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00-Psychiatry_Evidence-Prelims-ccc:9780340950050 26/10/09 15:22 Page i Psychiatry: An Evidence-Based Text TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk 00-Psychiatry_Evidence-Prelims-ccc:9780340950050 26/10/09 15:22 Page iii Psychiatry: An Evidence-Based Text Edited by Professor Basant Puri Honorary Consultant in Imaging and Psychiatry Hammersmith Hospital and Imperial College, London, UK Dr Ian Treasaden Head of Forensic Neurosciences, Lipid Neuroscience Group and Honorary Senior Lecturer in Psychiatry, Imperial College London and Consultant Forensic Psychiatrist, West London Mental Health NHS Trust, London, UK CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2009 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20130319 International Standard Book Number-13: 978-1-4441-1326-6 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reli- able data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judge- ment, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the drug companies’ printed instructions, and their websites, before administering any of the drugs recommended in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any elec- tronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or con- tact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com 00-Psychiatry_Evidence-Prelims-ccc:9780340950050 26/10/09 15:22 Page v Contents CONTRIBUTORS VII PREFACE XI ACKNOWLEDGEMENTS XII PART 1:THE FOUNDATIONS OF MODERN PSYCHIATRIC PRACTICE 1 History of psychiatry Trevor Turner 3 2 Introduction to evidence-based medicine Stuart Carney 16 3 History and philosophy of science Bill Fulford and Tom Thornton 19 4 Research methods and statistics Daniel Stahl and Morven Leese 34 5 Epidemiology Stephen Stansfeld and Charlotte Clark 72 6 How to practise evidence-based medicine Stuart Carney 83 7 Psychological assessment and psychometrics Ann Mortimer 89 PART 2: DEVELOPMENTAL, BEHAVIOURAL AND SOCIOCULTURAL PSYCHIATRY 8 Human development Marcus Munafò and Angela Attwood 103 9 Introduction to basic psychology Richard Gross 127 10 Awareness Richard Gross 137 11 Stress Richard Gross 153 12 Emotion Richard Gross 166 13 Information-processing and attention Richard Gross 179 14 Learning theory Richard Gross 195 15 Motivation Richard Gross 213 16 Perception Richard Gross 229 17 Memory Richard Gross 246 18 Language and thought Richard Gross 266 19 Personality John Green and Georgina Smith 278 20 Social psychology Raj Persaud 285 21 Social science and sociocultural psychiatry Mary Boulton 297 22 Cultural psychiatry Dinesh Bhugra and Sean Cross 307 PART 3: NEUROSCIENCE 23 Neuroanatomy Basant K Puri and Bari M Logan 331 24 Basic concepts in neurophysiology Paul Strutton 354 25 Neurophysiology of integrated behaviour Basant K Puri 361 26 Neurogenesis and cerebral plasticity Basant K Puri 374 27 The neuroendocrine system Peter Fitzgerald and Timothy G Dinan 385 28 The neurophysiology and neurochemistry of arousal and sleep John Shneerson 397 29 The electroencephalogram and evoked potential studies Caroline Brown and Jonathan Bird 400 30 Neurochemistry Gavin P Reynolds, Michael K Harte and Trisha A Jenkins 410 31 Neuropathology Steve M Gentleman 435 32 Neuroimaging Basant K Puri 445 33 Genetics Michael Gill and Jane McGrath 465 PART 4: MENTAL HEALTH PROBLEMS AND MENTAL ILLNESS 34 Classification and diagnostic systems Pesach Lichtenberg and RH Belmaker 489 35 Cognitive assessment Adam Zeman and Lorna Torrens 499 36 Neurology for psychiatrists Peter Garrard 519 37 Organic disorders David P Moore and Basant K Puri 541 38 Schizophrenia and paranoid psychoses Peter F Buckley and Peter Jones 593 39 Mood disorders/affective psychoses Ewa