Biological psychiatry has dominated psychiatric thinking for the
past 40 years, but the knowledge base of the discipline has
increased substantially more recently, particularly with advances
in genetics and neuroimaging. The third edition of Biological
Psychiatry has been thoroughly updated taking into account
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. It is within this context that there
is a considerable emphasis in the book on brain-behaviour
relationships both within and without the clinical setting.
This edition has been enhanced by the inclusion of new chapters,
one on anxiety and another on motivation and the addictions. The
chapter that relates to treatments has been extended to include the
latest information on brain stimulation techniques. The overall
book is well illustrated in order to help with an understanding of
the text.
For the third edition, Professor Michael Trimble has been joined
by Professor Mark George as co-author. These are two of the world’s
leading biological psychiatrists who both have considerable
clinical as well as research experience which they have brought to
the book. Unlike multiauthored texts, it has a continuity running
through it which aids understanding and prevents repetition.
This book is strongly recommended for all practising
psychiatrists and trainees wishing for an up-to-date,
authoritative, easy to digest and acessible review of the latest
advances and conceptualizations in the field. It will also appeal
to neurologists interested in neuropsychiatry and biological
psychiatry or the psychiatric aspects of neurological disorders, as
well as other practising clinicians (psychologists, social workers,
nurses) in the mental health field.
Daftar Isi
Acknowledgements.
Quotations.
Preface to the First Edition.
Preface to the Second Edition.
Introduction and Preface to the Third Edition.
1 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.
2 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.
3 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.
4 Classifications and Clinical Investigations.
Introduction.
Signs, symptoms, syndromes and disease.
Classification in psychiatry.
Clinical investigation.
5 Personality Disorders.
General introduction.
Introduction to the concept of personality.
Genetics.
Somatic variables.
Metabolic and biochemical findings.
Neurophysiological and neurological data.
Some outstanding issues.
6 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.
7 The Schizophrenias.
Introduction.
Genetics.
Somatic variables.
Metabolic and biochemical findings.
Neurochemical investigations.
Neurophysiological and neurological data.
Some outstanding issues.
8 Affective Disorders.
Introduction.
Genetics.
Metabolic and biochemical findings.
Neurochemical investigations.
Neurophysiological and neurological data.
Some outstanding issues.
9 The Addictions and Disorders of Motivation.
Introduction.
Disorders of motivation.
Conditioning.
Genetics.
Metabolic and biochemical findings.
Neurophysiological and neurological data.
Some outstanding issues.
10 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.
11 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.
12 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.
13 Epilogue: Progress toward a Neuroanatomically, Biological-psychiatrically Informed Classification Scheme in Psychiatry.
References.
Index.
Tentang Penulis
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. Hestudied general medicine, obtaining membership of the Royal Collegeof Physicians before going to the National Hospital Queen Squareand then the Maudsley Hospital to advance his training in neurologyand psychiatry. Following an internship in psychiatry at the Johns Hopkins Hospital, Baltimore, he returned to the National Hospitalto pursue a career in neuropsychiatry. He set up a research groupwith main interests in the interface disorders between neurologyand psychiatry, reflected in the developing recognition ofneuropsychiatry and behavioural neurology as independentdisciplines. The research group (Raymond-Way Unit) explored thebehavioural consequences of neurological disorders and theirtreatment, with a major interest in epilepsy and movementdisorders. His current writing and academic interests involveteaching and lecturing on neuroanatomical concepts relevant tounderstanding behaviour and its variations, in particular with aninterest in neuroaesthetics and neurotheology, namely the cerebralbasis of artistic and religious experiences.
Dr. George received his medical degree from the Medical University of South Carolina in Charleston in 1985, where hecontinued with dual residencies in neurology and psychiatry. He isboard certified in both areas. He worked for one year (1990-91) asa 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 theoverlaps between Obsessive-Compulsive Disorder and Gilles de la Tourette Syndrome. During this year he also worked on newfunctional imaging techniques (SPECT and PET) at the Institute of Nuclear Medicine, University College of London and Middlesex Schoolof Medicine, London. He wrote one of the first textbooks in the newarea 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 withnormal emotions, as well as using imaging to understand brainchanges which occur in depression and mania. This imaging workdirectly led to his pioneering use of transcranial magneticstimulation (TMS) as a probe of neuronal circuits regulating mood, and to clinical trials using TMS as an antidepressant. In 2008prefrontal TMS was FDA approved as an antidepressant treatment. In1995 he moved back to Charleston and built the functionalneuroimaging division and brain stimulation laboratories. Thisimaging 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-invasivestimulation, either separately or more recently in combination, tounderstand the brain regions involved in emotion regulation inhealth and disease. In 1998, he pioneered another new treatment forresistant depression, vagus nerve stimulation, that was recently FDA approved. He and his group have used MRI imaging to understandbrain stimulation brain effects. He is on several editorial reviewboards, and has published over 200 scientific articles, and haswritten or edited 5 books. He is the editor-in-chief of a newjournal, 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 hewas honored as one of 14 ‘Pioneers of Medical Progress’ saluted inthe August 2009 edition of US News & World Report.