Biological Psychiatry

by Trimble, Michael R.; George, Mark

• ISBN13: 9780470688946
• ISBN10: 0470688947
• Edition: 3rd
• Format: Hardcover
• Copyright: 2010-10-04
• Publisher: Wiley

Summary

The knowledge base of biological psychiatry has recently increased substantially, particularly in response to advances in genetics and neuroimaging. For its third edition, Biological Psychiatry has been thoroughly updated to account for these developments. As in the earlier editions of the book, there are comprehensive reviews and explanations of the latest advances in neurochemistry, neuroanatomy, genetics, and brain imaging-descriptions not only of methodologies but also of the application of these in clinical settings. This edition introduce two new chapters, one on anxiety and another on motivation and the addictions. The treatment chapter now includes the latest information on brain stimulation techniques. Skillfully written by two of the world's leading biological psychiatrists, the text facilitates understanding and prevents repetition.

Author Biography

Professor Trimble was for many years Professor of Behavioural Neurology and Consultant Physician to the Department of Psychological Medicine at the National Hospital Queen Square, London. He now holds emeritus status at the above institutions. He studied general medicine, obtaining membership of the Royal College of Physicians before going to the National Hospital Queen Square and then the Maudsley Hospital to advance his training in neurology and psychiatry. Following an internship in psychiatry at the Johns Hopkins Hospital, Baltimore, he returned to the National Hospital to pursue a career in neuropsychiatry. He set up a research group with main interests in the interface disorders between neurology and psychiatry, reflected in the developing recognition of neuropsychiatry and behavioural neurology as independent disciplines. The research group (Raymond-Way Unit) explored the behavioural consequences of neurological disorders and their treatment, with a major interest in epilepsy and movement disorders. His current writing and academic interests involve teaching and lecturing on neuroanatomical concepts relevant to understanding behaviour and its variations, in particular with an interest in neuroaesthetics and neurotheology, namely the cerebral basis of artistic and religious experiences.

Dr. George received his medical degree from the Medical University of South Carolina in Charleston in 1985, where he continued with dual residencies in neurology and psychiatry. He is board certified in both areas. He worked for one year (1990-91) as a Visiting Research Fellow in the Raymond Way Neuropsychiatry Research Group at the Institute of Neurology, London. He and Professor Trimble used pharmacology and imaging to study the overlaps between Obsessive-Compulsive Disorder and Gilles de la Tourette Syndrome. During this year he also worked on new functional imaging techniques (SPECT and PET) at the Institute of Nuclear Medicine, University College of London and Middlesex School of Medicine, London. He wrote one of the first textbooks in the new area of brain activation and imaging. Dr George then moved to Washington, DC, working with Dr. Robert Post in the Biological Psychiatry Branch of the Intramural National Institute of Mental Health.  He was one of the first to use functional imaging (particularly oxygen PET) to assess brain changes associated with normal emotions, as well as using imaging to understand brain changes which occur in depression and mania. This imaging work directly led to his pioneering use of transcranial magnetic stimulation (TMS) as a probe of neuronal circuits regulating mood, and to clinical trials using TMS as an antidepressant. In 2008 prefrontal TMS was FDA approved as an antidepressant treatment. In 1995 he moved back to Charleston and built the functional neuroimaging division and brain stimulation laboratories. This imaging group has grown into the MUSC Center for Advanced Imaging Research, which is now part of the SC Brain Imaging Center of Excellence. He continues to use imaging and non-invasive stimulation, either separately or more recently in combination, to understand the brain regions involved in emotion regulation in health and disease. In 1998, he pioneered another new treatment for resistant depression, vagus nerve stimulation, that was recently FDA approved. He and his group have used MRI imaging to understand brain stimulation brain effects. He is on several editorial review boards, and has published over 200 scientific articles, and has written or edited 5 books. He is the editor-in-chief of a new journal, Brain Stimulation.
He has received several international awards, including the World Federation of Societies of Biological Psychiatry Lifetime Achievement Award (2007), the NARSAD Falcone Award (2008) and he was honored as one of 14 'Pioneers of Medical Progress' saluted in the August 2009 edition of US News & World Report.

Table of Contents

Acknowledgements

Quotations

Preface to the First Edition

Preface to the Second Edition

Introduction and Preface to the Third Edition

Principles of Brain Function and Structure: 1 Genetics, Physiology and Chemistry

Introduction

Genetics

Brain chemistry and metabolism

The metabolism of glucose

Proteins and fatty acids

Cell membranes

Synapses

Receptors

Neurones

Neurotransmitters

Interrelationships among transmitters

Transmitter dispersal

CNS inflammation

Principles of Brain Function and Structure: 2 Anatomy

Introduction

The neuroanatomy of emotion

Individual anatomical structures

Ascending and descending limbic-system connections

Macrosystems

The basal ganglia and the re-entrant circuits

The ventral striatum and 'limbic striatum'

The ascending cholinergic systems

Cortical regions of interest

The cerebellum

Important Brain-Behaviour Relationships

Introduction

Important anatomical structures for understanding behaviour

Some specific behaviours

Limbic lobe disorders in a clinical context

Re-entrant circuits in a clinical context

The frontal lobes in a clinical context

Laterality

Classifications and Clinical Investigations

Introduction

Signs, symptoms, syndromes and disease

Classification in psychiatry

Clinical investigation

Personality Disorders

General introduction

Introduction to the concept of personality

Genetics

Somatic variables

Metabolic and biochemical findings

Neurophysiological and neurological data

Some outstanding issues

Anxiety Disorders

Introduction

Genetics

Somatic variables

Metabolic and biochemical findings

Neurochemical investigations

Neurophysiological and neurological data

Imaging

Obsessive-compulsive disorder

Post-traumatic stress disorder

Some outstanding issues

The Schizophrenias

Introduction

Genetics

Somatic variables

Metabolic and biochemical findings

Neurochemical investigations

Neurophysiological and neurological data

Some outstanding issues

Affective Disorders

Introduction

Genetics

Metabolic and biochemical findings

Neurochemical investigations

Neurophysiological and neurological data

Some outstanding issues

The Addictions and Disorders of Motivation

Introduction

Disorders of motivation

Conditioning

Genetics

Metabolic and biochemical findings

Neurophysiological and neurological data

Some outstanding issues

Epilepsy

Introduction

Prevalence and clinical characteristics

Classification

Genetics

Symptomatic epilepsy

Biochemical findings

Investigation and differential diagnosis

Psychiatric disorders in epilepsy

Cognitive deterioration and epilepsy

Some outstanding issues

The Dementias

Introduction

Definition

Prevalence

Diagnosis and classification

Alzheimer's disease

Dementia of frontal-lobe type

Focal cortical atrophies

Dementia with Lewy bodies

Vascular dementias

Other forms of dementia

Further causes of dementia

Some outstanding issues

Biological Treatments

Introduction

Pharmacology: pharmacokinetics and pharmacodynamics

Antidepressants

Antipsychotic drugs

Anxiolytics and hypnotics

Beta-Adrenergic blockers

Lithium

Anticonvulsants

Drugs for the treatment of dementia

Medications for the addictions

Brain-stimulation therapies

Sleep-deprivation therapy

Epilogue: Progress toward a Neuroanatomically, Biological-psychiatrically Informed Classification Scheme in Psychiatry

References

Index

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