Wisniewska Young, Nicol Ferrier, Brian Lunn and Andrew Brittlebank 610 00-Psychiatry_Evidence-Prelims-ccc:9780340950050 26/10/09 15:22 Page vi vi Contents 40 Neurotic and stress-related disorders Ian Treasaden 640 41 Dissociative (conversion), hypochondriasis and other somatoform disorders Ian Treasaden 665 42 Eating disorders Kate Webb, Ewa Zadeh, Victoria Mountford and J Hubert Lacey 687 43 Personality disorders Peter Tyrer 704 44 Perinatal psychiatry Ian Brockington 715 45 Psychosexual medicine Sandy Goldbeck-Wood 733 46 Gender identity disorders James Barrett 754 47 Paraphilias and sexual offenders Ian Treasaden 761 48 Psychiatric assessment of physical illness Geoffrey Lloyd 779 49 Overlapping multi-system, multi-organ illnesses/syndromes Malcolm Hooper 788 50 Multiple chemical sensitivity Malcolm Hooper 793 51 Mental health problems in patients with myalgic encephalomyelitis and fibromyalgia syndrome Byron Hyde 821 52 Pain and psychiatry Stephen Tyrer 835 53 Sleep disorders John Shneerson 844 54 Suicide and deliberate self-harm Chris Hawley, Paul St John Smith and Ash Padhi 854 55 Emergency psychiatry Basant K Puri and Ian Treasaden 870 56 Care of the dying and bereaved Hilary Pavis and Maelie Swanwick 876 PART 5: APPROACHES TO TREATMENT 57 Clinical psychopharmacology Malcolm Lader and David Taylor 893 58 Electroconvulsive therapy Alan Scott 922 59 Transcranial magnetic stimulation and vagus nerve stimulation RH Belmaker 931 60 Psychotherapy: an introduction C Susan Mizen 934 61 Dynamic psychotherapy Chris Mace 947 62 Family therapy Rudi Dallos 955 63 Marital therapy David Hewison 967 64 Group therapy John Gordon and Gabriel Kirtchuk 973 65 Cognitive-behavioural therapy Rebecca Martinez and Chris Williams 984 66 Other individual psychotherapies Basant K Puri 994 67 Therapeutic communities Kingsley Norton and Fiona Warren 1003 68 Effectiveness of psychotherapy Peter Fonagy 1009 PART 6: CLINICAL SPECIALTIES 69 Addiction psychiatry Ilana B Crome and Roger Bloor 1021 70 Child and adolescent psychiatry Sami Timimi and Kedar Dwivedi 1047 71 Learning disability psychiatry Mark Dickinson and Iqbal Singh 1079 72 Old-age psychiatry Boben Benjamin and Alistair Burns 1100 73 Rehabilitation psychiatry Frank Holloway and Sridevi Kalidindi 1120 PART 7: MENTAL HEALTH SERVICE PROVISION 74 Management of psychiatric services Hameen Markar and Borislav Iankov 1137 75 Advice to special medical services Geoffrey Lloyd 1142 PART 8: LEGAL AND ETHICAL ASPECTS OF PSYCHIATRY 76 Forensic psychiatry Ian Treasaden 1153 77 Legal aspects of psychiatric care, with particular reference to England and Wales Ian Treasaden 1214 78 Ethics and law Gwen Adshead 1234 79 Risk assessment Anthony Maden 1239 APPENDIX 1248 INDEX 1249 00-Psychiatry_Evidence-Prelims-ccc:9780340950050 26/10/09 15:22 Page vii Contributors Angela Attwood BSc PhD Charlotte Clark BSc (Hons) PhD Department of Experimental Psychology, University of Lecturer in Environmental and Mental Health Bristol, Bristol, UK Epidemiology, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of James Barrett MB BS(Hons) BSc MSc FRCPsych Medicine & Dentistry, Queen Mary, University of London, Lead Clinician, National Gender Identity Clinic, London, UK London, UK RH Belmaker MD Ilana Crome MA MD MPhil FRCPsych Hoffer-Vickar Professor of Psychiatry, Ben Gurion Academic Director of Psychiatry and Professor of Addiction University of the Negev, Beer-Sheva, Israel Psychiatry, Keele University Medical School, Harplands Hospital, Staffordshire, UK Boben Benjamin BSc (Hons) MD LRCP LRCS LMSSA MRCPsych Specialist Registrar in Old Age Psychiatry, Wythenshawe Sean Cross BSc (Hons) MBChB MSt MRCPsych Hospital, Manchester, UK SpR, Department of Liaison Psychiatry, St