Massachusetts General Hospital Comprehensive Clinical Psychiatry Second Edition This page intentionally left blank Massachusetts General Hospital Comprehensive Clinical Psychiatry SECOND EDITION THEODORE A. STERN MD Chief, Avery D. Weisman Psychiatry Consultation Service Massachusetts General Hospital Director, Office for Clinical Careers Massachusetts General Hospital Ned H. Cassem Professor of Psychiatry in the field of Psychosomatic Medicine/Consultation Harvard Medical School Boston, MA, USA MAURIZIO FAVA MD Director, Clinical Research Program Executive Vice-Chair, Department of Psychiatry Executive Director, Clinical Trials Network and Institute, Massachusetts General Hospital Slater Family Professor of Psychiatry, Harvard Medical School Boston, MA, USA TIMOTHY E. WILENS MD Senior Staff, Child Psychiatry and Pediatric Psychopharmacology Director of the Center for Addiction Medicine Massachusetts General Hospital Associate Professor of Psychiatry Harvard Medical School Boston, MA, USA JERROLD F. ROSENBAUM MD Psychiatrist-in-Chief, Massachusetts General Hospital Chair, Executive Committee on Research Massachusetts General Hospital Stanley Cobb Professor of Psychiatry Harvard Medical School Boston, MA, USA London, New York, Oxford, Philadelphia, St Louis, Sydney, Toronto © 2016, Elsevier Inc All rights reserved. First edition 2008 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). The following chapters are in the public domain: 27 Drug Addiction 30 Bipolar Disorder 36 Sexual Disorders and Sexual Dysfunction 47 Lithium and Its Role in Psychiatry 48 The Use of Antiepileptic Drugs in Psychiatry 74 Neuropsychiatric Dysfunction 90 Military Psychiatry Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. ISBN: 978-0-323-29507-9 eISBN: 978-0-323-32899-9 Content Strategist: Charlotta Kryhl Content Development Specialist: Alexandra Mortimer Content Coordinator: Sam Crowe Project Manager: Andrew Riley Design: Christian Bilbow Illustration Manager: Amy Naylor Illustrator: MacPS Marketing Manager: Nyasha Kapenzi Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 Contents Preface,  ix 11 Brief Psychotherapy: An Overview,  111 James E. Groves, Mark A. Blais and John B. Taylor List of Contributors,  x 12 Couples Therapy,  120 Dedication,  xxi Anne K. Fishel and Jeanne McKeon 13 Family Therapy,  128 PART I Anne K. Fishel and David Harris Rubin Approach to the Patient, 1 14 Group Psychotherapy,  138  1 The Doctor–Patient Relationship,  1 Anne Alonso†, Marni Chanoff and Kathleen Hubbs Ulman Christopher Gordon and Eugene V. Beresin 15 Hypnosis,  146  2 The Psychiatric Interview,  8 Owen S. Surman, Lee Baer and Alex S. Keuroghlian Eugene V. Beresin and Christopher Gordon 16 Cognitive-behavioral Therapy, Behavioral Therapy,   3 Laboratory Tests and Diagnostic Procedures,  20 and Cognitive Therapy,  152 Felicia A. Smith and Charlotte Hogan Susan E. Sprich, Bunmi O. Olatunji, Hannah E. Reese, Michael W. Otto, Elizabeth Rosenfield and Sabine Wilhelm  4 Treatment Adherence,  39 Lara Traeger, Megan Moore Brennan PART V and John B. Herman Psychiatric Diagnoses and Conditions, 165 PART II 17 The DSM-5: A System for Psychiatric  Diagnosis,  165 Human Development, 47 Anna M. Georgiopoulos and Abigail L. Donovan  5 Child, Adolescent, and Adult Development,  47 Eric P. Hazen, Annah N. Abrams PART VI and Anna C. Muriel Disorders of Cognition, 173 18 Delirium,  173 PART III Jason P. Caplan, Ned H. Cassem, George B. Murray† and Psychological and Neuropsychological Theodore A. Stern Testing, 63 19 Dementia,  184  6 Diagnostic Rating Scales and Psychiatric  Jennifer