Clinical PsychiatryPDF电子书下载

CHAPTER Ⅰ INTRODUCTION 1

The Foundations of Psychiatry 1

Diagnosis 6

The Field of Psychiatry 8

Psychiatry and Medicine 9

Psychiatry and Sociology 9

Psychiatry and Psychology 10

Contemporary Schools of Psychiatry 12

Kraepelin＇s System and its Influence 12

Wernicke and the Cerebral Localizers 14

Psychobiology 15

Psychoanalysis 16

The Multidimensional Approach 24

CHAPTER Ⅱ EXAMINATION OF THE PSYCHIATRIC PATIENT 31

Introductory 31

History 35

Mental State 37

Scheme for Case-Taking 39

History 39

Mental State 41

Examination of Non-co-operative or Stuporose Patients 43

Schema for the Examination of Organic Cases 45

CHAPTER Ⅲ MENTAL DEFICIENCY 53

Definitions and Classifications 53

Incidence 55

Aetiology and Pathology 55

Genetical Aspects of Mental Defect 55

Aetiology and Pathology other than Genetical 64

Clinical Features 68

Early Diagnosis 68

Disorders of Development 69

The Feeble-Minded (Moron) 71

The Low-Grade Mental Defective (Imbecility) 75

Idiocy 77

Special Forms of Mental Deficiency 78

Other Forms of Mental Defect with a Definite Pathology 81

Diagnosis and Differential Diagnosis 84

Prognosis 86

Treatment 87

Prevention 87

Treatment and Training 89

CHAPTER Ⅳ PSYCHOPATHIC PERSONALITY AND NEUROTIC REACTIONS 91

Historical Development of the Concept of Psychopathy 91

Modern Development of the Concept of Psychopathy 94

Aetiological Aspects of Constitution 98

Heredity 98

Somatic Factors 102

Psychological Factors 104

Pathological Factors 105

Special Forms of Reaction and of Personality 109

The Depressive Reaction 109

The Neurasthenic Reaction 114

The Anxiety Reaction 117

Hysteria 123

Anorexia Nervosa 138

Obsessional States 140

Irritability 150

Hypochondriasis 154

The Paranoid Reaction 157

The Unstable Drifter 164

The Cold and the Emotionally Callous 166

The Sexually Perverse 169

Psychological Treatment of Neurosis and Psychopathy 181

Group Therapy 184

CHAPTER Ⅴ AFFECTIVE DISORDERS 187

Definition 187

Incidence and Aetiology 187

Basic Personality 190

Precipitation 191

Physical Constitution 191

Pathology and Psychopathology 193

Clinical Picture 196

Affective Constitutions 196

Affective Psychoses 197

Course and Prognosis 206

Diagnosis and Differential Diagnosis 208

Treatment 211

CHAPTER ⅥSCHIZOPHRENIA 218

Definition 218

Incidence 219

Aetiology and Pathology 219

(1) Heredity 219

(2) The Schizoid Constitution 221

(3) Endocrines 223

(4) Metabolism 224

(5) Central Nervous System 225

(6) Precipitation 226

Psychopathology 230

(1) Disturbance of Thinking 231

(2) Disturbance of Emotions 234

(3) Disturbances of Volition 235

(4) Catatonic Symptons 236

(5) Primary Delusions 237

(6) Hallucinations 238

Occurrence of Symptoms：General Qualities 240

Clinical Picture 242

(1) Simple Schizophrenia 242

(2) Hebephrenic Schizophrenia 244

(3) Catatonic Schizophrenia 248

(4) Paranoid Schizophrenia 252

(5) Atypical and Mixed Clinical Pictures 258

Outcome 262

Residual States，Deterioration，Death 262

Course and Prognosis 264

Pointers of Prognostic Significance 268

Diagnosis and Differential Diagnosis 270

Diagnostic Value of Symptoms 271

Differential Diagnosis 275

Treatment 277

(1) Prophylaxis 277

(2) Psychological and Social Treatment 280

(3) Physical Treatment 283

CHAPTER Ⅶ SYMPTOMATIC PSYCHOSES 291

Aetiology and Pathology 291

Clinical Picture 294

(1) General 294

(2) Special Clinical Features in Various Physical Conditions 298

Course and Prognosis 315

Diagnosis and Differential Diagnosis 315

Treatment 316

CHAPTER Ⅷ CHEMICAL INTOXICATIONS AND ADDICTIONS 318

Anoxaemia 318

Carbon Monoxide Poisoning 320

Chronic Carbon Monoxide Poisoning 322

Cyanide 323

Industrial Intoxications 323

Lead 323

Mercury 324

Manganese 324

Arsenic 324

Other Industrial Poisons 325

Alcohol and Alcoholism 325

Incidence 326

Aetiology and Pathology 329

Clinical Picture 331

The Diagnosis of States of Alcoholic Aetiology 342

Treatment 343

Ether 347

Sedative Drugs：Bromides and Barbiturates 347

Bromides 348

Barbiturates 349

