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The Intelligent Clinician's Guide to the DSM-5 explores all revisions to the latest version of the Diagnostic and Statistics Manual, and shows clinicians how they can best apply the strong points and shortcomings of psychiatry's most contentious resource. Written by a celebrated professor ofpsychiatry, this reader-friendly book uses evidence-based critiques and new research to point out where DSM-5 is right, where it is wrong, and where the jury's still out. Along the way, The Intelligent Clinician's Guide to the DSM-5 sifts through the many public controversies and clinical debatessurrounding the drafting of the manual and shows how they inform a modern understanding of psychiatric illness, diagnosis and treatment. This book is necessary reading for all mental health professionals as they grapple with the first major revision of the DSM to appear in over 30 years.
In 2013, the American Psychiatric Association published the 5th edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Often referred to as the "bible" of psychiatry, the manual only classifies mental disorders and does not explain them or guide their treatment. While science should be the basis of any diagnostic system, to date, there is no knowledge on whether most conditions listed in the manual are true diseases. Moreover, in DSM-5 the overall definition of mental disorder is weak, failing to distinguish psychopathology from normality. In spite of all the progress that has been made in neuroscience over the last few decades, the psychiatric community is no closer to understanding the etiology and pathogenesis of mental disorders than it was fifty years ago. In Making the DSM-5, prominent experts delve into the debate about psychiatric nosology and examine the conceptual and pragmatic issues underlying the new manual. While retracing the historic controversy over DSM, considering the political context and economic impact of the manual, and focusing on what was revised or left unchanged in the new edition, this timely volume addresses the main concerns of the future of psychiatry and questions whether the DSM legacy can truly improve the specialty and advance its goals.
Normal0falsefalsefalseMicrosoftInternetExplorer4Organizing a vast body of scientific literature, this indispensable book presents the state of the art in understanding borderline personality disorder (BPD) and distills key treatment principles that therapists need to know. Rather than advocating a particular approach, Joel Paris examines a range of therapies and identifies the core ingredients of effective intervention. He offers specific guidance for meeting the needs of this challenging population, including ways to improve diagnosis, promote emotion regulation and impulse control, maintain appropriate therapeutic boundaries, and deal with suicidality and other crises. Highly readable, practical, and humane, the book also explains the latest thinking on the causes of BPD and how it develops.
"Dr. Paris has written an honest, balanced presentation of the ways in which psychiatric drugs are evaluated and prescribed. He highlights the complexity of the task, the limits of what is known and the mixed picture that research often produces. His conclusions are refreshing because they are built from an even-handed, pragmatic assessment of the empirical evidence. The result is a stimulating look at the world of treatments for emotional disorders that acknowledges the usefulness of both biological and psychosocial explanations where appropriate. His recommendations provide helpful roadmaps for patients, practitioners and researchers alike. The book is sure to serve as a welcome catalyst for the continuing debates about which treatments are likely to produce the best outcomes."--Roger P. Greenberg, Ph.D. Distinguished Professor and Head, Psychology Division Dept. of Psychiatry & Behavioral Science SUNY Upstate Medical University, NY, USAThe message of this book is that psychiatrists have some very good drugs, but can expect bad results when they are over-used, prescribed outside of evidence-based indications, or given to the wrong patients. While acknowledging that many current agents are highly effective and have revolutionized the treatment of certain disorders, Joel Paris criticizes their use outside of an evidence base. Too many patients are either over-medicated or are misdiagnosed to justify aggressive treatment. Dr. Paris calls for more government funding of clinical trials to establish, without bias, the effectiveness of these agents. He has written this book for practitioners and trainees to show that scientific evidence supports a more cautious and conservative approach to drug therapy.After describing the history of psychopharmacology, including its early successes, Dr. Paris reviews the relationship between psychiatry and the pharmaceutical industry. This problem has received considerable popular attention in recent years and Dr. Paris documents initiatives to increase transparency and decrease the influence of pharmaceutical marketing on diagnosis and prescribing habits.Dr Paris then examines some major controversies. One is the fact that newer drugs have not been shown to be superior to older agents. Another is that while the number of prescriptions for antidepressants has increased dramatically, meta-analyses show that their value is more limited than previously believed. Still another is the widespread prescription of mood stabilizers and antipsychotic drugs for patients, including children and adolescents, who do not have bipolar illness. Polypharmacy is an especially contentious area: very few drug combinations have been tested in clinical trials, yet many patients end up on a cocktail of powerful drugs, each with its own side effects.Dr Paris briefly considers alternatives to pharmacology and again calls for more clinical trials of these approaches. He also discusses the current trend to medicalizing what many would describe as normal distress and states succinctly: Some things in life are worth being upset about.
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