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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
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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

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 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
9 Coping with Medical Illness and Psychotherapy of PART VIII
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

Oliver Freudenreich, Donald C. Goff and David C. Henderson
Psychiatric Disorders, 247
23 Impulse-Control Disorders, 247 43 Antidepressants, 489
Maurizio Fava and George I. Papakostas
Anna R. Weissman, Cathleen M. Gould and Kathy M. Sanders

24 Somatic Symptom Disorders, 255 44 Pharmacological Approaches to Treatment-Resistant

Ted Avi Gerstenblith and Nicholas Kontos
Depression, 506
Ji Hyun Baek, Andrew A. Nierenberg and Maurizio Fava
25 Factitious Disorders and Malingering, 265
Felicia A. Smith
45 Electroconvulsive Therapy, 510
Charles A. Welch
26 Alcohol-Related Disorders, 270
John F. Kelly and John A. Renner
46 Neurotherapeutics, 518
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
Maurizio Fava, Søren Dinesen Østergaard and Paolo Cassano
49 Pharmacotherapy of Attention-Deficit/Hyperactivity
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
36 Sexual Disorders and Sexual Dysfunction, 402 Psychosomatic Medicine, 599
Linda C. Shafer 54 Psychiatric Consultation to Medical and Surgical
37 Eating Disorders: Evaluation and Patients, 599
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
38 Grief, Bereavement, and Adjustment Disorders, 428 Syndrome, 608
Gregory L. Fricchione, Scott R. Beach, Jeff C. Huffman,
Alicia D. Powell
George Bush and Theodore A. Stern
39 Personality and Personality Disorders, 433
Mark A. Blais, Patrick Smallwood, James E. Groves,
56 Psycho-oncology: Psychiatric Co-morbidities and
Rafael A. Rivas-Vazquez and Christopher J. Hopwood
Complications of Cancer and Cancer
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
Rebecca Weintraub Brendel 76 Clinical Neurophysiology and
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
Albert S. Yeung and Trina E. Chang 78 Differential Diagnosis and Treatment of
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

66 Culture and Psychiatry, 718 PART XIX

David C. Henderson, Brenda Vincenzi, Albert S. Yeung and Law and Psychiatry, 897
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
PART XVIII Care in Special Settings, 937
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
 List of Contributors

Robert S. Abernethy III, MD Ji Hyun Baek, MD Eugene V. Beresin, MD

Psychiatrist Research Fellow Senior Educator in Child and
Massachusetts General Hospital Massachusetts General Hospital Adolescent Psychiatry Massachusetts
Assistant Professor Boston, MA, USA General Hospital Executive Director
Department of Psychiatry Ch 44 Pharmacological Approaches to Massachusetts General Hospital Clay
Harvard Medical School Treatment-Resistant Depression Center for Young Healthy Minds
Boston, MA, USA Professor of Psychiatry
Lee Baer, PhD
Ch 10 An Overview of the Psychotherapies Harvard Medical School
Associate Chief of Psychology
Department of Psychiatry Massachusetts
Annah N. Abrams, MD Department of Psychiatry
General Hospital
Director, Pediatric Psycho-oncology Massachusetts General Hospital
Boston MA, USA
Massachusetts General Hospital Clinical Professor of Psychology
Ch 01 The Doctor–Patient Relationship
Assistant Professor of Psychiatry Harvard Medical School
Ch 02 The Psychiatric Interview
Harvard Medical School Boston, MA, USA
Ch 93 Psychiatry and the Media
Boston, MA, USA Ch 15 Hypnosis
Ch 5 Child, Adolescent, and Adult Ch 62 Statistics in Psychiatric Research Matt Bianchi MD
Development Director, Sleep Division
Scott R. Beach, MD
† Massachusetts General Hospital
Anne Alonso, PhD, CGP, DFAGPA Associate Training Director
Assistant Professor of Neurology
Director, The Center for Psychoanalytic MGH/McLean Adult Psychiatry
Harvard Medical School
Studies and The Endowment for the Residency Program
Boston, MA, USA
Advancement of Psychotherapy Assistant Psychiatrist
Ch 22 Sleep Disorders
Massachusetts General Hospital Acute Psychiatric and Consultation-
Clinical Professor of Psychology Liaison Services Joseph Biederman, MD
Department of Psychiatry Massachusetts General Hospital Director of the Joint Program in
Harvard Medical School Assistant Professor of Psychiatry Pediatric Psychopharmacology
Boston, MA, USA Harvard Medical School McLean and Massachusetts General
Boston, MA, USA Hospital
Menekse Alpay, MD
Ch 51 Side Effects of Psychotropic Professor of Psychiatry
Clinical Assistant
Medications Harvard Medical School
Department of Psychiatry
Ch 55 Life-threatening Conditions in Boston, MA, USA
Massachusetts General Hospital
Psychiatry: Catatonia, Neuroleptic Ch 49 Pharmacotherapy of Attention-
Instructor
Malignant Syndrome, and Serotonin Deficit/Hyperactivity Disorder across the
Department of Psychiatry
Syndrome Life Span
Harvard Medical School
Boston, MA, USA BJ Beck, MSN, MD Mark A. Blais, PsyD
Ch 79 Pathophysiology, Psychiatric Staff, Robert B. Andrews Unit Director, Psychological Evaluation and
Co-morbidity, and Treatment of Pain Massachusetts General Hospital Research Laboratory
Assistant Professor, Part-Time, Massachusetts General Hospital
Jonathan E. Alpert, MD, PhD
Department of Psychiatry Associate Professor of Psychology
Associate Chief of Psychiatry for
Harvard Medical School Harvard Medical School
Clinical Services
Boston, MA, USA Boston, MA, USA
Director, Depression Clinical and
Ch 21 Mental Disorders Due to Another Ch 7 Understanding and Applying
Research Program
Medical Condition Psychological Assessment
Massachusetts General Hospital
Ch 59 Approaches to Collaborative Care Ch 11 Brief Psychotherapy: An Overview
Joyce R. Tedlow Associate Professor of
and Primary Care Psychiatry Ch 39 Personality and Personality
Psychiatry
Ch 67 Community Psychiatry Disorders
Harvard Medical School
Ch 83 Intimate Partner Violence
Boston, MA, USA
Ch 50 Drug–Drug Interactions in David M. Benedek, MD
Psychopharmacology Deputy Chair
Department of Psychiatry
Uniformed Services University
Bethesda, MD, USA
Ch 90 Military Psychiatry

