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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.
Edited by clinicians who were involved with transcranial magnetic stimulation (TMS) from the beginning, Transcranial Magnetic Stimulation: Clinical Applications for Psychiatric Practice offers everything the mental health practitioner needs to know about this innovative and well-established treatment. It is increasingly clear that different combinations of biological, neurobehavioral, and symptomatic factors contribute to the problem of "treatment resistance" in psychiatric disorders. Fortunately, a number of neuromodulation approaches, including TMS, are providing more options for clinicians to combat psychiatric problems. However, guidance about how to identify patients who are good candidates for TMS and how to comanage them during treatment is scarce because instruction on this modality has yet to be integrated into most psychiatry residencies. Thus, this text fills a great need, providing clinicians with an evidence-based foundation for the efficacy and safety of TMS. Despite the rapid growth of this innovative option, many practitioners are unclear about how best to utilize TMS. The book addresses these clinical concerns systematically and thoroughly: * Clinical vignettes illustrate how to identify appropriate patients for referral to a TMS clinician.* Discussions of treatment resistance, psychiatric and medical comorbidities, and preparation of the patient for TMS are included.* Because TMS is likely to be used concurrently with other treatments, the book explains how to best integrate this modality with psychotherapy, pharmacotherapy, and other forms of neuromodulation to improve outcomes.* In-depth coverage is provided on how to coordinate efforts between the primary treatment and TMS teams to assure the best outcomes during acute, continuation, and maintenance treatment.* Chapters provide a review of topic-specific literature, as well as clinical vignettes that highlight how to integrate TMS into patient care. * Key clinical points summarize the optimal clinical application of TMS for the general mental health provider.* The evolving nature of TMS research, such as the ongoing development of this and related technologies, as well as its expanding use as a potential treatment for other clinical neuropsychiatric conditions, is also addressed. Transcranial Magnetic Stimulation: Clinical Applications for Psychiatric Practice guides the general psychiatrist and mental health clinician on how to integrate this treatment modality into their practice by presenting an update on the current clinical role of TMS and a road map to its potential future.
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