Evidence for the efficacy of behavioral approaches to the treatment and management of physical illness is mounting, as is the evidence for behavioral interventions for psychological disorders. A pressing question that remains is how to effectively treat co-morbid physical and psychological illnesses. Diseases co-occur more often than not, and the co-occurrence of physical and psychological illnesses is associated with greater impairment and healthcare costs. Unfortunately, the treatment literature has traditionally been disease-specific, with fewer insights and discoveries regarding the underlying processes of co-morbid physical and psychological illnesses, and even fewer of approaches to treatment. Research on co-morbidities between physical and psychological illnesses has focused primarily on depression. Quite extensive literatures describe the negative impact of depression on type 2 diabetes, cardiovascular disease, cancer, obesity, pain, and other physical illnesses. More recently, higher rates of physical illness have been documented in individuals with bipolar disorder, anxiety disorders, schizophrenia, and impulse control disorders. Studies emanating from the National Comorbidity Survey-Replication (NCS-R), the only U.S. population-based database that includes diagnostic information on all DSM-IV psychological disorders, have revealed strong links between a number of physical and psychological illnesses. These data draw attention to the prevalence of physical and psychological co-morbidities at the population level, which has stimulated research on the biobehavioral mechanisms of those co-morbidities, with the goal of developing and improving treatment approaches. As this area of research grows, practical resources are needed for clinicians and researchers who encounter individuals with co-morbid physical and psychological illnesses in their work. This book is the first to provide a comprehensive overview of psychological co-morbidities of physical illness, biological and behavioral mechanisms of those co-morbidities, and implications for treatment. Each chapter focuses on a physical condition, such as obesity, type 2 diabetes, HIV infection, tobacco dependence, cardiovascular disease, cancer, asthma, pain, irritable bowel syndrome, autoimmune disorders, and obstetric/gynecological conditions. Chapters are structured to cover 1) the epidemiology of the most prevalent co-morbid psychological disorders within that physical condition (e.g., depression and other mood disorders, anxiety disorders, psychotic disorders, impulse control disorders, and eating disorders; 2) biobehavioral mechanisms of the co-morbidity; 3) a review of the behavioral treatment literature including evidence-based practice guidelines (where available); and 4) treatment considerations including issues of stepped care, evidence-based treatment decisions, treatment sequencing, treatment blending, treatment interactions, and contraindications. Content is guided by available research evidence and relevant theoretical models, and it is presented in such a way as to inform clinical practice, identify important gaps in the research literature, and provide directions for future research. The book serves as a tool for clinicians and researchers who work in the area of behavioral medicine in medical, academic, and/or training settings. Patients with psychological and medical co-morbidities may be encountered by clinicians working in either mental health or medical settings, where the presenting problem could be either the psychological disorder or the medical disorder. As such, assessment and treatment issues are discussed from both perspectives. For the clinician, the book reviews brief assessment tools, provides practical summaries of the treatment outcome literature and treatment considerations (e.g., treatment sequencing, contraindications), and includes treatment decision hierarchies that help the clinician incorporate each facet of evidence-based decisions (the evidence, patient characteristics, and their own expertise). For the researcher, the book brings together the literature for the medical and psychological disorder, highlighting still unanswered research questions relevant to the co-morbidity. Literature relevant to the underlying biobehavioral mechanisms of the co-morbidity as well as treatment are summarized. While a vast literature exists for the treatment of these disorders in isolation, one important purpose of this book is to bring together this literature to uncover specific areas in need of future study that will further our understanding of why different disorders co-occur and the best ways to treat them when they do.

The intent of this book is to examine the psychological and social worlds of physically ill patients-an area that particularly needs attention today, since the great advances in medical science have caused many to minimize pa tients' emotional concerns. However, the pendulum has begun to swing back to the interrelationship of body and mind. Quality of life is again becoming a critical consideration in treatment. In writing the book I have drawn upon my own clinical experiences as a psychologist working with the physically ill. I have also drawn upon studies of the psychological factors in medical illness, and I was pleased to find a growing body of research. Although the book is primarily directed to psy chotherapists, it will benefit anyone involved in the care of those with medical problems, such as family and friends, as well as medical professionals. vii Acknowledgments I would particularly like to thank Redjeb Jordania for his endless patience, support, and encouragement from the very beginning of this project, and for his valuable suggestions and editorial comments along the way.

