Download ABC of mental health by Teifion Davies; T K J Craig PDF

By Teifion Davies; T K J Craig

Psychological healthiness prone have replaced thoroughly within the united kingdom, and the hot variation of ABC of psychological Health has been completely up to date and revised to mirror this.

Providing transparent functional suggestion on the best way to know, diagnose and deal with psychological problems effectively and effectively, with sections on making a choice on medicinal drugs and mental remedies, and bettering compliance, ABC of psychological Health additionally includes info at the significant different types of psychological wellbeing and fitness problems, the psychological well-being wishes of weak teams (such because the aged, youngsters, homeless and ethnic minorities) and the mental treatments.

Fully modern with contemporary psychological overall healthiness laws, this new version is as finished because it is valuable. through protecting the psychological well-being wishes of designated teams, this ABC equips GPs, medical institution medical professionals, nurses, counsellors and social staff with the entire details they want for the daily administration of sufferers with psychological illnesses

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Generalised anxiety disorder Generalised anxiety disorder (GAD) affects 4% of the general population, with a slight female preponderance, but accounts for almost 30% of ‘psychiatric’ consultations in general practice. indd 29 Disorder Focus of attention Perceived threat Panic Autonomic symptoms Impending internal disaster Social phobia Internal impression of self as social object Negative social evaluation Obsessive– Intrusive thoughts compulsive disorder Responsibility for harm to self or others Post-traumatic stress disorder Trauma or its consequences Serious continuing threat to self or the world Generalised anxiety disorder Wide variety of situations and worry itself Danger to self or others First line Cognitive behavioural therapy (CBT) Self-help CBT Second line (for cases with major interpersonal difficulties) Counselling Psychodynamic psychotherapy Treatment-resistant cases Switch to or combine with pharmacotherapy First line CBT Self-help CBT Treatment-resistant cases Switch to or combine with pharmacotherapy First line CBT Treatment-resistant cases Switch to or combine with pharmacotherapy First line CBT (in vivo exposure) First line CBT Eye movement desensitisation reprocessing (EMDR) Second line Psychodynamic psychotherapy (if not suitable for CBT and evidence of early childhood trauma) Treatment-resistant cases Add or switch to pharmacotherapy First line CBT including exposure with response prevention Treatment-resistant cases CBT plus medication Inpatient CBT with a worse prognosis in women.

If the patient does not respond to two of these treatment options, then referral for specialist assessment and treatment is indicated. 3 Diagnosis of generalised anxiety disorder • • • • Persistent (>six months) ‘free floating’ anxiety or apprehension Disturbed sleep (early and middle insomnia, not restful) Muscle tension, tremor, restlessness Autonomic overactivity (sweating, tachycardia, epigastric discomfort) • May be secondary to or subsumed by other psychiatric disorders such as depression or schizophrenia (see Chapter 1) • Exclude physical disorders that may mimic anxiety: { Excessive caffeine use { Thyrotoxicosis, parathyroid disease { Hypoglycaemia { Drug or alcohol withdrawal { Phaeochromocytoma, carcinoid syndrome { Cardiac dysrhythmias, mitral valve disease Self-help and general management This may be the first line of treatment for less severe cases, and can be used in conjunction with medication.

To minimise the risk of discontinuation symptoms when stopping, SSRIs should be withdrawn gradually. Tricyclic antidepressants The side effects of tricyclic antidepressants make them an unnecessary choice as first-line treatment for anxiety disorders. indd 30 Buspirone Although dependence has not been seen with buspirone, many patients are dubious about its efficacy, perhaps because of its slow onset of action. For chronic anxiety, this is not such a drawback. A trial of up to eight weeks’ treatment with at least 30 mg buspirone daily, after gradually increasing the dose for the first two weeks, is often successful.

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