Thomas’ Hospital, London, UK Dinesh Bhugra MA MSc MBBS FRCPsych MPhil Phd Professor of Mental Health and Cultural Diversity, Institute Rudi Dallos BA MSc PhD Dip (Clin Psych) Department of Clinical Psychology, University of of Psychiatry, Kings College London, London, UK Plymouth, UK Jonathan Bird BSc MBChB FRCPsych Mark Dickinson BSc MBBS MRCPsych Consultant Neuropsychiatrist and Clinical Electro - The Combined Learning Disability Team, Enfield, encephalographer, The Burden Institute, Frenchay Hospital, Middlesex, UK Bristol, UK Timothy G Dinan MD PhD FRCPsych Roger Bloor MD MPsyMed FRCPsych Department of Psychiatry, University College Cork, Ireland Senior Lecturer and Consultant Psychiatrist, Keele University Medical School, Harplands Hospital, Kedar Nath Dwivedi MBBS MD DPM FRCPsych Staffordshire, UK Director, International Institute of Child and Adolescent Mental Heath, Visiting Professor, London Metropolitan Mary Boulton BA PhD HonMFPH University, Formerly, Consultant Child and Adolescent Professor of Health Sociology, School of Health and Social Psychiatrist, Northampton, UK Care, Oxford Brookes University, Oxford, UK Nicol Ferrier BSc MD FRCPsych FRCPed Andrew Brittlebank MA FRCPsych Institute of Neuroscience, Newcastle University, Newcastle Director of Medical Education, Northumberland Tyne and upon Tyne, UK Wear NHS Trust, St Nicholas Hospital, Newcastle upon Peter Fitzgerald MB MRCPsych Tyne, UK Department of Psychiatry, University College Cork, Ireland Ian Brockington MB B Chir MPhil MD FRCP FRCPsych Peter Fonagy PhD FBA Professor Emeritus, University of Birmingham Freud Memorial Professor of Psychoanalysis, University College London, Chief Executive, The Anna Freud Centre, Caroline Brown BSc PhD Senior Lecturer, Department of Psychology, University of London, UK the West of England , Bristol, UK Bill (KWM) Fulford DPhil FRCP FRCPsych Fellow of St Cross College, Member of the Philosophy Peter F Buckley MD Professor and Chairman, Department of Psychiatry, Faculty and Honorary Consultant Psychiatrist, University Associate Dean for Leadership Development, Medical of Oxford; Professor of Philosophy and Mental Health, College of Georgia, Augusta, Georgia, USA University of Warwick; Co-Director, Institute for Philosophy, Diversity and Mental Health, University of Alistair Burns MBChB FRCP FRCPsych MD MPhil DHMSA Central Lancashire; and Special Adviser for Values-Based Professor of Old Age Psychiatry, Deputy Dean (Clinical Practice, Department of Health, London, UK Affairs) University of Manchester, Manchester, UK Peter Garrard PhD FRCP Stuart Carney MBChB MPH MRCPsych FAcadMed Reader in Neurology, University of Southampton School of Deputy National Director, UK Foundation Programme, Medicine Division of Clinical Neuroscience Southampton, Cardiff, UK UK 00-Psychiatry_Evidence-Prelims-ccc:9780340950050 26/10/09 15:22 Page viii viii Contributors Steve Gentleman BSc PhD Borislav Iankov MBBS MRCPsych Deputy Head of Division (Teaching), Reader in Specialty Training Registrar – General Adult Psychiatry, Experimental Neuropathology, Department of Clinical Bedfordshire & Luton Mental Health and Social Care Neuroscience, Division of Neuroscience & Mental Health, Partnership Trust, Luton, UK Imperial College London, London, UK Trisha A Jenkins BSc PhD Michael Gill MD MRCPsych FTCD Department of Psychiatry, Queen’s University Belfast, Professor of Psychiatry and Head of Department, Belfast, UK Department of Psychiatry, Trinity Centre for Health Peter B Jones MD PhD FRCIP FRCPsych FMedSci Sciences, St. James’ Hospital, Dublin, Ireland Professor of Psychiatry and Head of Department, Sandy Goldbeck-Wood MBChB MIPM MA (Psychoanalytic Department of Psychiatry, University of