x
 List of Contributors xi

Christina P.C. Borba, PhD, MPH Eric Bui, MD, PhD Christopher Carter, PsyD
Director of Research Center for Anxiety and Traumatic Stress Director, Behavioral Medicine
The Chester M. Pierce, M.D. Division of Disorders Spaulding Rehabilitation Hospital
Global Psychiatry Massachusetts General Hospital/ Clinical Assistant in Psychology
Massachusetts General Hospital Harvard Medical School Clinical Psychologist
Assistant Professor of Psychology in Boston, MA, USA Massachusetts General Hospital
Psychiatry Ch 32 Anxiety Disorders Clinical Instructor, Department of
Harvard Medical School Ch 41 The Pharmacotherapy of Anxiety Psychology
Boston, MA, USA Disorders Harvard Medical School
Ch 94 Global Mental Health in the Boston, MA, USA
George Bush, MD, MMSc
Twenty-First Century Ch 82 Psychiatric Manifestations of
Director, Massachusetts General
Traumatic Brain Disorder
Jeff Q. Bostic, MD, EdD Hospital Cingulate Cortex Research
Director, School Psychiatry Laboratory Paolo Cassano, MD, PhD
Massachusetts General Hospital Assistant Director, MGH Psychiatric Depression Clinical and Research
Yawkey Center for Outpatient Care Neuroimaging Research Program Program (DCRP)
Associate Clinical Professor of Associate Professor of Psychiatry, Massachusetts General Hospital
Psychiatry Harvard Medical School Instructor in Psychiatry
Harvard Medical School Boston, MA, USA Harvard Medical School
Boston, MA, USA Ch 55 Life-threatening Conditions in Boston, MA, USA
Ch 69 Child and Adolescent Psychiatric Psychiatry: Catatonia, Neuroleptic Ch 29 Mood Disorders: Depressive
Disorders Malignant Syndrome, and Serotonin Disorders (Major Depressive Disorder)
Syndrome
Rebecca Weintraub Brendel MD, JD Ned H. Cassem, MA, PhL, MD, SJ, BD
Clinical Director David C. Buxton, MD Senior Psychiatrist (Retired)
Red Sox Foundation and Massachusetts Fellow in Child and Adolescent Massachusetts General Hospital
General Hospital Home Base Program Psychiatry Professor Emeritus of Psychiatry
Assistant Professor of Psychiatry Massachusetts General Hospital and Harvard Medical School
Harvard Medical School McLean Hospital and Harvard Boston, MA
Boston, MA, USA Medical School Ch 18 Delirium
Ch 53 The Suicidal Patient Boston, MA, USA Ch 60, Psychiatric and Ethical Aspects of
Ch 60 Psychiatric and Ethical Aspects of Ch 69 Child and Adolescent Psychiatric Care at the End of Life
Care at the End of Life Disorders
Trina E. Chang, MD, MPH
Ch 84 Psychiatric Correlates and
Amanda W. Calkins, PhD Director of Community-Based Studies
Consequences of Abuse and Neglect
Center for Anxiety and Traumatic Stress Depression Clinical and Research
Ch 86 The Role of Psychiatrists in the
Disorders, Program
Criminal Justice System
Massachusetts General Hospital/ Massachusetts General Hospital
Ch 87 Legal and Ethical Issues in
Harvard Medical School, Instructor in, Department of Psychiatry
Psychiatry II: Malpractice and Boundary
Boston, MA, USA Harvard Medical School
Violations
Ch 32 Anxiety Disorders Boston, MA , USA
Megan Moore Brennan, MD Ch 61 Psychiatric Epidemiology
Joan A. Camprodon, MD, MPH, PhD
Attending Psychiatrist
Director, Laboratory for Marni Chanoff, MD
Bassett Medical Center
Neuropsychiatry and Clinical Associate
Assistant Clinical Professor, Columbia
Neuromodulation McLean Hospital
University College of Physicians and
Director, Transcranial Magnetic Instructor in Psychiatry
Surgeons
Stimulation Clinical Service Harvard Medical School
Cooperstown, NY, USA
Massachusetts General Hospital Boston, MA, USA
Ch 4 Treatment Adherence
Instructor of Psychiatry Ch 14 Group Psychotherapy
Christina A. Brezing, MD Harvard Medical School Ch 91 Disaster Psychiatry
Clinical and Research Fellow Boston, MA
Lee S. Cohen, MD
Division of Substance Abuse Ch 40 Psychiatric Neuroscience:
Director, Center for Women’s Mental
Department of Psychiatry Incorporating Pathophysiology into
Health
Columbia University College of Clinical Case Formulation
Perinatal and Reproductive Psychiatry
Physicians and Surgeons Ch 46 Neurotherapeutics
Clinical Research Program
New York, NY, USA Ch 72 Neuroanatomical Systems Relevant
Massachusetts General Hospital
Ch 53 The Suicidal Patient to Neuropsychiatric Disorders
Professor of Psychiatry
Hannah E. Brown, MD Jason P. Caplan, MD Harvard Medical School
Schizophrenia Program Massachusetts Chair, Department of Psychiatry Boston, MA, USA
General Hospital Associate Professor of Psychiatry Ch 31 Psychiatric Illness during Pregnancy
Instructor in Psychiatry, Harvard Creighton University School of and the Postpartum Period
Medical School Medicine at St. Joseph’s Hospital and
Boston, MA, USA Medical Center
Ch 28 Psychosis and Schizophrenia Phoenix, AZ, USA
Ch 18 Delirium
xii List of Contributors