Amphetamine 351

Morphine 352

Cannabis 356

Cocaine 359

Mescaline 361

CHAPTER Ⅸ THE EPILEPSIES 365

Definition 365

Physiological Basis 366

Incidence 369

Aetiology 369

Heredity 370

Associations 372

Clinical Manifestations 374

Major Epilepsy (Grand Mal) 374

Petit Mal 377

Mood Changes 378

Psychomotor Attacks，Automatisms，Twilight States and Fugues 379

Epileptic Psychoses 382

Personality Deterioration and Dementia 383

Differential Diagnosis 386

Treatment 388

CHAPTER Ⅹ MENTAL DISORDER IN TRAUMA，INFECTION AND TUMOUR OF THE BRAIN 392

Introductory 392

Psychological Changes Produced by Organic Brain Disease 393

Clouding of Consciousness 393

The Dysmnesic Syndrome 394

Dementia 394

The General Behaviour of the Patient with Organic Disease of the Brain 396

Injuries of the Brain 398

Aetiology and Pathology 398

Mental Symptoms in the Acute Stage 399

The Convalescent Stage 401

The Chronic Stage 402

Differential Diagnosis 409

Prognosis and Treatment 410

Meningitis 412

Acute Meningitis 412

Tuberculous Meningitis 412

Encephalitis 413

Sub-acute Encephalitis 414

Epidemic Encephalitis 415

Paralysis Agitans 418

Hepato-lenticular Degeneration (Wilson＇s Disease) 419

Syphilis of the Central Nervous System 419

Psychological Reactions to Infection 419

Mental Changes in the Primary and Secondary Stages 420

Meningo-vascular Syphilis 420

Parenchymatous Syphilis 422

Prognosis and Treatment of Neurosyphilis 427

Cerebral Tumour 429

Incidence 429

General Features 431

Focal Symptoms 432

Diagnosis 441

Aids to Diagnosis 443

Treatment 444

Cerebral Abscess 444

Disseminated Sclerosis 444

Diagnosis 446

Treatment 446

CHAPTER Ⅺ AGEING AND THE MENTAL DISEASES OF THE AGED 448

General Aspects 448

Dementia in Middle Age 455

The Significance of Presenile Dementia 455

Alzheimer＇s Disease 457

Pick＇s Disease 460

Jakob-Creutzfeldt＇s Disease 462

Huntington＇s Chorea 463

Presenile Dementia with Cerebellar Atrophy 467

Dementia due to Thalamic Degeneration 468

Kraepelin＇s Disease 468

Schilder＇s Disease 468

Marchiafava＇s Disease 468

Other Forms of Presenile Dementia 468

Investigation and Differential Diagnosis of Dementia in Middle Age 470

Mental Disease in Old Age 473

Introduction 473

The Natural History of the Five Main Groups of Old-Age Mental Disorder 475

Affective Psychosis 478

Senile Psychosis 482

Psychoses due to Cerebrovascular Disease 485

Aetiological Aspects 485

Morbid Anatomy 489

Clinical Picture 490

Diagnosis 494

Treatment 494

Cerebral Thromboangiitis Obliterans 496

Other Cerebrovascular Syndromes 498

Delirious States 498

Late Paraphrenia 501

Suicide in Old Age 502

General Management of Old Patients 504

CHAPTER Ⅻ CHILD PSYCHIATRY 507

Introductory 507

Incidence：Child Psychiatric Services 509

Psychiatric Examination of the Child 510

Mental Deficiency 511

Psychoneurotic Reactions and Psychopathic Personalities 512

The Parent-Child Relationship 513

Single Psychopathic Symptoms 514

Depressive and Neurasthenic Reactions 530

Fear Reactions and Anxiety 530

Hysteria 531

Irritability 533

Obsessional-Compulsive States 534

Affective Psychoses 535

Schizophrenia 536

Symptomatic Psychoses and Psychological Reactions to Physical Illness 538

Epilepsy and Other Organic Conditions 540

Epilepsy 540

Encephalitis 542

Early Dementias 542

Focal Symptoms 543

CHAPTER ⅩⅢ ADMINISTRATIVE AND LEGAL PSYCHIATRY 545

Voluntary Treatment 545

Procedure Governing Commitment 548

England and Wales 548

Scotland and Ireland 550

Scandinavian Countries 551

Switzerland，Germany and Austria 553

Other European Countries 554

United States of America 556

Considerations for Reform of Present Procedures 557

Mental Deficiency 559

Boarding-out and Guardianship 560

The Organization and Administration of Psychiatric Services 562

The Mental Patient in Civil Law 563

Marriage and Divorce 564

Sterilization 565

Criminal Responsibility 567

England 567

Scotland 571

United States of America 572

Scandinavian Countries 574

Other European Countries 576

Possible Improvement of the British System 577