R. Gatchel, Christopher I. Wright, William E. Falk and Instruments,  63 Nhi-Ha Trinh Joshua L. Roffman, David Mischoulon and Maurizio Fava 20 Intellectual Disability,  198  7 Understanding and Applying Psychological  John N. Julian Assessment,  73 Mark A. Blais, Samuel Justin Sinclair and Sheila M. O’Keefe PART VII  8 Neuropsychological Assessment,  82 Mental Disorders Due to Another Medical Janet Cohen Sherman, Catherine Leveroni and Condition, 205 Lauren Norton Pollak 21 Mental Disorders Due to Another Medical  Condition,  205 PART IV BJ Beck and Kathryn J. Tompkins The Psychotherapies, 97 PART VIII  9 Coping with Medical Illness and Psychotherapy of  the Medically Ill,  97 Sleep Disorders, 229 Steven C. Schlozman and James E. Groves 22 Sleep Disorders,  229 10 An Overview of the Psychotherapies,  102 Jeffrey B. Weilburg, John W. Stakes, Matt Bianchi and Robert S. Abernethy III and Steven C. Schlozman Ted Avi Gerstenblith v vi Contents PART IX 42  Antipsychotic Drugs,  475 Psychiatric Disorders, 247 Oliver Freudenreich, Donald C. Goff and David C. Henderson 43 Antidepressants,  489 23 Impulse-Control Disorders,  247 Maurizio Fava and George I. Papakostas Anna R. Weissman, Cathleen M. Gould and Kathy M. Sanders 44 Pharmacological Approaches to Treatment-Resistant  24 Somatic Symptom Disorders,  255 Depression,  506 Ted Avi Gerstenblith and Nicholas Kontos Ji Hyun Baek, Andrew A. Nierenberg and Maurizio Fava 25 Factitious Disorders and Malingering,  265 45  Electroconvulsive Therapy,  510 Felicia A. Smith Charles A. Welch 26 Alcohol-Related Disorders,  270 46 Neurotherapeutics,  518 John F. Kelly and John A. Renner Joan A. Camprodon, Navneet Kaur, Scott L. Rauch and 27 Drug Addiction,  291 Darin D. Dougherty John A. Renner and E. Nalan Ward 47 Lithium and Its Role in Psychiatry,  525 28 Psychosis and Schizophrenia,  307 Roy H. Perlis and Michael J. Ostacher Oliver Freudenreich, Hannah E. Brown and Daphne J. Holt 48 The Use of Antiepileptic Drugs in Psychiatry,  532 29 Mood Disorders: Depressive Disorders  Michael J. Ostacher and Honor Hsin (Major Depressive Disorder),  324 49 Pharmacotherapy of Attention-Deficit/Hyperactivity  Maurizio Fava, Søren Dinesen Østergaard and Paolo Cassano Disorder across the Life Span,  538 30 Bipolar Disorder,  330 Jefferson B. Prince, Timothy E. Wilens, Thomas J. Spencer and Roy H. Perlis and Michael J. Ostacher Joseph Biederman 31 Psychiatric Illness during Pregnancy and the  50 Drug–Drug Interactions in  Post-partum Period,  343 Psychopharmacology,  552 Ruta M. Nonacs, Betty Wang, Adele C. Viguera and Lee S. Cohen Jonathan E. Alpert 32 Anxiety Disorders,  353 51 Side Effects of Psychotropic Medications,  567 Amanda W. Calkins, Eric Bui, Charles T. Taylor, Jeff C. Huffman, Scott R. Beach and Theodore A. Stern Mark H. Pollack, Richard T. LeBeau and Naomi M. Simon 52 Natural Medications in Psychiatry,  581 33 Obsessive-compulsive Disorder and Obsessive- Felicia A. Smith and David Mischoulon compulsive and Related Disorders,  367 S. Evelyn Stewart, Daniel Lafleur, Darin D. Dougherty, PART XI Sabine Wilhelm, Nancy J. Keuthen and Michael A. Jenike Special Topics in Psychiatry, 589 34 Trauma and Posttraumatic Stress Disorder,  380 53 The Suicidal Patient,  589 Sharon Dekel, Mark W. Gilbertson, Scott P. Orr, Scott L. Rauch, Rebecca Weintraub Brendel, Christina A. Brezing, Nellie E. Wood and Roger K. Pitman Isabel T. Lagomasino, Roy H. Perlis and Theodore A. Stern 35 Dissociative Disorders,  395 Steven C. Schlozman and Ruta M. Nonacs PART XII Psychosomatic Medicine, 599 36 Sexual Disorders and Sexual Dysfunction,  402 Linda C. Shafer 54 