M. Cornelia Cremens, MD, MPH Darin D. Dougherty, MD, MSc William E. Falk, MD
Director, Inpatient Geriatric Psychiatry Director, Division of Neurotherapeutics Director, Geriatric Psychiatry
Massachusetts General Hospital Massachusetts General Hospital Department of Psychiatry
Assistant Professor, Department of Associate Professor of Psychiatry Massachusetts General Hospital
Psychiatry Harvard Medical School Assistant Professor in Psychiatry
Harvard Medical School Boston, MA, USA Harvard Medical School
Boston, MA, USA Ch 33 Obsessive-compulsive Disorder and Boston, MA, USA
Ch 71 Geriatric Psychiatry Obsessive-compulsive and Related Ch 19 Dementia
Disorders
Sharon Dekel, PhD Maurizio Fava, MD
Ch 46 Neurotherapeutics
Research, Department of Psychiatry Director, Clinical Research Program
Ch 75 Neuroimaging in Psychiatry
Massachusetts General Hospital and Executive Vice-Chair, Department of
Harvard Medical School Simon Ducharme MD, MSc Psychiatry
Boston, MA, USA Sidney R. Baer Fellow in Behavioral Executive Director, Clinical Trials
Ch 34 Trauma and Posttraumatic Stress Neurology and Neuropsychiatry Network and Institute
Disorder Department of Neurology Massachusetts General Hospital
McLean Hospital Slater Family Professor of Psychiatry,
Hannah Delong, BA
Belmont, MA, USA Harvard Medical School
Research Coordinator
Research Fellow, Department of Boston, MA, USA
Massachusetts General Hospital
Psychiatry and Neurology Ch 6 Diagnostic Rating Scales and
Boston, MA, USA
Massachusetts General Hospital Psychiatric Instruments
Ch 41 The Pharmacotherapy of Anxiety
Harvard Medical School Ch 29 Mood Disorders: Depressive
Disorders
Boston, MA, USA Disorders (Major Depressive Disorder)
Jennifer L. Derenne, MD Ch 74 Neuropsychiatric Principles and Ch 43 Antidepressants
Clinical Associate Professor of Differential Diagnosis Ch 44 Pharmacological Approaches to
Psychiatry and Behavioral Sciences Treatment-Resistant Depression
Daniel H. Ebert, MD, PhD
Division of Child and Adolescent
Assistant in Psychiatry Carlos Fernandez-Robles, MD
Psychiatry
Massachusetts General Hospital Associate Director, Center for Psychiatry
Stanford University School of Medicine
Instructor in Neurobiology Oncology and Behavioral Sciences
Stanford, CA, USA
Harvard Medical School Assistant Psychiatrist, The
Ch 37 Eating Disorders: Evaluation and
Boston, MA, USA Avery D. Weisman
Management
Ch 63 Genetics and Psychiatry MD, Psychiatry Consultation Service
Bradford C. Dickerson, MD, MMSc Somatic Therapies Service
Kamryn T. Eddy, PhD
Co-Director, Neuroimaging Group Massachusetts General Hospital
Co-Director, Eating Disorders Clinical
Gerontology Research Unit Instructor, Department of Psychiatry
and Research Program
Department of Psychiatry Harvard Medical School
Massachusetts General Hospital
Clinical Director, Morphometry Service Boston, MA, USA
Assistant Professor of Psychiatry
Department of Neurology Ch 56 Psycho-oncology: Psychiatric
(Psychology)
Staff Behavioral Neurologist, Memory Co-morbidities and Complications of
Harvard Medical School
Disorders Unit Cancer and Cancer Treatment
Boston, MA, USA
Alzheimer’s Disease Research Center
Ch 37 Eating Disorders: Evaluation and Christine T. Finn, MD
Department of Neurology
Management Director, Psychiatry Residency Training
Massachusetts General Hospital
Program
Assistant Professor, Department of Judith G. Edersheim, JD, MD
Director, Crises and Consultation
Neurology Co-Director, Center for Law
Service
Harvard Medical School Brain & Behavior
Assistant Professor of Psychiatry
Boston, MA, USA Massachusetts General Hospital
Giesel School of Medicine at
Ch 72 Neuroanatomical Systems Relevant Assistant Clinical Professor of
Dartmouth
to Neuropsychiatric Disorders Psychiatry
Lebanon, NH, USA
Harvard Medical School
Abigail L. Donovan, MD Ch 63 Genetics and Psychiatry
Boston, MA, USA
Department of Child and Adolescent
Ch 85 Legal and Ethical Issues in Anne K. Fishel, PhD
Psychiatry
Psychiatry I: Informed Consent, Director, Family and Couples Therapy
Massachusetts General Hospital
Competency, Treatment Refusal, and Program
Assistant Professor of Psychiatry
Civil Commitment Massachusetts General Hospital
Harvard Medical School
Associate Clinical Professor of
Boston, MA, USA A. Evan Eyler, MD, MPH
Psychology
Ch 17 The DSM-5: A System for Associate Professor, Departments of
Harvard Medical School
Psychiatric Diagnosis Psychiatry and Family Medicine
Boston, MA, USA
Ch 92 Coping with the Rigors of University of Vermont College of
Ch 12 Couples Therapy
Psychiatric Practice Medicine
Ch 13 Family Therapy
Burlington, VT, USA
Ch 89 Rehabilitation Psychiatry
 List of Contributors xiii

