer H, Holtforth MG, Frischknecht E, Znoj HJ

This preliminary study investigates the effectiveness of a treatment program in which neuropsychological interventions are supplemented by psychotherapeutic interventions to foster the adjustment process. Eleven patients who had an adjustment disorder following an acquired brain injury were recruited for the treatment group. Measures were assessed at the beginning and end using the Structured Clinical Interview, the Beck Depression Inventory, the Goal Attainment Scaling procedure, and the Trier Coping Scales. Significant pre- to post-assessment differences emerged in terms of depression and coping styles. The findings suggest that patients benefit from an integrated treatment program to foster adjustment. These findings encourage further investigation of this integrative treatment in larger samples through randomized controlled trials with adequate control treatments.

Psychother Psychosom. 2010; 79(2): 73-86
Schulte IE, Petermann F, Noeker M

To review the extant literature on functional abdominal pain in childhood through the lens of the developmental psychopathology perspective and to systematize research results by means of a two-stage pathway model in which the emergence of functional abdominal pain and its potential transition into a somatoform adjustment disorder is outlined.Using electronic searches for published studies and previous reviews about functional abdominal pain.An association of functional abdominal pain with internalizing symptoms, poor well-being of family members, major life events and daily stressors is found. The impact of stress on pain seems to be moderated by the children's coping style and their perceived competence and self-efficacy to manage the pain experience. There is evidence for the influence of modeling and operant mechanisms on pain experiences. A new term, 'somatoform adjustment disorder', and its relation to functional abdominal pain is discussed.It seems that those children with functional abdominal pain who cannot adapt to the pain indeed run the risk of developing a somatoform adjustment disorder.