Patients with mental and substance use disorders have shown
higher rates of morbidity and mortality from medical illnesses than
the general population, and physicians are also increasingly aware
of adverse effects of psychiatric medications on metabolic and
cardiovascular health. In light of these problems, this book
addresses an important unmet need of patients with mental disorders
-- namely, the lack of integration of general medical care with
psychiatric care and the related problem of barriers to
collaboration and communication among health care providers.
Managing Metabolic Abnormalities in the Psychiatrically Ill is the
first book to provide a current review of the relationships among
psychiatric illnesses, metabolic abnormalities, and treatment,
focusing on how clinicians can tailor care to those
doubly-afflicted patients.
The book integrates research findings into practical clinical
guidelines that spell out what psychiatrists need to know when
their patients with mental illness suffer from -- or are at risk of
developing -- obesity, diabetes, cardiovascular disease, or the
metabolic syndrome. The contributors address those risks that need
to be considered in the overall context of treatment, background
risks of medical illnesses associated with specific psychiatric
disorders themselves, and the means of applying these data to
treatment recommendations, monitoring, and clinical practice. Among
the specific topics addressed are: - Potential effects of
psychotropics on appetite, body weight, and metabolic parameters in
obese patients, and the potential effects of anti-obesity agents on
psychotic, manic, and depressive syndromes- Increased risk of type
2 diabetes among individuals with psychotic and mood disorders due
to neurobiological changes and behavioral effects associated with
these disorders- Greater risk for cardiovascular disease among the
mentally ill, stressing the importance of mental health providers
understanding cardiovascular risk classification and modification
strategies- An association between dysregulation of glucose and
lipid metabolism and the related risk of type 2 diabetes during
treatment with any of the eight second-generation antipsychotics
currently available in the United States- Guidance in choice of
medications and appropriate monitoring strategies for
hyperlipidemia, along with recognition of which antipsychotics pose
the greatest risk and an understanding of the common dyslipidemia
patterns seen with their use
Chapters include key clinical concepts, quick-reference tables,
and extensive references, and a final chapter provides an
assessment tool for evaluating patients' metabolic risk. Together,
the chapters in this book constitute an authoritative clinical
guide that enables psychiatrists to better integrate the treatment
of patients' mental disorders with their metabolic conditions.
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