Alice W. Flaherty, MD, PhD Adrienne T. Gerken, MD Donna B. Greenberg, MD

Neurologist, Massachusetts General Resident in Psychiatry Psychiatrist, Center for Psychiatry
Hospital Massachusetts General Hospital and Oncology and Behavioral Sciences
Associate Professor of Neurology and McLean Hospital Massachusetts General Hospital
Psychiatry Clinical Fellow in Psychiatry Associate Professor of Psychiatry
Harvard Medical School Harvard Medical School Harvard Medical School
Boston, MA, USA Boston, MA, USA Boston, MA, USA
Ch 81 Movement Disorders Ch 65 Aggression and Violence Ch 56 Psycho-oncology: Psychiatric
Co-morbidities and Complications of
Oliver Freudenreich, MD Ted Avi Gerstenblith MD
Cancer and Cancer Treatment
Medical Director, Massachusetts Fellow in Psychosomatic Medicine
General Hospital Schizophrenia Massachusetts General Hospital David M. Greer, MD, MA, FCCM,
Program Clinical Fellow in Psychiatry FAHA, FNCS, FAAN
Associate Professor of Psychiatry Harvard Medical School Professor of Neurology and
Harvard Medical School Massachusetts General Hospital Neurosurgery
Boston, MA, USA Boston, MA, USA Vice Chairman of Neurology
Ch 28 Psychosis and Schizophrenia Ch 22 Sleep Disorders Yale University School of Medicine
Ch 42 Antipsychotic Drugs Ch 24 Somatic Symptom and Disorders New Haven, CT, USA
Ch 57 Psychiatric Aspects of HIV Infection Ch 80 Psychiatric Aspects of Stroke
Mark W. Gilbertson, PhD
and AIDS Syndromes
Psychologist, Veterans Affairs Medical
Ch 64 Serious Mental Illness
Center Anne F. Gross MD
Gregory L. Fricchione, MD Manchester, NH, USA Assistant Professor of Psychiatry
Associate Chief of the Department of Instructor in Psychology, Department of Associate Residency Training Director
Psychiatry Psychiatry Oregon Health & Science University
Massachusetts General Hospital Brigham and Women’s Hospital and Portland, Oregon, USA
Director, Division of Psychiatry and Harvard Medical School Ch 65 Aggression and Violence
Medicine Boston, MA, USA
James E. Groves, MD
Director, Benson-Henry Institute for Ch 34 Trauma and Posttraumatic Stress
Psychiatry Service
Mind Body Medicine Disorder
Massachusetts General Hospital
Director, Psychosomatic Medicine
Donald C. Goff, MD Associate Clinical Professor of
Postdoctoral Fellowship
Director, Nathan Kline Institute for Psychiatry
Senior Scientist, Pierce Division of
Psychiatric Research Harvard Medical School
Global Psychiatry
Vice Chair of Psychiatry Boston, MA, USA
Professor of Psychiatry
NYU Langone Medical Center Ch 9 Coping with Medical Illness and
Harvard Medical School
Marvin Stern Professor of Psychiatry Psychotherapy of the Medically Ill
Boston, MA, USA
NYU School of Medicine Ch 11 Brief Psychotherapy: An Overview
Ch 55 Life-threatening Conditions in
New York City, NY, USA Ch 39 Personality and Personality
Psychiatry: Catatonia, Neuroleptic
Ch 42 Antipsychotic Drugs Disorders
Malignant Syndrome, and Serotonin
Syndrome Christopher Gordon, MD Eric P. Hazen, MD
Ch 66 Culture and Psychiatry Assistant Psychiatrist Director, Child and Adolescent
Ch 94 Global Mental Health in the Massachusetts General Hospital Psychiatry Consultation-Liaison
Twenty-First Century Medical Director and Senior Vice Service
President for Clinical Services Massachusetts General Hospital
Jennifer R. Gatchel, MD PhD
Advocates, Inc Associate Training Director
Chief Resident in Psychopharmacology
Associate Clinical Professor of Massachusetts General Hospital/McLean
Massachusetts General Hospital and
Psychiatry Child and Adolescent Psychiatry
McLean Hospital Adult Psychiatry
Harvard Medical School Program
Residency Program,Harvard Medical
Boston, MA, USA Instructor in Psychiatry
School
Ch 1 The Doctor–Patient Relationship Harvard Medical School
Boston, MA, USA
Ch 2 The Psychiatric Interview Boston, MA, USA
Ch 19 Dementia
Ch 05 Child, Adolescent, and Adult
Cathleen M. Gould, MD
Anna M. Georgiopoulos, MD Development
Residency Training Director
Department of Child and Adolescent
Department of Psychiatry Sean P. Heffernan, MD
Psychiatry
Rush University Medical Center Alexander Wilson Schweizer Fellow
Massachusetts General Hospital
Assistant Professor of Psychiatry Department of Psychiatry and
Assistant Professor of Psychiatry, Part
Rush Medical College Behavioral Sciences
Time
Chicago, IL, USA Johns Hopkins Hospital
Harvard Medical School
Ch 23 Impulse-Control Disorders Johns Hopkins University School of
Boston, MA, USA
Medicine
Ch 17 The DSM-5: A System for
Baltimore, MD, USA
Psychiatric Diagnosis
Ch 80 Psychiatric Aspects of Stroke
Syndromes
xiv List of Contributors

