Psychotic depression is a dangerous and debilitating illness that, tragically, often has fatal consequences. Studies indicate that between 16% and 54% of all depressed adults suffer from a psychosis. While this condition is completely treatable, thousands of cases remain misdiagnosed or overlooked because of a lack of interest and awareness among clinicians, the pharmaceutical industry, and the National Institute of Mental Health. As the first comprehensive guide to cover assessment, treatment, and management of patients with psychotic depression, Clinical Manual for Diagnosis and Treatment of Psychotic Depression , by Dr. Anthony Rothschild, is an invaluable resource for both clinicians and students. Drawing on his own experience in clinical care and careful consideration of the existing medical literature, Dr. Rothschild systematically describes the history, epidemiology, and possible biological causes of psychotic depression and outlines various approaches for diagnosis and assessment. He then offers a practical guide for individualized treatment strategies for psychotic depression, such as electroconvulsive therapy, psychotherapy, and recent breakthroughs in pharmacologic treatment. In addition, Dr. Rothschild identifies issues of care and management for specific patient populations including seniors, adolescents, women in the postpartum, and patients at risk for suicide in a variety of treatment settings. Each chapter includes the following features to emphasize the data and further enhance learning: Detailed tables and charts Key clinical points that summarize the main ideas of the chapter A recommended reading list of books and periodicals that address similar topics Analysis and review of relevant clinical studies Dr. Rothschild has spent more than 25 years treating patients with psychotic depression and studying the challenges inherent in diagnosing and managing this serious disorder. His findings are compiled in this easy-to-read, evidence-based manual that can benefit clinicians at all levels of training, including psychiatrists, psychologists, neurologists, internists, family and general practitioners, nurses, social workers, and clinical students. While much remains to be discussed regarding the nature of psychotic depression as a distinct illness, the existing knowledge about this condition is too significant to be ignored. The only comprehensive manual of its kind, Clinical Manual for Diagnosis and Treatment of Psychotic Depression is an important reference for any psychiatric setting.
Author(s): Anthony J. Rothschild, Anthony J. Rothschild
Edition: 1
Publisher: American Psychiatric Publishing, Inc.
Year: 2008
Language: English
Pages: 207
Contents......Page 8
Preface......Page 16
Acknowledgments......Page 20
1 Introduction......Page 22
References......Page 32
Recommended Reading......Page 34
Prevalence of Psychotic Depression in the Community......Page 36
Prevalence of Psychotic Depression in Patients With Major Depression......Page 37
Prevalence of Psychotic Depression in Patients With Unipolar Versus Bipolar Disorder......Page 38
Key Clinical Points......Page 42
References......Page 43
Recommended Reading......Page 45
Family Studies......Page 46
Genetics......Page 48
References......Page 51
Recommended Reading......Page 54
4 Biology......Page 56
Dysregulation of the Hypothalamic-Pituitary-Adrenal Axis......Page 57
Studies of the Dopaminergic System......Page 61
Growth Hormone Response to Growth Hormone–Releasing Hormone......Page 63
Studies of the Serotonergic System......Page 65
Neuroimaging Studies......Page 66
Electroencephalographic Studies......Page 68
Key Clinical Points......Page 69
References......Page 70
Recommended Reading......Page 76
Clinical Presentation......Page 78
Assessment......Page 79
Differential Diagnosis and Common Misdiagnoses......Page 81
Relationship to Bipolar Disorder......Page 87
Late-Life Psychotic Depression......Page 88
Adolescent Psychotic Depression......Page 89
Psychotic Depression in Minority Populations......Page 90
Key Clinical Points......Page 91
References......Page 92
Recommended Reading......Page 96
6 Treatment......Page 98
Considering Electroconvulsive Therapy Versus Medications......Page 99
The Electroconvulsive Therapy Procedure......Page 102
Medication Treatment of Psychotic Depression......Page 105
Continuation and Maintenance Treatment......Page 120
Psychotherapy for Patients With Psychotic Depression......Page 125
Family Support and Involvement......Page 126
Return to Work and Reintegration Into the Community......Page 127
Key Clinical Points......Page 128
References......Page 130
Recommended Reading......Page 135
Short-Term Course......Page 136
Long-Term Course......Page 137
Mortality Rates......Page 139
Cognitive Disturbances......Page 140
References......Page 143
Recommended Reading......Page 146
Hospitalization......Page 148
Partial Hospitalization and Intensive Day Treatment......Page 152
Outpatient Treatment......Page 153
Key Clinical Points......Page 154
Recommended Reading......Page 155
9 Nursing Care......Page 156
Priority Nursing Interventions......Page 157
Nursing Management of Medical Illnesses and Somatic Complaints......Page 160
Nursing Assessment of Efficacy of Medications and Side Effects......Page 163
Medication Adherence and Informed Consent for ECT......Page 166
Nursing Care for Patients Undergoing ECT......Page 169
Special Considerations for Postpartum Patients With Psychotic Depression......Page 172
Key Clinical Points......Page 174
References......Page 175
Recommended Reading......Page 177
Postpartum Psychotic Depression......Page 178
Suicide Risk in Patients With Psychotic Depression......Page 184
Patients With Treatment-Refractory Psychotic Depression......Page 189
Children and Adolescents......Page 191
Key Clinical Points......Page 192
References......Page 193
Recommended Reading......Page 196
A......Page 198
C......Page 199
E......Page 200
G......Page 201
M......Page 202
N......Page 203
O......Page 204
P......Page 205
S......Page 207
Y......Page 208