The successful integration of psychological factors into the management of physical disabilities is critical to successful health-care delivery. This book provides a comprehensive and accessible guide to the best practice and approaches in this field. Paul Kennedy brings together contributions from a range of experienced researchers and practitioners, who explore the emotional, motivational and psychological factors associated with the rehabilitation and treatment of people with a range of physical disabilities, including spinal cord injury, stroke, and chronic pain. The book is divided into three sections, covering: the scope of psychological processes in physical rehabilitation psychological applications and practitioner perspectives general organizational challenges and developments. The Psychological Management of Physical Disabilities will be of great interest to all clinical psychologists, health psychologists, occupational therapists, counsellors, physiotherapists, physicians and rehabilitation nurses. Service providers know how important psychological factors are. This book explains why and how psychological models and research can support rehabilitation and improve individual well-being.

The group of European Medical Research Councils (EMRC) was formed in 1971 and became a Standing Committee of the European Science Foundation (ESF) in 1975. EMRC is an association of medical research councils or equivalent organizations in Western Europe. The National Institutes of Health, the Israel Academy of Sciences, and the European Office of WHO are associated with EMRC and take an active part in its activities. The main aims of EMRC are to exchange information on the research policies pursued by its member organizations and to initiate and stimulate inter national cooperation in biomedical research. Since this research is highly international in itself, EMRC concentrates its activities on furthering international collaboration in those fields where it can play a significant role as a complement of existing channels. Mental illness research has been judged by EMRC to fulfill these criteria. After a survey of the activities of the member organizations in mental illness research, EMRC decided in 1978 to set up a study group to analyze areas where EMRC could contribute. As a result of the work of the study group, five workshops have been arranged to define present knowledge in some specific areas and to delineate research needs. The present volume contains the proceedings of the fifth workshop, held in 1987 and dealing with interactions between mental and physical illness. EMRC hopes that this volume will contribute both to intensified research and to research cooperation on mental illnesses.

Meet the challenges of mental health treatments for the physically unwell with this essential guide Treating mental health conditions in physically unwell patients presents unique challenges for clinicians and other practitioners. Psychotropic medications, so effective in physically healthy patients, can have disappointing outcomes in the physically unwell, not to mention generating serious possible side effects that can complicate or impair physical treatment plans. Many clinicians face difficult decisions about prescribing for mental health conditions in such cases, and reliable information for them is scarce. The Maudsley Prescribing Guidelines for Mental Health Conditions in Physical Illness meets this urgent need with a comprehensive guide to the safe and effective pharmacological management of mental illness in physically unwell patients. Covering a wide range of physical health conditions and comorbidities, the book summarizes the key evidence and incorporates the full battery of potential pharmacological measures. It's an essential resource for any clinical practitioner looking to balance the physical and mental wellbeing of seriously ill patients. The Maudsley Prescribing Guidelines for Mental Health Conditions in Physical Illness readers will also find: Coverage of mental health conditions including depression, anxiety, psychosis, and bipolar affective disorder Detailed discussion of physical health conditions including cardiac disease, diabetes, chronic obstructive pulmonary disease, and many more Treatment of complex and frequently encountered clinical scenarios such as restarting psychotropics after overdose and steroid-induced psychiatric conditions The Maudsley Prescribing Guidelines for Mental Health Conditions in Physical Illness is ideal for clinical pharmacists, nurses, or doctors who work with mentally ill patients with physical comorbidities.