David C. Henderson, MD Honor Hsin, MD, PhD Jesse M. Katon

Director, Schizophrenia Clinical and Resident in Psychiatry Intern, Massachusetts General Hospital
Research Program Department of Psychiatry and Boston, MA, USA
Director, Chester M. Pierce, M.D. Behavioral Sciences Ch 94 Global Mental Health in the
Division of Global Psychiatry Stanford University School of Medicine Twenty-First Century
Associate Professor of Psychiatry Stanford, CA, USA
Navneet Kaur, BS
Massachusetts General Hospital Ch 48 The Use of Antiepileptic Drugs in
Clinical Research Coordinator
Harvard Medical School Psychiatry
Laboratory for Neuropsychiatry and
Boston, MA, USA
Jeff C. Huffman, MD Neuromodulation
Ch 42 Antipsychotic Drugs
Director, Cardiac Psych Inpatient Division of Neurotherapeutics
Ch 66 Culture and Psychiatry
Program, MGH Massachusetts General Hospital
Ch 94 Global Mental Health in the
Medical Director, Inpatient Psychiatry Boston, MA, USA
Twenty-First Century
Massachusetts General Hospital Ch 46 Neurotherapeutics
John B. Herman, MD Associate Professor of Psychiatry,
John F. Kelly, PhD
Associate Chief of Psychiatry Harvard Medical School
Program Director, Addiction Recovery
Massachusetts General Hospital Boston, MA, USA
Management Service
Associate Professor of Psychiatry Ch 51 Side Effects of Psychotropic
Massachusetts General Hospital
Harvard Medical School Medications
Elizabeth R. Spallin Associate Professor
Boston, MA, USA Ch 55 Life-threatening Conditions in
of Psychiatry in Addiction Medicine
Ch 4 Treatment Adherence Psychiatry: Catatonia, Neuroleptic
Harvard Medical School
Malignant Syndrome, and Serotonin
José A. Hidalgo, MD Boston, MA, USA
Syndrome
Psychiatrist at the Law and Psychiatry Ch 26 Alcohol-Related Disorders
Ch 80 Psychiatric Aspects of Stroke
Service
Syndromes Alex S. Keuroghlian, MD MSc
Massachusetts General Hospital
Clinical Fellow in Psychiatry
Instructor of Psychiatry, Harvard Lucy A. Epstein Hutner, MD
Massachusetts General Hospital
Medical School Associate Director, Psychiatry Residency
Harvard Medical School
Boston, MA, USA Training Program
Boston, MA, USA
Ch 85 Legal and Ethical Issues in Assistant Professor of Psychiatry
Ch 15 Hypnosis
Psychiatry I: Informed Consent, New York University School of
Competency, Treatment Refusal, and Medicine Nancy J. Keuthen, PhD
Civil Commitment New York, NY, USA Director, Trichotillomania Program and
Ch 60 Psychiatric and Ethical Aspects of Chief Psychologist
John P. Hirdes, PhD
Care at the End of Life OCD and Related Disorders Program
Professor, School of Public Health and
Ch 80 Psychiatric Aspects of Stroke Department of Psychiatry
Health Systems
Syndromes Massachusetts General Hospital
University of Waterloo
Associate Professor
Waterloo, Ontario, Canada Ana Ivkovic, MD
Department of Psychology (Psychiatry)
Ch 89 Rehabilitation Psychiatry Assistant in Psychiatry
Harvard Medical School
Massachusetts General Hospital
Charlotte Hogan, MD Boston, MA, USA
Instructor in Psychiatry
Resident in Psychiatry Ch 33 Obsessive-compulsive Disorder and
Harvard Medical School
Massachusetts General Hospital and Obsessive-compulsive and Related
Boston, MA, USA
McLean Hospital Disorders
Ch 81 Movement Disorders
Clinical Fellow, Department of
Ch 88 Emergency Psychiatry Shahram Khoshbin, MD
Psychiatry
Neurologist, Brigham and Women’s
Harvard Medical School Michael A. Jenike, MD
Hospital
Boston, MA, USA Founder, OCD Program
Associate Professor of Neurology
Ch 3 Laboratory Tests and Diagnostic Massachusetts General Hospital
Harvard Medical School
Procedures Founder, OCD Institute
Boston, MA, USA
McLean Hospital
Daphne J. Holt, MD, PhD, Ch 76 Clinical Neurophysiology and
Professor of Psychiatry
Director of Research Electroencephalography
Harvard Medical School
Massachusetts General Hospital Ch 77 Psychiatric Manifestations and
Boston, Massachusetts, USA
Schizophrenia Program Treatment of Seizure Disorders
Ch 33 Obsessive-compulsive Disorder and
Assistant Professor of Psychiatry
Obsessive-compulsive and Related Gustavo Kinrys, MD
Harvard Medical School
Disorders Associate Medical Director
Boston, MA, USA
Clinical Trials Network and
Ch 28 Psychosis and Schizophrenia John N. Julian, MD, MS
Institute(CTNI)
Ch 72 Neuroanatomical Systems Relevant Assistant Child Psychiatrist
Bipolar Clinic and Research Program
to Neuropsychiatric Disorders McLean Hospital
(BCRP)
Belmont
Christopher J. Hopwood, PhD Massachusetts General Hospital
Assistant Professor, Part-Time
Associate Professor of Clinical Assistant Professor of Psychiatry
Department of Psychiatry
Psychology Harvard Medical School
Harvard Medical School
Michigan State University Boston, MA, USA
Boston, MA, USA
East Lansing, MI, USA Ch 41 The Pharmacotherapy of Anxiety
Ch 20 Intellectual Disability
Ch 39 Personality and Personality Disorders
Disorders
 List of Contributors xv

Anne Klibanski, MD Guy Maytal, MD Anna C. Muriel, MD, MPH

Chief, Neuroendocrine Unit Associate Director, Ambulatory Chief, Division of Pediatric
Massachusetts General Hospital Psychiatry Psychosocial Oncology
Laurie Carrol Guthart Professor of Director, Primary Care Psychiatry & Dana-Farber/ Children’s Hospital
Medicine Urgent Care Psychiatry Cancer and Blood Disorders Center
Harvard Medical School Massachusetts General Hospital Assistant Professor of Psychiatry
Boston, MA, USA Instructor in Psychiatry Harvard Medical School
Ch 37 Eating Disorders: Evaluation and Harvard Medical School Boston, MA, USA
Management Boston, MA, USA Ch 5 Child, Adolescent, and Adult
Ch 60 Psychiatric and Ethical Aspects of Development
Nicholas Kontos, MD
Care at the End of Life
Director of Transplantation Psychiatry Evan D. Murray, MD
Massachusetts General Hospital Jeanne McKeon, EdD Assistant in Neurology
Co-Associate Director Private Practice McLean Hospital
Psychosomatic Medicine Fellowship Marblehead Belmont, MA, USA
Program Massachusetts, USA Massachusetts General Hospital
Massachusetts General Hospital Ch 12 Couples Therapy Boston, MA, USA
Assistant Professor of Psychiatry Director, Traumatic Brain Injury Service
Diane W. Mickley MD, FACP, FAED
Harvard Medical School Manchester VA Medical Center
Founder and Director, Wilkins Center
Boston, MA, USA Manchester, New Hampshire, USA
for Eating Disorders
Ch 24 Somatic Symptom Disorders Instructor in Neurology
Clinical Associate Professor,
Ch 54 Psychiatric Consultation to Medical Harvard Medical School
Department of Psychiatry
and Surgical Patients Boston, MA, USA
Yale Medical School
Ch 73 The Neurological Examination
Lawrence Kutner, PhD Greenwich, CT, USA
Ch 74 Neuropsychiatric Principles and
Executive Director Ch 37 Eating Disorders: Evaluation and
Differential Diagnosis
Jack Kent Cooke Foundation Management
Lansdowne, VA, USA George B. Murray, BS, PhL, MS, MSc,
Nada Milosavljevic, MD, JD
Ch 93 Psychiatry and the Media MD†
Director, School-Based Integrative
Senior Psychiatrist (Retired)
Daniel Lafleur, MD Health Program
Massachusetts General Hospital
Child Psychiatry Clinician Scientist Massachusetts General Hospital
Associate Professor Emeritus of
Child and Youth Mental Health Instructor, Psychiatry
Psychiatry
Program Harvard Medical School
Harvard Medical School
British Columbia Children’s Hospital Boston, MA, USA
Boston, MA, USA
Department of Psychiatry Ch 84 Psychiatric Correlates and
Ch 18 Delirium
University of British Columbia Consequences of Abuse and Neglect
Vancouver, Canada Helen B. Murray, BA
David Mischoulon, MD, PhD
Ch 33 Obsessive-compulsive Disorder and Clinical Research Coordinator
Director of Research, Depression
Obsessive-compulsive and Related Eating Disorders Clinical and Research
Clinical and Research Program
Disorders Program
Department of Psychiatry
Massachusetts General Hospital
Isabel T. Lagomasino, MD, MSHS Massachusetts General Hospital
Boston, MA, USA
Director, Adult Psychiatry Residency Associate Professor of Psychiatry
Ch 37 Eating Disorders: Evaluation and
Training Program Harvard Medical School
Management
LAC + USC Medical Center Boston, MA, USA
Assistant Professor, Department of Ch 6 Diagnostic Rating Scales and Shamim H. Nejad, MD
Psychiatry and Behavioral Sciences Psychiatric Instruments Director, Adult Burns and Trauma
University of Southern California Ch 52 Natural Medications in Psychiatry Psychiatry
Keck School of Medicine Division of Psychiatry and Medicine
Richard F. Mollica MD, MAR
Los Angeles, CA, USA Psychiatry Consultation Service
Director, Harvard Program in Refugee
Ch 53 The Suicidal Patient Massachusetts General Hospital
Trauma
Assistant Professor of Psychiatry
Richard T. LeBeau, PhD Massachusetts General Hospital
Harvard Medical School
Department of Psychology Professor, Department of Psychiatry
Boston, MA, USA
University of California Harvard Medical School
Ch 79 Pathophysiology, Psychiatric
Los Angeles, CA, USA Boston, MA, USA
Co-morbidity, and Treatment of Pain
Ch 32 Anxiety Disorders Ch 94 Global Mental Health in the
Ch 80 Psychiatric Aspects of Stroke
Twenty-First Century
Catherine Leveroni, PhD Syndromes
Psychology Assessment Center
Massachusetts General Hospital
Assistant Professor of Psychiatry
Harvard Medical School
Boston, MA, USA
Ch 8 Neuropsychological Assessment
xvi List of Contributors

