KAPLAN & SADOCK’S POCKET HANDBOOK OF CLINICAL PSYCHIATRY Sixth Edition B J. S , M.D. ENJAMIN ADOCK Menas S. Gregory Professor of Psychiatry Department of Psychiatry New York University School of Medicine Attending Psychiatrist, Tisch Hospital Attending Psychiatrist, Bellevue Hospital Center New York, New York S A , M.D. AMOON HMAD Associate Professor of Psychiatry Department of Psychiatry New York University School of Medicine Attending Physician and Unit Chief Inpatient Psychiatry Bellevue Hospital Center New York, New York V A. S , M.D. IRGINIA ADOCK Professor of Psychiatry Department of Psychiatry New York University School of Medicine Attending Psychiatrist, Tisch Hospital Attending Psychiatrist, Bellevue Hospital Center New York, New York Acquisitions Editor: Chris Teja Development Editor: Ashley Fischer Editorial Coordinator: Alexis Pozonsky Marketing Manager: Rachel Mante Leung Production Project Manager: Bridgett Dougherty Design Coordinator: Holly McLaughlin Manufacturing Coordinator: Beth Welsh Prepress Vendor: Aptara, Inc. 6th edition Copyright © 2019 Wolters Kluwer. Copyright © 2010 Wolters Kluwer Health / Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at [email protected], or via our website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China Library of Congress Cataloging-in-Publication Data Names: Sadock, Benjamin J., author. | Ahmad, Samoon, author. | Sadock, Virginia A., author. Title: Kaplan & Sadock’s pocket handbook of clinical psychiatry / Benjamin J. Sadock, Samoon Ahmad, Virginia A. Sadock. Other titles: Kaplan and Sadock’s pocket handbook of clinical psychiatry | Pocket handbook of clinical psychiatry | Complemented by (expression): Kaplan & Sadock’s comprehensive textbook of psychiatry. 10th ed. Description: Sixth edition. | Philadelphia: Wolters Kluwer, [2019] | Complemented by: Kaplan & Sadock’s comprehensive textbook of psychiatry / editors, Benjamin J. Sadock, Virginia A. Sadock, Pedro Ruiz. 10th ed. 2017. | Includes bibliographical references and index. Identifiers: LCCN 2017044540 | ISBN 9781496386939 (alk. paper) Subjects: | MESH: Mental Disorders | Psychiatry | Handbooks Classification: LCC RC454 | NLM WM 34 | DDC 616.89—dc23 LC record available at https://lccn.loc.gov/2017044540 This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy, comprehensiveness, or currency of the content of this work. 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LWW.com Dedicated to our children James and Victoria and to our grandchildren Celia, Emily, Oliver and Joel B.J.S V.A.S Dedicated to my parents Riffat and Naseem and my son Daniel S.A Preface Psychiatry underwent a sea change since the last edition of this book was published: A new classification of mental disorders was developed and codified in a fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association. The reader will find all of those changes incorporated into this new, sixth edition of the Pocket Handbook of Clinical Psychiatry. Every section in this book has been updated and revised and all the diagnoses of mental disorder conform to the criteria listed in DSM-5. Each disorder is described using the specific parameters of diagnosis, epidemiology, etiology, clinical signs and symptoms, differential diagnosis, and treatment. This book serves as a ready reference to diagnose and treat the full range of mental disorders in both adults and children. Over the years, psychiatrists and nonpsychiatric physicians have found it to be a useful guide as have medical students, especially during their rotations through psychiatry. It is also used by psychologists, social workers, psychiatric nurses, and many other mental health professionals. The Pocket Handbook is a minicompanion to the recently published encyclopedic tenth edition of Kaplan & Sadock’s Comprehensive Textbook of Psychiatry (CTP-X) and each chapter in this book ends with references to the more detailed relevant sections in that textbook. The authors, Benjamin Sadock, M.D. and Virginia Sadock, M.D. are particularly pleased that Samoon Ahmad, M.D., a close friend and professional associate has joined them as a full author. He is a distinguished psychiatrist with a national and international reputation as both an educator and clinician. His participation has immeasurably helped and enhanced the preparation of this book. We wish to thank several persons who have helped. We want to acknowledge Norman Sussman, M.D. who has collaborated with us as consulting and contributing editor in many Kaplan & Sadock books. We also thank James Sadock, M.D. and Victoria Sadock Gregg, M.D., experts in adult and child emergency medicine respectively, for their help. Our assistant, Heidiann Grech