People with learning disabilities are at greater risk of physical and psychiatric illness than the population at large, but their health needs are often not adequately supported. This book is a practical guide for those caring for people with learning disabilities living in community settings. It is designed to help the carers to better understand what the service users' health needs may be, how to recognise problems, and how to meet their needs. Chapter topics include physical health issues such as epilepsy, common health problems and diet and well-being; mental health issues such as dementia, depression, bipolar disorder and anxiety; and information related to common issues such as sleep and swallowing problems. The book also includes advice on screening programmes and health checks. Written in an accessible and straightforward style, this book will be an invaluable guide for anyone caring for someone with a learning disability, including social carers, health facilitators, community nurses and family carers.

This publication presents evidence about the magnitude and severe consequences of comorbidity of mental and physical illnesses from a personal and societal perspective. Leading experts address the huge burden of co-morbidity to the affected individual as well as the public health aspects, the costs to society and interaction with factors stemming from the context of socioeconomic developments. The authors discuss the clinical challenge of managing cardiovascular illnesses, cancer, infectious diseases and other physical illness when they occur with a range of mental and behavioral disorders, including substance abuse, eating disorders and anxiety. Also covered are the organization of health services, the training of different categories of health personnel and the multidisciplinary engagement necessary to prevent and manage comorbidity effectively. The book is essential reading for general practitioners, internists, public health specialists, psychiatrists, cardiologists, oncologists, medical educationalists and other health care professionals.

This accessible, practical text provides mental health practitioners with the core knowledge and skills they need to be able to care effectively for the physical health of those who have been diagnosed with mental illness. Linked closely to professional standards, and with a clear values- and evidence-base, the book aims to raise awareness of the physical health needs of individuals with mental health problems, outline the physical health assessment process and suggest health enhancing interventions for use in clinical practice. Consideration will be given to the following aspects of physical wellbeing; - cardiovascular health - diabetes - sexual health - respiratory health - cancer - wound care - substance misuse - infection control - medicine management Further chapters on legal and ethical issues explain the need to practise appropriately within the Mental Health Act and the Mental Capacity Act, while a linking theme throughout the book stresses the importance of health promotion. Backed up by case examples and with a range of reflective exercises throughout, The Physical Care of People with Mental Health Problems is a key text for students and practitioners working in mental health services. It will also be useful reading for practice nurses, district nurses, midwives and all allied health practitioners.

This popular and groundbreaking book was the first of its kind to focus on providing mental health nurses with the core knowledge of the physical health issues that they need for their work. Considering the risk factors and assessment priorities amongst different mental health client groups, the book provides clinical insights into how best to work with service users to ensure their health is assessed and improved. In this fully updated second edition the book addresses the latest research and policy, as well as expanding coverage of: Assessment principles and skills Adverse reactions, side effects and patient education Working with older and younger patients Multi-professional working Each chapter includes case studies, examples, diagrams and exercises for self-testing and reflection, which will help readers develop their own skills and practice. Physical Health and Well Being in Mental Health Nursing is a must-have text for students and practitioners working in mental health nursing. It is also useful reading for practice nurses, district nurses, midwives and all allied health practitioners. "People living with serious mental health problems often have significant physical health problems that are estimated to shorten their life expectancy by up to 15 years. This is unacceptable, and avoidable and mental health nurses have a crucial role to play in addressing this situation. The second edition of this excellent text is timely. Underpinned by a sound evidence base and peppered with practical examples throughout, this book contains essential knowledge and skills that will enable mental health nurses to help service users transform their health and wellbeing, and live longer, healthier and more satisfying lives. " Patrick CallaghanProfessor of Mental Nursing Head of School of Health SciencesUniversity of Nottingham "This new edition of an established text will be welcomed by students, academics and service users. The physical health of those with enduring mental illness is an important, but neglected, aspect of health care responsible for considerable, preventable, morbidity. This popular, accessible book raises the profile of this Cinderella subject in the nursing curriculum. Healthcare outcomes will be improved if practitioners follow Mike's advice throughout the text, most particularly: One small step we can take, which will make a huge difference to the physical health of mental health service users, is to regularly monitor and screen for adverse drug reactions (p.184)." Sue Jordan, Reader, College of Human and Health Sciences, Swansea University