Stephen E. Nicolson, MD Dost Öngür, MD, PhD George I. Papakostas, MD

Director, Adult Psychiatry Consultation Chief Scientific Director
Service Psychotic Disorders Division Clinical Trials Network and Institute
Vanderbilt University Medical Center McLean Hospital Massachusetts General Hospital
Assistant Professor of Psychiatry Belmont, MA, USA Associate Professor of Psychiatry
Vanderbilt School of Medicine Associate Professor of Psychiatry Harvard Medical School
Nashville, Tennessee, USA Harvard Medical School Boston, MA, USA
Ch 78 Differential Diagnosis and Boston, MA, USA Ch 43 Antidepressants
Treatment of Headaches Ch 72 Neuroanatomical Systems Relevant
Roy H. Perlis, MD, MSc
to Neuropsychiatric Disorders
Andrew A. Nierenberg, MD Medical Director, Bipolar Clinic and
Associate Director, Depression Clinical Claire E. Oppenheim, BS Research Program
and Research Program Senior Clinical Research Coordinator Massachusetts General Hospital
Director, Bipolar Clinic and Research Schizophrenia Clinical and Research Associate Professor of Psychiatry
Program Program and The Chester M. Pierce Harvard Medical School
Director, Clinical Research Support MD Division of Global Psychiatry Boston, Massachusetts, USA
Office Department of Psychiatry Ch 30 Bipolar Disorder
Massachusetts General Hospital Massachusetts General Hospital Ch 47 Lithium and Its Role in Psychiatry
Professor of Psychiatry Boston, MA, USA Ch 53 The Suicidal Patient
Harvard Medical School Ch 94 Global Mental Health in the
William F. Pirl, MD, MPH
Boston, MA, USA Twenty-First Century
Director, Center for Psychiatry
Ch 44 Pharmacological Approaches to
Scott P. Orr, PhD Oncology and Behavioral Sciences
Treatment-Resistant Depression
Associate Professor of Psychology, Massachusetts General Hospital
Ruta M. Nonacs, MD, PhD Department of Psychiatry Associate Professor
Assistant Psychiatrist Massachusetts General Hospital and Department of Psychiatry
Massachusetts General Hospital Harvard Medical School Harvard Medical School
Instructor, Department of Psychiatry Boston, MA, USA Boston, MA, USA
Harvard Medical School Ch 34 Trauma and Posttraumatic Stress Ch 56 Psycho-oncology: Psychiatric
Boston, MA, USA Disorder Co-morbidities and Complications of
Ch 31 Psychiatric Illness during Pregnancy Cancer and Cancer Treatment
Michael J. Ostacher, MD, MPH, MMSc
and the Postpartum Period
Associate Director, Bipolar Disorder and Roger K. Pitman, MD
Ch 35 Dissociative Disorders
Depression Research Program, Professor of Psychiatry
Kevin M. O’Brien, EdD, MA VAPAHCS Director, MIRECC Fellowship Massachusetts General Hospital and
Director, Disaster Mental Health Program, Harvard Medical School
Services VAPAHCS Associate Professor of Boston, MA, USA
District of Columbia Psychiatry, Ch 34 Trauma and Posttraumatic Stress
Department of Behavioral Health Department of Psychiatry and Disorder
Washington, DC, USA Behavioral Sciences
Mark H. Pollack, MD
Ch 91 Disaster Psychiatry Stanford University School of Medicine
Department of Psychiatry
Palo Alto, CA, USA
Sheila M. O’Keefe, EdD Rush University Medical Center
Ch 30 Bipolar Disorder
Director of Psychology Training Chicago, IL, USA
Ch 47 Lithium and Its Role in Psychiatry
Massachusetts General Hospital Ch 32 Anxiety Disorders
Ch 48 The Use of Antiepileptic Drugs in
Instructor, Department of Psychology Ch 41 The Pharmacotherapy of Anxiety
Psychiatry
Harvard Medical School Disorders
Boston, MA, USA Søren Dinesen Østergaard, MD, PhD
Lauren Norton Pollak, PhD
Ch 7 Understanding and Applying Research Fellow, Depression Clinical
Psychology Assessment Center
Psychological Assessment and Research Program (DCRP)
Massachusetts General Hospital
Massachusetts General Hospital
Bunmi O. Olatunji, PhD Boston, MA, USA
Research Fellow in Psychiatry
Director of Clinical Training, Ch 8 Neuropsychological Assessment
Harvard Medical School
Department of Psychology,
Boston, MA, USA Alicia D. Powell, MD
Vanderbilt University
Ch 29 Mood Disorders: Depressive Assistant Medical Director
Associate Professor of Psychology and
Disorders (Major Depressive Disorder) Vinfen Corporation
Psychiatry
Cambridge, MA, USA
Vanderbilt University Michael W. Otto, PhD
Ch 38 Grief, Bereavement, and
Nashville, TN, USA Professor, Department of Psychology
Adjustment Disorders
Ch 16 Cognitive-Behavioral Therapy, Boston University
Behavioral Therapy, and Cognitive Boston, MA, USA
Therapy Ch 16 Cognitive-behavioral Therapy,
Behavioral Therapy, and Cognitive
Cheryl K. Olson, MPH, ScD
Therapy
Independent Public Health Researcher
Reston, VA, USA
Ch 93 Psychiatry and the Media
 List of Contributors xvii

