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MENTAL DISORDERS -
THEORETICAL AND
EMPIRICAL PERSPECTIVES
Edited by Robert Woolfolk and Lesley Allen
Mental Disorders - Theoretical and Empirical Perspectives
http://dx.doi.org/10.5772/46217
Edited by Robert Woolfolk and Lesley Allen
Contributors
Lawrence Lam, Mohamed Dammak, Mary Jane Ditton, Sharon Lawn, Jeanette Walsh, Anne Barbara, Margaret
Springgay, Patricia Sutton, Gregory Garvey, Afusat Busari, Rajkumar Kamatchi, Ashok Kumar Jainer, Bettahalasoor
Somashekar, Marek Marzanski, Arabinda Narayan Chowdhury, Apu Chakraborty, Maria Lambri, Lance Patrick, Lara Del
Col, Michela Gatta, Paolo Testa, Lara Dal Zotto, Andrea Spoto, Pier Antonio Battistella Battistella, Maxim De Sauma,
John Matthews, Robert Woolfolk, Lesley Allen, Narong Maneeton, Benchalak Maneeton, Ewa Wojtyna, Agnieszka
Wiszniewicz, Crístia Rosineiri Gonçalves Lopes Corrêa, Adeyi Adoga, Obindo J. Taiwo, Maja Rus Makovec, Velko S. Rus,
Karin Sernec
Published by InTech
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Copyright © 2013 InTech
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First published January, 2013
Printed in Croatia
A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from orders@intechopen.com
Mental Disorders - Theoretical and Empirical Perspectives, Edited by Robert Woolfolk and Lesley Allen
p. cm.
ISBN 978-953-51-0919-8
free online editions of InTech
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Contents
Preface VII
Chapter 1 Treatment-Resistant Schizophrenia: Prevalence and
Risk Factors 1
Mohamed Dammak
Chapter 2 Cognitive Behavioral Therapy Approach for Suicidal Thinking
and Behaviors in Depression 23
John D. Matthews
Chapter 3 Cognitive Behaviour Therapy in the Management of Conduct
Disorder Among Adolescents 45
Afusat Olanike Busari
Chapter 4 Anxiolytics Use in the Families with (Non)dependent Member:
Relation to Dependence Indicators, Self and Family Perceptions
Including Social Neuroscience Perspective 65
Maja Rus-Makovec, Karin Sernec and Velko S. Rus
Chapter 5 Management of Delirium 85
Narong Maneeton and Benchalak Maneeton
Chapter 6 Racism and Mental Illness in the UK 119
Apu Chakraborty, Lance Patrick and Maria Lambri
Chapter 7 Rethinking Dissociation in an Age of Virtual Worlds 157
Gregory Patrick Garvey
Chapter 8 Somatic Symptom Disorder 173
Lesley A. Allen and Robert L. Woolfolk
Chapter 9 The Bond We Share: Experiences of Caring for a Person with
Mental and Physical Health Conditions 199
Sharon Lawn, Jeannette Walsh, Anne Barbara, Margaret Springgay
and Patricia Sutton
Chapter 10 Working on Adolescent’s Motivation to Improve the Outcome
Within a Multimodal Treatment 231
Gatta Michela, Testa C. Paolo, Del Col Lara, Spoto Andrea, Dal Zotto
Lara, De Sauma Maxim and Battistella Pier Antonio
Chapter 11 Parent-Child Attachment, Parental Depression, and Perception
of Child Behavioural/Emotional Problems 255
Lawrence T. Lam
Chapter 12 Current Advances in the Treatment of Major Depression: Shift
Towards Receptor Specific Drugs 269
Ashok Kumar Jainer
Chapter 13 The Characteristics of Nicotine Addiction Among Patients with
Schizophrenia 289
Ewa Wojtyna and Agnieszka Wiszniewicz
Chapter 14 Post Traumatic Eco-Stress Disorder (PTESD): A Qualitative Study
from Sundarban Delta, India 309
Arabinda N. Chowdhury, Ranajit Mondal, Mrinal K Biswas and
Arabinda Brahma
Chapter 15 The Association Between Tinnitus and Mental Illnesses 349
Adeyi A. Adoga and Taiwo J. Obindo
Chapter 16 Attention – Deficit Hyperactivity Disorder (ADHD) in Psychiatry
and Psychoanalysis 371
Crístia Rosineiri Gonçalves Lopes Corrêa
Chapter 17 Quality in Delivery of Mental Health Services 389
Mary Ditton
ContentsVI
Preface
In Mental Disorders - Theoretical and Empirical Perspectives an international and
multicultural array of experts provide cutting edge empirical and theoretical contributions
to the scientific understanding of psychopathology. The range of genres is wide, from
qualitative studies to tightly-controlled randomized trials. Every important theme in this
broad field is at least touched upon, both breaking new ground and analyzing and
critiquing perennial themes. Chapters cover depression, somatization, schizophrenia,
pediatric psychiatry, and issues related to care giving, just to name a few. The authors
assembled are a distinguished international group from diverse disciplines and different
cultures. Many of the chapters present material that is appearing in the literature for the first
time. The volume will edify students, practitioners, and researchers and will constitute a
welcome addition to any library of scholars who wish to stay abreast of cutting edge
developments in experimental psychopathology and both pharmacological and
psychosocial treatment. Mental Disorders - Theoretical and Empirical perspectives is a book
that will leave readers not only better informed about particular issues, but also more aware
of the scope of the mental health field as it exists in our continually changing, multicultural
world.