Cambridge, Studies) Dip (ERT) Cambridge, UK Specialist Doctor in Obstetrics and Gynaecology, Ipswich Sridevi Kalidindi MRCPsych Hospital, Suffolk, UK Consultant Psychiatrist in Recovery and Rehabilitation John Gordon AB (Harvard) Psychiatry, Croydon Integrated Adult Mental Health Consultant Adult Psychotherapist, Forensic Psychotherapy Service, South London and Maudsley Foundation NHS Department and the Cassel Hospital, West London Mental Trust, Bethlem Royal Hospital, Beckenham, UK Health NHS Trust; Psychoanalyst (British Psychoanalytic Gabriel Kirtchuk Association); Group Analyst (Institute of Group Analysis); Consultant Psychiatrist in Psychotherapy, Psychotherapy Lecturer, Faculty of Continuing Education, Birkbeck Training Department, West London Mental Health NHS College, University of London; and Honorary Senior Trust, Southall, Middlesex, UK Lecturer, Imperial College Medical School, London, UK J Hubert Lacey MD MPhil FRCPsych John Green BA MScClinPsych PhD Professor of Psychiatry, St George’s, University of London Chief Psychologist, CNW Department of Clinical Health and Director of St George’s Eating Disorders Service, Psychology, St. Mary’s Hospital, London NHS Foundation London Trust, UK; and Honorary Senior Lecturer in Behavioural Sciences, Imperial College, London Malcolm Lader OBE LLB DSc MD PhD FRCPsych FMed Sci Emeritus Professor of Clinical Psychopharmacology, Richard Gross BA (Jt Hons) MA (Ed) Cert Ed Institute of Psychiatry, King’s College London, UK Full time academic author of many widely-used Psychology texts Morven Leese MSc PhD Health Service and Population Research Department, Michael K Harte BSc PhD Institute of Psychiatry, Kings College London, London, UK Division of Pharmacology, School of Pharmacy, University of Bradford, Bradford, UK Pesach Lichtenberg MD Department of Psychiatry, Herzog Hospital; and Clinical Chris Hawley MB BS MRCPsych Senior Lecturer in Psychiatry, Hadassah Medical School of Hertfordshire Partnership Foundation Trust, St Albans; and the Hebrew University of Jerusalem, Israel Bedfordshire and Hertfordshire Postgraduate Medical School, University of Hertfordshire, Hatfield, UK Geoffrey G Lloyd FCC Psych MD MA Visiting Consultant Psychiatrist, Priory Hospital North David Hewison LLB PGDipSW CQSW MA ProfMbr SAP London, London, UK DipMarPsych FMbr SCPP DCplPsychPsych CertMgmt (Open) Senior Couple Psychoanalytic Psychotherapist and Head of Brian Lunn MB ChB FRCPsych Research, Tavistock Centre for Couple Relationships, Honorary Clinical Senior Lecturer School of Medical London, UK Sciences Education Development, Newcastle University, Newcastle upon Tyne, UK Frank Holloway FRCPsych Consultant Psychiatrist and Clinical Director, Croydon Chris Mace MD FRCPsych Integrated Adult Mental Health Service, South London and Consultant Psychotherapist, Coventry and Warwickshire Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Partnership Trust, Honorary Associate Professor in Beckenham, UK Psychotherapy, University of Warwick, UK Malcolm Hooper PhD BPharm MRIC CChem Hameen Markar FRCP FRCPsych MPhil Emeritus Professor of Medicinal Chemistry, University of Medical Director, Bedfordshire & Luton Mental Health and Sunderland, Sunderland, UK Social Care Partnership NHS Trust, Luton, UK Byron Hyde MD Rebecca Martinez DM MSc MRCEP MRCPsych Chairman, Nightingale Research Foundation, Ottawa, Clinical Lecturer in Psychiatry, Faculty of Medicine, Canada University of Glasgow, Glasgow, UK 00-Psychiatry_Evidence-Prelims-ccc:9780340950050 26/10/09 15:22 Page ix Contributors ix Jane McGrath MB MRCPsych Paul St John Smith MA (Oxon) BM BCh FRCPsych Department of Psychiatry, Trinity Centre for Health Consultant Psychiatrist, Hertfordshire Partnership