Laura M. Prager, MD Scott L. Rauch, MD Jerrold F. Rosenbaum, MD

Psychiatrist, Lung Transplant Team President and Psychiatrist in Chief Chief, Psychiatry Service,
Director, Child Psychiatry Emergency McLean Hospital Massachusetts General Hospital
Consult Service Belmont, MA, USA Stanley Cobb Professor of Psychiatry
Massachusetts General Hospital Chair, Partners Psychiatry and Mental Harvard Medical School
Assistant Professor of Psychiatry Health Boston, MA, USA
Harvard Medical School Professor of Psychiatry Ch 70 Psychiatric and Substance Use
Boston, MA, USA Harvard Medical School Disorders in Transitioning Adolescents
Ch 58 Organ Transplantation: Pre- Belmont, MA, USA and Young Adults
transplant Assessment and Post- Ch 34 Trauma and Posttraumatic Stress
Elizabeth Rosenfield, BA
transplant Management Disorder
Research Coordinator, Department of
Ch 88 Emergency Psychiatry Ch 46 Neurotherapeutics
Psychiatry
Ch 72 Neuroanatomical Systems Relevant
Bruce H. Price, MD Massachusetts General Hospital
to Neuropsychiatric Disorders
Chief of Neurology Boston, MA, USA
Ch 75 Neuroimaging in Psychiatry
McLean Hospital Ch 16 Cognitive-behavioral Therapy,
Belmont, MA, USA Hannah E. Reese, PhD Behavioral Therapy, and Cognitive
Associate Professor of Neurology Assistant Professor Therapy
Harvard Medical School Department of Psychology
J. Niels Rosenquist, MD, PhD
Boston, MA, USA Bowdoin College
Assistant in Psychiatry
Ch 73 The Neurological Examination Brunswick, ME, USA
Massachusetts General Hospital
Ch 74 Neuropsychiatric Principles and Ch 16 Cognitive-behavioral Therapy,
Instructor in Psychiatry
Differential Diagnosis Behavioral Therapy, and Cognitive
Harvard Medical School
Therapy
Jefferson B. Prince, MD Boston, MA, USA
Director of Child Psychiatry John A. Renner, Jr., MD Ch 68 Managed Care and Psychiatry
Massachusetts General for Children at Associate Professor
David Harris Rubin, MD
North Shore Medical Center and Staff Department of Psychiatry
Director of Child and Adolescent
Pediatric Psychopharmacology Clinic Boston University School of Medicine
Psychiatry
Massachusetts General Hospital Clinical Instructor
Residency Training
Instructor in Psychiatry Department of Psychiatry
Massachusetts General Hospital and
Harvard Medical School Harvard Medical School
McLean Hospital
Yawkey Center for Outpatient Care Associate Chief
Associate Director
Boston, MA, USA Department of Psychiatry
MGH Psychiatry Academy
Ch 49 Pharmacotherapy of Attention- Boston VA Healthcare System
Lecturer in Psychiatry
Deficit/Hyperactivity Disorder across the Boston, Massachusetts, USA
Harvard Medical School
Life Span Ch 26 Alcohol-Related Disorders
Boston, MA, USA
Ch 69 Child and Adolescent Psychiatric Ch 27 Drug Addiction
Ch 13 Family Therapy
Disorders
Elspeth Cameron Ritchie, MD, MPH,
James R. Rundell, MD
John Querques, MD COL (Ret)
Medical Director
Co-Associate Director, Psychosomatic Chief Medical Officer
Mental Health Homeless Programs
Medicine Fellowship Program District of Columbia
Minneapolis Veterans Administration
Massachusetts General Hospital Department of Behavioral Health
Health Care System
Assistant Professor of Psychiatry, Washington, DC, USA
Professor of Psychiatry
Harvard Medical School Ch 91 Disaster Psychiatry
University of Minnesota
Boston, MA, USA
Rafael A. Rivas-Vazquez, PsyD, ABPP Minneapolis, MN, USA
Ch 54 Psychiatric Consultation to Medical
Adjunct Associate Professor Ch 90 Military Psychiatry
and Surgical Patients
Department of Psychology University of
Ch 57 Psychiatric Aspects of HIV Infection Kathy M. Sanders, MD
Miami
and AIDS State Medical Director
Miami, Florida, USA
Deputy Commissioner, Clinical &
Terry Rabinowitz, MD, DDS Ch 39 Personality and Personality
Professional Services
Medical Director Disorders
Department of Mental Health
Division of Consultation Psychiatry and
Joshua L. Roffman, MD, MMSc Commonwealth of Massachusetts
Psychosomatic Medicine
Department of Psychiatry Assistant Professor of Psychiatry
Medical Director
Massachusetts General Hospital Harvard Medical School
Telemedicine
Assistant Professor of Psychiatry Boston, MA, USA
Fletcher Allen Health Care
Harvard Medical School Ch 23 Impulse-Control Disorders
Professor, Departments of Psychiatry
Boston, MA, USA Ch 65 Aggression and Violence
and Family Medicine
Ch 06 Diagnostic Rating Scales and
University of Vermont College of
Psychiatric Instruments
Medicine
Ch 40 Psychiatric Neuroscience:
Burlington, VT, USA
Incorporating Pathophysiology into
Ch 89 Rehabilitation Psychiatry
Clinical Case Formulation
xviii List of Contributors