Editor:
Prof. Robert Woolfolk
Princeton University/Rutgers University,
USA
Co-editor:
Lesley Allen
Department of Psychology,
Princeton University,
Princeton, NJ, USA
Chapter 1
Treatment-Resistant Schizophrenia:
Prevalence and Risk Factors
Mohamed Dammak
Additional information is available at the end of the chapter
http://dx.doi.org/10.5772/52430
1. Introduction
Despite significant progress in the treatment of schizophrenia in recent decades, the evolution
of a large rate of patients suffering from this mental disorder is little influenced by treatment
[1]. The management of these patients, so-called treatment resistant, constitutes a public health
problem. Indeed, these very symptomatic patients often require long periods of hospitalization
[2], and their care consumes a disproportionately large share of total cost management of
schizophrenia [3].
Following the renewed interest in clozapine since 1988, thanks to the baseline study on the
neuroleptic Kane and al [4], and the development in this period of several explicit criteria
defining treatment-resistant schizophrenia (TRS), like those of Kane [4], Dencker and al [5] and
Brenner and al [6], some studies have subsequently estimated its prevalence.
The large number and variety of risk factors associated with poor prognosis or poor response
to treatment, reported in the literature, suggest that several pathophysiological mechanisms
may contribute to the emergence of resistance.
In this work, we tried to shed light on the prevalence of this concept, as well as its risk factors,
through a critical review of the literature.
2. Methodology
In our literature review, we conducted a literature search in two databases MEDLINE and
PUBMED. We used the following keywords: treatment-resistant, refractory, schizophrenia,
© 2013 Dammak; licensee InTech. This is an open access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
prevalence, Correlates, predictors, poor outcome, Treatment refractoriness, Treatment
response, poor prognosis.
For studies estimating the prevalence of TRS, we selected the works that have considered the
resistance as a categorical diagnosis, defining it by explicit criteria.
For risk factors of TRS, we selected studies that have specifically studied the risk factors of
resistance, and the studies that studied the risk factors of poor prognosis or poor response to
treatment.
3. Prevalence of treatment-resistant schizophrenia
3.1. Results
The prevalence of resistant schizophrenia ranged from 5 to 60% (Table 1) in the four
studies in the literature. Vanelle only found a low rate of 5% resistance because of too
restrictive criteria of resistance corresponding to stages 5 and 6 of Dencker and May de‐
fining TRS. The results of the other three studies suggest that an important rate of pa‐
tients do not derive virtually any benefit of treatment and that the TRS is therefore a
true public health problem [7]. Many authors agree on the fact that 1/5 to 1/3 of patients
are resistant to treatment [1]. Methodological differences between these different studies
concerning inclusion criteria and the TRS criteria were important, which explains the
wide variation in the estimate of the prevalence of TRS: 5 to 60%. The study by Juarez-
Reyes and al [8] illustrates this fact. Applying the criteria of the FDA (Food and Drugs
Administration) for the prescription of Clozapine in the United States of America, Juarez-
Reyes et al found in their sample a prevalence of 42.9% of resistant patients, but apply‐
ing the more restrictive criteria of Kane on the same sample, the prevalence dropped to
12.9%.
These methodological differences reflect a lack of consensus on the concept of TRS, which
seems to hamper research in this field, since the studies found were few, relatively old and
only conducted between 1990 and 1996.