Sciences, St. James’ Hospital, Dublin, Ireland Foundation Trust, St Albans, UK C Susan Mizen MBBS MRCPsych Memb SAP Daniel Stahl Dipl Biol Dr rer nat Consultant Psychiatrist in Psychotherapy, Wonford House Lecturer in Biostatistics, Dept of Biostatistics & Computing, Hospital, Exeter, UK Institute of Psychiatry, Kings College London, London, UK David P Moore MD Stephen Stansfeld MB BS PhD MRCP FRCPsych Associate Clinical Professor, Department of Psychiatry and Chair & Centre Lead for Psychiatry, Centre for Psychiatry, Department of Neurosurgery, University of Louisville Wolfson Institute of Preventive Medicine, Barts and the School of Medicine, Louisville, Kentucky, USA London School of Medicine & Dentistry, Queen Mary, University of London, London, UK Ann Mortimer BSc MMedSc MD FRCPsych Foundation chair in Psychiatry and Head of Department of Maelie Swanwick FRCP Psychiatry, University of Hull, Hull, UK Consultant in Palliative Medicine, Nightingale Macmillan Unit, Royal Derby Hospital, Derby, UK Victoria Mountford BA Hons DClinPsych Clinical Psychologist and Honorary Research Fellow, St David Taylor BSc FFPH Chief Pharmacist, South London and Maudsley NHS George’s Eating Disorders Service and St George’s, Foundation Trust, London, UK University of London Marcus R Munafò PhD Tim Thornton Reader in Biological Psychology, Department of Director of Philosophy and Professor of Philosophy and Experimental Psychology, University of Bristol, Bristol, UK Mental Health, International School for Communities, Rights and Inclusion, University of Central Lancashire, Kingsley Norton MA (Cantab) MD FRCPsych Preston, UK Consultant Psychotherapist, West London Mental Health Services, Southall, Middlesex, UK Sami Timimi MBChB MRCPsych Consultant child and Adolescent Psychiatrist, Lincolnshire Ash Padhi SpR Partnership NHS Trust, Visiting Professor of Child and Specialist Trainee, Hertfordshire Partnership Foundation Adolescent Psychiatry, Faculty of Health and Social Trust, St Albans, UK Sciences, Lincoln University Hilary Pavis MA MRCGP Lorna Torrens BA DClinPsych Consultant in Palliative Medicine, Nightingale Macmillan Head of Clinical Psychology, Astley Ainslie Hospital, Unit, Royal Derby Hospital, Derby, UK Edinburgh, UK Raj Persaud FRCPsych Trevor Turner DHMSA MD FRCPsych Consultant Psychiatrist, Emeritus Visiting Gresham Consultant Psychiatrist, East London Foundation Trust, Professor for the Public Understanding of Psychiatry, Homerton University Hospital London; and Honorary Gresham Collge, London, UK Senior Clinical Lecturer, Barts and the London School of Medicine & Dentistry, Queen Mary, University of London, Gavin P Reynolds BA PhD UK Professor of Neuroscience, Department of Psychiatry, Queen’s University Belfast, Belfast, UK Peter Tyrer FMedSci FRCPsych Department of Psychological Medicine, Imperial College Allan Scott BSc MPhil MD MBA FRCPsych London, London, UK Consultant Psychiatrist, Royal Edinburgh Hospital, Edinburgh, UK Stephen Tyrer MB LMCC FRCPsych Consultant in Psychiatry and Pain, Mental Health Unit, John Shneerson MA DM MD FRCP FCCP Southland Hospital, Invercargill, New Zealand Sleep Disorders Unit, Papworth Hospital, Cambridge, UK Fiona Warren MA PhD Iqbal Singh MB BS FRCPsych Department of Psychology, Faculty of Arts and Human Consultant Psychiatrist in Learning Disability, The Riverside Sciences, University of Surrey, Guildford, UK Centre, Hillingdon Hospital, Uxbridge, Middlesex, UK Kate Webb MRCPsych Georgina Smith Sp R and Honorary Research Assistant, St George’s Eating Department of Clinical Health Psychology, St. Mary’s Disorders Service and St George’s, University of London, Hospital, London, UK London, UK

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