Psychiatric Consultation to Medical and Surgical  Patients,  599 37 Eating Disorders: Evaluation and  Nicholas Kontos and John Querques Management,  412 Jennifer J. Thomas, Diane W. Mickley, Jennifer L. Derenne, 55 Life-threatening Conditions in Psychiatry: Catatonia,  Anne Klibanski, Helen B. Murray and Kamryn T. Eddy Neuroleptic Malignant Syndrome, and Serotonin  Syndrome,  608 38 Grief, Bereavement, and Adjustment Disorders,  428 Gregory L. Fricchione, Scott R. Beach, Jeff C. Huffman, Alicia D. Powell George Bush and Theodore A. Stern 39 Personality and Personality Disorders,  433 56 Psycho-oncology: Psychiatric Co-morbidities and  Mark A. Blais, Patrick Smallwood, James E. Groves, Complications of Cancer and Cancer  Rafael A. Rivas-Vazquez and Christopher J. Hopwood Treatment,  618 Carlos Fernandez-Robles, Donna B. Greenberg and William F. Pirl PART X 57 Psychiatric Aspects of HIV Infection  Treatment Approaches, 445 and AIDS,  627 John Querques and Oliver Freudenreich 40 Psychiatric Neuroscience: Incorporating  Pathophysiology into Clinical Case  58 Organ Transplantation: Pre-transplant Assessment  Formulation,  445 and Post-transplant Management,  638 Joan A. Camprodon and Joshua L. Roffman Laura M. Prager 41 The Pharmacotherapy of Anxiety Disorders,  464 59 Approaches to Collaborative Care and Primary Care  Eric Bui, Mark H. Pollack, Gustavo Kinrys, Hannah Delong, Psychiatry,  645 Débora Vasconcelos e Sá and Naomi M. Simon BJ Beck Contents vii 60 Psychiatric and Ethical Aspects of Care at the End  75 Neuroimaging in Psychiatry,  815 of Life,  652 Darin D. Dougherty and Scott L. Rauch Guy Maytal, Lucy A. Epstein Hutner, Ned H. Cassem and 76 Clinical Neurophysiology and  Rebecca Weintraub Brendel Electroencephalography,  821 Haythum O. Tayeb and Shahram Khoshbin PART XIII Psychiatric Epidemiology and 77 Psychiatric Manifestations and Treatment of Seizure  Statistics, 659 Disorders,  829 Daniel Weisholtz and Shahram Khoshbin 61 Psychiatric Epidemiology,  659 78 Differential Diagnosis and Treatment of  Albert S. Yeung and Trina E. Chang Headaches,  839 62 Statistics in Psychiatric Research,  667 Stephen E. Nicolson Lee Baer 79 Pathophysiology, Psychiatric Co-morbidity, and  Treatment of Pain,  852 PART XIV Ajay D. Wasan, Menekse Alpay and Shamim H. Nejad Genetics and Psychiatry, 677 80 Psychiatric Aspects of Stroke Syndromes,  863 63 Genetics and Psychiatry,  677 Sean P. Heffernan, Shamim H. Nejad, Lucy A. Epstein Hutner, Daniel H. Ebert, Christine T. Finn and Jordan W. Smoller David M. Greer and Jeff C. Huffman PART XV 81 Movement Disorders,  871 Alice W. Flaherty and Ana Ivkovic Social and Community Psychiatry, 703 82 Psychiatric Manifestations of Traumatic Brain  64 Serious Mental Illness,  703 Disorder,  883 Oliver Freudenreich, Mark Viron and Derri Shtasel Christopher Carter and Kaloyan S. Tanev 65 Aggression and Violence,  709 Adrienne T. Gerken, Anne F. Gross and Kathy M. Sanders PART XIX 66 Culture and Psychiatry,  718 Law and Psychiatry, 897 David C. Henderson, Brenda Vincenzi, Albert S. Yeung and Gregory L. Fricchione 83 Intimate Partner Violence,  897 67 Community Psychiatry,  726 BJ Beck BJ Beck 84 Psychiatric Correlates and Consequences of Abuse  68 Managed Care and Psychiatry,  734 and Neglect,  904 John B. Taylor and J. Niels Rosenquist Nada Milosavljevic, John B. Taylor and Rebecca Weintraub Brendel PART XVI 85 Legal and Ethical Issues in Psychiatry I: Informed  Child Psychiatry, 741 Consent, Competency, Treatment Refusal, and Civil  Commitment,  912 69 Child and Adolescent Psychiatric Disorders,  741 Ronald Schouten, Judith G. Edersheim