3.2. Discussion of methodological differences
The methodological differences were related to:
3.2.1. Inclusion criteria
Essock [11] required in his sample only inpatients that must have had a total hospitalization
of at least 24 months for the preceding 5 years as inclusion criteria. It is clear that in such sample
the prevalence of TRS will be overestimated. By applying FDA criteria for eligibility to
Clozapine in this sample, Essock found the highest rate of TRS: 60%. Indeed, if outpatients
were including in the sample, prevalence of TRS would be less elevated. Essock [11] justified
such restrictive inclusion criteria by the fact "to ensure that Clozapine was most available for
Mental Disorders - Theoretical and Empirical Perspectives
2
[...]... Schizophr Bull (1995) , 21(1), 1-1 2 [51] Mcdonell, M, & Mcclellan, J (2007) Early-onset schizophrenia In E Mash & R Bark‐ ley (Eds.), Assessment of childhood disorders (4th ed., New York: Guilford Press., 52 6-5 50 17 18 Mental Disorders - Theoretical and Empirical Perspectives [52] Brickman, A M, Buchsbaum, M S, Shihabuddin, L, Byne, W, Newmark, R E, Brand, J, et al Thalamus size and outcome in schizophrenia... Psychiatry (2001) , 158, 114 0-1 142 [77] Mitelman, S A, & Buchsbaum, M S Very poor outcome schizophrenia: clinical and neuroimaging aspects Int Rev Psychiatry (2007) Aug;, 19(4), 34 5-5 7 19 20 Mental Disorders - Theoretical and Empirical Perspectives [78] Davis, K L, Buchsbaum, M S, Shihabuddin, L, Spiegel-cohen, J, Metzger, M, Frecska, E, et al Ventricular enlargement in poor-outcome schizophrenia Biological... for understanding the pathophysiology of schizophrenia J Clin Psychiatry (1996) suppl 9): 5-9 21 22 Mental Disorders - Theoretical and Empirical Perspectives [102] Robinson, D G, & Woerner, M G Alvir JMJ, Geisler S, Koreen A, Sheitman B et al P redictors of treatment response from a first episode of schizophrenia or schizoaffec‐ tive disorder Am J Psychiatry (1999) , 156, 54 4-5 49 [103] Andreasen, N... (1993) , 29, 30 9-3 14 [25] Van Putten, T, Marder, S R, & Mintz, J A controlled dose comparison of haloperidol in newly admitted schizophrenic patients Archives of General Psychiatry (1990) , 47, 75 4-7 58 15 16 Mental Disorders - Theoretical and Empirical Perspectives [26] Dixon, L B, Lehman, A F, & Levine, J Conventional antipsychotic medications for schizophrenia Schizophr Bull (1995) , 21, 56 7-5 77 [27] Shalev,... precipitating factors [35] and a history of substance abuse [6 7-7 0] were associated with poor response to treatment 7 8 Mental Disorders - Theoretical and Empirical Perspectives 4.3 Risk factors associated with cognitive deficits Several literature reviews have summarized the evidence for associations between functional outcome and cognitive deficits [7 1-7 3] These reviews have regarded ranks of functional outcome... experience and interfere with achieving value-based goals Errors in logic are the final problematic aspects of cognition to be addressed The most common errors in logic include: mind reading (assumption that others are reacting negatively without sufficient evidence); overgeneralization (specific events defines life in general); all-or-nothing thinking (events are 25 26 Mental Disorders - Theoretical and Empirical. .. Lieberman, J A Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis Am J Psychiatry (2005) Oct;, 162(10), 178 5-8 04 [98] Sheitman, B B, & Lieberman, J A The natural history and pathophysiology of treat‐ ment resistant schizophrenia J Psychiatr Res (1998) May-Aug;32( 3-4 ):14 3-5 0 [99] Lieberman, J A Neuroprotection: a new strategy in... [99] Finally, understanding the mechanism by which duration of untreated psychosis influences prognosis may lead to better understanding of the pathophysiology of schizophrenia and to improved current treatment strategies [97] 11 12 Mental Disorders - Theoretical and Empirical Perspectives 4.8.2 Cognitive deficits Cognitive impairment has emerged as an important new target in schizophrenia therapeutics... 149 9-5 07 [113] Goff, D C Coyle JT: The emerging role of glutamate in the pathophysiology and treatment of schizophrenia American Journal of Psychiatry (2001) , 158, 136 7-1 377 [114] Milev, P, Ho, B-C, & Andreasen, N Predictive values of neurocognition and negative symptomes on functional outcome in schizophrenia: A longitudinal first-episode study with 7 year follow-up Am J Psychiatry (2005) , 162, 49 5-5 06... time to remission over three successive psychotic episodes and found that the time to reach remission more than tripled be‐ tween the first and third episode 9 10 Mental Disorders - Theoretical and Empirical Perspectives Moreover, the absence of a significant and rapid reduction of symptoms during the first days of neuroleptic treatment (3 to 7 days) [60], the dysphoric subjective response type at . MENTAL DISORDERS -
THEORETICAL AND
EMPIRICAL PERSPECTIVES
Edited by Robert Woolfolk and Lesley Allen
Mental Disorders - Theoretical and Empirical Perspectives
http://dx.doi.org/10.5772/46217
Edited. orders@intechopen.com
Mental Disorders - Theoretical and Empirical Perspectives, Edited by Robert Woolfolk and Lesley Allen
p. cm.
ISBN 97 8-9 5 3-5 1-0 91 9-8
free online
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