Increasingly, electroconvulsive therapy (ECT) is recognized as a proven, effective, and even life-saving intervention in certain mood and thought disorders when other treatments have had little or no effect. Despite the proven efficacy and safety of this standard treatment in psychiatry, its availability is variable. Part of this disparity in access is related to misunderstanding by laypersons regarding the treatment and its potential adverse effects. Adequate education and training of psychiatrists and their support staff are essential to ensuring patients' access to this vital treatment tool. The authors of Clinical Manual of Electroconvulsive Therapy offer this expansive yet reader-friendly volume to help psychiatrists successfully incorporate ECT into their clinical practices. It is also a valuable resource for medical students and psychiatric residents, as well as experienced clinicians and researchers.

The book updates the 1985 original and 1998 second edition of Electroconvulsive Therapy: A Programmed Text, and provides readers with a scheduled approach to understanding the fundamental concepts of ECT while offering practical guidance for establishing and maintaining an ECT program. Topics include the history of ECT, indications for use, patient referral and evaluation, the basics of ECT, clinical applications, anesthetics and other medications, seizure monitoring and management, ictal motor and cardiovascular response, adverse effects, and maintenance ECT. Included are detailed descriptions of recent advances including ultra-brief pulse ECT, oxygenation, muscle relaxation, and other modifications that have made this very effective treatment much safer and more acceptable to patients. Currently, it is estimated that more than 100,000 people receive ECT treatments each year in the U.S. Indications for use of ECT are for mood disorders such as major depressive disorder and mania, and thought disorders including schizophrenia and schizoaffective disorder. Indications for use in other psychiatric disorders and general medical disorders such as Parkinson's disease, which appears to respond especially well to ECT, are reviewed as well. This highly-readable manual is a must-have for the library of any clinician interested in or currently practicing ECT: - Provides background information on the origins of psychiatric treatments preceding ECT, including efforts using hydrotherapy and insulin comas - Includes an algorithm for the management of ECT seizure adequacy- Discusses contraindications as well as the potential adverse effects of ECT, including cognitive changes and cardiovascular complications- Provides specific information about ECT device manufacturers, reprintable patient information sheets, and a written informed consent form

This clinical manual comprehensively explores and explains the available knowledge regarding ECT -- based on extensive research over the past 70 years -- in order to help potential ECT clinicians make informed choices about the development and management of their ECT program.

This issue of the Psychiatric Clinics edited by Dr. John Beyer is dedicated to the topic of Bipolar Depression, from the genetics of the disorder, to the therapeutic options, to treatment in special populations. Articles in this issue include, but are not limited to: Differences in Bipolar and Unipolar Depression, Suicide and Bipolar Disorder, Social Relationships, Support, and Life Events in Bipolar Disorder, Treatment of Bipolar Depression in Pregnancy and the Post-Partum Period, Psychotherapy for Bipolar Depression, Cognition, Dementia, and Bipolar Depression, and Genetics of Bipolar Disorder.

How are the decisions made which produce the phenomenal arsenals of nuclear weapons in the world today? Who makes them? To whom are they answerable? What role does Parliament play? These questions have until now been shrouded in mystery. But until the answers to them are widely and openly known, those who are concerned about the build-up of nuclear arsenals cannot know how the process works, and to whom they should address themselves. That is why this book is a breakthrough. It explains, for the first time, how nuclear weapons decisions are made in each of the nuclear nations. The Oxford Research Group has brought together, entirely from non-classified sources, a mass of information to throw light on a hitherto invisible and unaccountable process.