and Jeff Q. Bostic, Jefferson B. Prince and David C. Buxton José A. Hidalgo 70 Psychiatric and Substance Use Disorders  86 The Role of Psychiatrists in the Criminal Justice  in Transitioning Adolescents and   System,  921 Young Adults,  755 Ronald Schouten and Rebecca Weintraub Brendel Timothy E. Wilens, Courtney Zulauf and Jerrold F. Rosenbaum 87 Legal and Ethical Issues in Psychiatry II: Malpractice  PART XVII and Boundary Violations,  929 Geriatric Psychiatry, 763 Ronald Schouten and Rebecca Weintraub Brendel 71 Geriatric Psychiatry,  763 M. Cornelia Cremens PART XX Care in Special Settings, 937 PART XVIII Neuropsychiatry, 771 88 Emergency Psychiatry,  937 Laura M. Prager and Ana Ivkovic 72 Neuroanatomical Systems Relevant to  Neuropsychiatric Disorders,  771 89 Rehabilitation Psychiatry,  950 Daphne J. Holt, Dost Öngür, Christopher I. Wright, Terry Rabinowitz, A. Evan Eyler, John P. Hirdes and Bradford C. Dickerson, Joan A. Camprodon and Scott L. Rauch Thomas D. Stewart 73 The Neurological Examination,  791 90 Military Psychiatry,  961 Evan D. Murray and Bruce H. Price Gary H. Wynn, James R. Rundell and David M. Benedek 74 Neuropsychiatric Principles and Differential  91 Disaster Psychiatry,  968 Diagnosis,  805 Elspeth Cameron Ritchie, Kevin M. O’Brien, Marni Chanoff and Simon Ducharme, Evan D. Murray and Bruce H. Price Samantha Andrien Stewart viii Contents PART XXI 94 Global Mental Health in the Twenty-First  Preparing for the Future, 975 Century,  990 Richard F. Mollica, Christina P.C. Borba, Jesse M. Katon, 92 Coping with the Rigors of Psychiatric Practice,  975 Claire E. Oppenheim, Gregory L. Fricchione and Abigail L. Donovan and Theodore A. Stern David C. Henderson 93 Psychiatry and the Media,  982 Cheryl K. Olson, Lawrence Kutner and Eugene V. Beresin Index,  1001 Preface Fortunately, the field of Psychiatry has continued to evolve. With the assistance of the watchful eyes of the staff at This observation led us to the realization that it was time for Elsevier (led by Charlotta Kryhl, Alexandra Mortimer, Andrew a new and updated comprehensive textbook of Psychiatry, Riley, and Sam Crowe) our journey was completed in less than written by our clinicians and researchers here at the Massachu- two years, enabling us to include the most up-to-date informa- setts General Hospital. Once again, our faculty was up to the tion available in each content area. In addition, Naomi Plasky challenge; they collaborated enthusiastically and efficiently to (at the Massachusetts General Hospital) helped shepherd create this comprehensive compendium covering the diagno- us through thousands of emails and packages among more sis, pathophysiology, evaluation, and treatment of a wide than 175 authors who contributed to the production of 94 variety of psychiatric conditions and states. chapters. We are incredibly appreciative of the countless hours spent On behalf of the patients we serve, we hope that this conceptualizing, creating, updating, and refining each chapter edition facilitates the conceptualization, diagnosis, under- in this volume; yeoman’s work was done by all. Without all standing, and treatment of psychiatric problems and brings involved pulling at the oars this endeavor would not have much-needed relief. been possible. To match learning styles of our readers and to solidify T.A.S. knowledge gained through perusal of this text, we have also M.F. included 600 board-style multiple-choice questions (MCQs) and detailed annotated answers (geared to each chapter). T.E.W. These MCQs are available online at https://expertconsult. J.F.R. inkling.com. ix