Tasman Allan - Clinical guide to the diagnosis and treatment of mental disorders

This edition first published 2010

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Library of Congress Cataloguing-in-Publication Data

Clinical guide to the diagnosis and treatment of mental disorders/[edited by] Michael B. First, Allan Tasman. 2nd ed.

p.; cm.

Includes bibliographical references and index.

ISBN 978-0-470-74520-5 (pbk)

1. Mental illness. 2. Psychiatry. I. First, Michael B., 1956- II. Tasman, Allan, 1947- [DNLM: 1. Mental Disordersdiagnosis. 2. Mental Disorderstherapy. WM 140 C6405 2009]

RC469.C555 2009

616.89-dc22

2009022473

ISBN: 9780470745205

To Leslee, my bashert

Michael

To my family with love and thanks for your support and inspiration

Allan

Preface

The publication of DSM-III in 1980 revolutionized psychiatry. Among its many accomplishments (e.g., increased diagnostic reliability), it provided a common language for naming, describing, and identifying the complete range of mental disorders seen in clinical practice, as well as an organizational plan embodied in the diagnostic groupings contained in the DSM-III classification (i.e., grouping together Organic Mental Disorders, Psychotic Disorders, Mood Disorder, Anxiety Disorders, etc.). Its appeal is several-fold: 1) it is authoritative: the information contained in the DSM is authored by the leading experts in psychiatry and psychology; 2) it is comprehensive: all disorders seen by mental health professionals practice are covered in the DSM; 3) it is clinically useful: material included in the DSM is intended to be of practical use in making psychiatric diagnoses; 4) it is educational: material is included also for the purpose of educating the reader about mental disorders, such as how they present, sex ratio, prevalence rates; and 5) it is relatively concise: all the information in contained in a single volume, of around 900 pages in length.

Although the DSM is indispensable in the evaluation and treatment of patients with mental disorders, arriving at a psychiatric diagnosis is only the first step in the process. Once the clinician determines the diagnosis, he or she must then choose from among a range of available treatment options. Certainly the biggest limitation of the DSM-IV-TR is its omission of any information about the management and treatment of psychiatric patients. DSM-IV-TR users must turn elsewhere for information about which treatment to chooseeither to books written specifically about the treatment of a disorder or books covering psychiatric treatment in general. In editing this book, Clinical Guide to the Diagnosis and Treatment of Mental Disorders, we have adapted material from the Disorders section of the two-volume textbook Psychiatry, 3rd Edition (edited by Tasman, Kay, Lieberman, First, and Maj) which was published in May 2008. Like its original source, it covers all of the disorders included the DSM-IV-TR but the content has been edited to meet the clinical needs of the readership. Rather than producing a reference book about mental disorders, we see this book as an accessible and brief clinical guide to diagnosis and treatment. As such, the Etiology sections from the original book have been eliminated and the Diagnosis and Treatment sections have been condensed with the goal of retaining only information which is clinically relevant. In addition, details of studies establishing the epidemiology of the disorders or the efficacy of treatments have been removed, as have all of the references. Readers interested in this information should refer to the corresponding chapters in the original book.

The organization of the chapters in this book closely parallels the layout of disorders in the DSM-IV-TR. The amount of space allocated to each disorder in this book varies according to clinical importance. Thus, unlike DSM-IV-TR, in which all of the anxiety disorders are covered in the same chapter, the book splits up the major anxiety disorders among several different chapters. Within each chapter, this book for the most part follows a consistent structure. The Diagnosis section for each disorder begins with introductory material describing the features of the disorder and includes information about assessment issues, comorbid conditions, course (which includes age at onset, prognosis and outcome), and differential diagnosis. The Treatment sections summarize the available treatments for the disorders, and often are broken down into Somatic Treatments and Psychosocial Treatments for ease of reference.