Steven C. Schlozman, MD Samuel Justin Sinclair, PhD John W. Stakes, MD

Co-Director, Medical Student Education Director of Research, Psychological Massachusetts General Hospital
in Psychiatry Evaluation and Research Laboratory Physician Director
Harvard Medical School Staff (The PEaRL) Senior Advisor
Psychiatrist Massachusetts General Hospital Network Development Massachusetts
Massachusetts General Hospital, Boston, MA, USA General Hospital
Assistant Professor of Psychiatry Ch 7 Understanding and Applying Instructor of Neurology, Harvard
Harvard Medical School Psychological Assessment Medical School Neurologist
Boston, MA, USA Boston, MA, USA
Patrick Smallwood, MD
Ch 9 Coping with Medical Illness and Ch 22 Sleep Disorders
Medical Director
Psychotherapy of the Medically Ill
Psychosomatic Medicine Theodore A. Stern, MD
Ch 10 An Overview of the Psychotherapies
Medical Director Chief, Avery D. Weisman Psychiatry
Ch 35 Dissociative Disorders
Emergency Mental Health Services Consultation Service
Ronald Schouten, MD, JD University of Massachusetts Medical Director, Office for Clinical Careers
Director, Law & Psychiatry Service Center Massachusetts General Hospital
Massachusetts General Hospital Assistant Professor, Department of Boston, MA, USA
Associate Professor of Psychiatry Psychiatry Ned H. Cassem Professor of Psychiatry
Harvard Medical School University of Massachusetts Medical in the Field of Psychosomatic
Boston, MA, USA School Medicine/Consultation
Ch 85 Legal and Ethical Issues in Worcester, MA, USA Harvard Medical School
Psychiatry I: Informed Consent, Ch 39 Personality and Personality Boston, MA, USA
Competency, Treatment Refusal, and Disorders Ch 18 Delirium
Civil Commitment Ch 51 Side Effects of Psychotropic
Felicia A. Smith, MD
Ch 86, The Role of Psychiatrists in the Medications
Program Director, MGH/McLean Adult
Criminal Justice System Ch 53 The Suicidal Patient
Psychiatry Residency
Ch 87 Legal and Ethical Issues in Ch 55 Life-threatening Conditions in
Associate Director, MGH Division of
Psychiatry II: Malpractice and Boundary Psychiatry: Catatonia, Neuroleptic
Psychiatry and Medicine
Violations Malignant Syndrome, and Serotonin
Assistant Professor of Psychiatry
Syndrome
Linda C. Shafer, MD Harvard Medical School, Boston, MA,
Ch 92 Coping with the Rigors of
Psychiatrist USA
Psychiatric Practice
Massachusetts General Hospital Ch 3 Laboratory Tests and Diagnostic
Wang Ambulatory Care Center Procedures S. Evelyn Stewart, MD
Assistant Professor of Psychiatry Ch 25 Factitious Disorders and Director, Pediatric OCD Program
Harvard Medical School Malingering Associate Professor of Psychiatry,
Boston, MA , USA Ch 52 Natural Medications in Psychiatry University of British Columbia
Ch 36 Sexual Disorders and Sexual Senior Clinician Scientist,
Jordan W. Smoller, MD, ScD
Dysfunction Child and Family Research Institute
Director, Psychiatric Genetics and
Vancouver, BC, Canada
Janet Cohen Sherman, PhD, Associate Vice-Chair
Ch 33 Obsessive-compulsive and Obsessive-
Psychology Assessment Center Department of Psychiatry
compulsive and Related Disorders
Massachusetts General Hospital Massachusetts General Hospital
Assistant Professor of Psychiatry Professor of Psychiatry Samantha Andrien Stewart MD
Harvard Medical School Harvard Medical School Attending Psychiatrist
Boston, MA, USA Boston, MA, USA Department of Consultation-Liaison
Ch 8 Neuropsychological Assessment Ch 63 Genetics and Psychiatry Psychiatry
Bellevue Hospital
Derri Shtasel, MD, MPH Thomas J. Spencer, MD
Associate Professor, Department of
Director, Division of Public and Associate Director
Clinical Psychiatry
Community Psychiatry Pediatric Psychopharmacology Clinic
Columbia University and New York
Massachusetts General Hospital Massachusetts General Hospital
University
Associate Professor of Psychiatry Associate Professor of Psychiatry
New York, NY, USA
Harvard Medical School Harvard Medical School
Ch 91 Disaster Psychiatry
Boston, MA, USA Boston, MA, USA
Ch 64 Serious Mental Illness Ch 49 Pharmacotherapy of Attention- Thomas D. Stewart, MD
Deficit/Hyperactivity Disorder across the Associate Clinical Professor,
Naomi M. Simon, MD, MSc
Life Span Department of Psychiatry
Center for Anxiety and Traumatic Stress
Yale University School of Medicine
Disorders Susan E. Sprich, PhD
New Haven, CT, USA
Massachusetts General Hospital Director, Cognitive-Behavioral Therapy
Ch 89 Rehabilitation Psychiatry
Chief Medical Officer Program
Red Sox Foundation and MGH Home Massachusetts General Hospital Owen S. Surman, MD
Base Program Assistant Professor of Psychology in the Psychiatrist, Massachusetts General
Associate Professor of Psychiatry, Department of Psychiatry Hospital
Harvard Medical School Director Harvard Medical School Associate Professor of Psychiatry
Boston, MA, USA Boston, MA, USA Harvard Medical School
Ch 32 Anxiety Disorders Ch 16 Cognitive-behavioral Therapy, Boston, MA, USA
Ch 41 The Pharmacotherapy of Anxiety Behavioral Therapy, and Cognitive Ch 15 Hypnosis
Disorders Therapy