positive predictive value of a diagnostic test 121 postnatal depression 470 Edinburgh Postnatal Panksepp, Jaak 12 \200\22313 paradoxical insomnia 424 paralysis 806 paranoid delusion 101 p araphasia 101 paraphrenia 522 parapraxis 837 parasomnia overlap disorder 441 parasomnias 44 0 Depression Scale 471 postpartum psychosis 470 \200\2231 post-traumatic amnesia 154 post-traumatic delirium 154 post-traumatic stress disorder children and adolescents 646 cultural context 911 diagnosis 390 \200\2231 management 392 \200\2233 sleep disturbance 455 arousal disorders 442 \200\2233 nocturnal panic attacks 443 dialectical behavioral therapy 508 medication 508 psychodynamic therapy 509 NREM sleep disorders 442 posturing 102 Prader \200\223Willi syndrome 746 pregnancy, prescribing REM sleep therapeutic disorders 446 \200\2237 community 508 \200\230normal personality \200\231 parasuicide in 968 \200\2239 assessment 784 \200\2235 elderly people 525 management after 786 \200\2237 492 \200\2233 pregnancy-associated disorders 468 \200\2239 and offending 691 outcome 510 psychopathy 496 severe 496 \200\2237 anxiety/mood pareidolic illusions 56 parent management training 667 symptoms 468 hyperemesis gravidarum 468 miscarriage/abortion 468 pseudocyesis 468 \200\2239 personal safety 35 \200\22382 pervasive developmental parietal lobe functioning 72 \200\2233 disorder not otherwise speci \201 ed 759 Parkinsonism 167 akinetic 993 drug-induced 944 \200\2235 Parkinson \200\231s disease 168 \200\2239 paroxetine 268 \200\2239, 277 passivity phenomena 101 pathological jealousy 221, premature ejaculation 478 \200\2239 premenstrual disorders pervasive developmental disorders 758 \200\2239 phantom mirror image 101 phenelzine 273, 959 \200\22379 phenomenology 84 phenylcyclidine 58 6 phenylketonuria 750 phenytoin 940 phobias 101 \200\2232, 366 \200\2239, etiology 466 assessment tools 467 differential diagnosis 466 investigations 466 morbidity 4 66 psychiatric 569 pathological unconsciousness 66 consultation 466 patients treatment 467 368 \200\22395 27_Semple_Index.indd 1053 12/7/2012 5:37:01 PM INDEX 1054 Q qi-gong psychotic reaction 919 premenstrual dysphoric disorder 464, 466 \200\2237 psychic anxiety 54 psychoanalysis 836 \200\2237 premenstrual ef \201 cacy and symptoms 464 limitations 838 \200\2239 QT interval, prolonged 973 qualitative studies 122 \200\2233 Quality of Life Interview 80 q uestioning techniques 38 quetiapine 202, 259, 326, frequency 465 indications and premenstrual syndrome/ tension 464, 466 \200\2237 contraindications 838 pioneers of 826 \200\2237 theory of 828 \200\2239 training 839 treatment 838 psychodynamic prescribing cardiovascular 331, 959 \200\22379 disease 972 \200\2233 children and R randomized controlled adolescents 665 psychotherapy 820, 840 \200\2231 epilepsy 978 \200\2239 lactation 970 \200\2231 liver disease 974 \200\2235 pregnancy 968 \200\2239 renal impairment 976 \200\2237 psychodynamic therapy 509 psychogenic polydipsia 103 psychogeriatrics 512 \200\22313 psycho logical pillow 103 psychomotor agitation 103 psychomotor trials 114 \200\22315 rape 682 \200\2233 rationalization 831 reaction formation 831 reactive attachment disorder 621 pressure of speech 102 pressure of thought 102 priapism 102, 942 \200\2233 Primary Care Eva luation of Mental Disorders 80 retardation 103 psychomythology 20 \200\2231 psychopathology 84 descriptive 84 dynamic (Fre udian) 84 reboxetine 268 \200\2239, 280 recovered memories 381 re \202 ex hallucination 57, 103 regr ession 830 regression to the mean 15 \200\22331 reinforcement 845 relative risk 115, 119 re duction of 115 relaxation training 426 remission, natural 15 \200\22331 REM sleep behavior disorder 446 renal impairment, prion diseases 146 prison psychiatry 700 mental disorder in prisoners 701 psychopathy 496 Psychopathy checklist \200\224 mental health Revised (PCL-R) 496, 497 \200\223510 services 701 psychophysiological insomnia 424 prisoner assessment 702 prison remand 700 prison sentence 701 suicide in prison 703 transfe r of prisoners to hospital 704 \200\2235 psychosexual development 832 \200\2233 psychosis alcohol-induced 568 children and prescribing in 976 \200\2237 treatment in repression 830 reproductive psychiatry 462 resilience 618 restless legs syndrome 450 retrog rade amnesia 103, hospital 702 \200\2233 procedural memory 67 professional resources adolescents 658 \200\2239 elderly people 522 \200\2233 \201 tness to drive 904 postpartum 470 \200\2231 online 1022 psychostimulants, effects on progressive supranuclear 154 palsy 167 projection 830 projective identi \201 cation 830 prolonged grief disorder 389 sleep 459 psychosurgery/ Rett \200\231s syndrome 752 \200\2233 reverse Fr goli neurosurgery 296 \200\2237 syndrome 230 history 297 reverse subjective double psychotherapy 12 \200\22313, syndrome 230 reversible monoamine 819 \200\22363 promazine 200, 959 \200\22379 property damage 688 propriospinal myoclonus at assessment for 822 \200\2233 cognitive/behavioral therapies 820 \200\2231 oxidase inhibitors 272 \200\2236 rhythmic movement disorder, sleep- related 451 sleep onset 453 pseudocyesis 102, 468 \200\2239 pseudodementia 102, 520 pseudo-hallucinatio ns 57, group 842 \200\2233 interpersonal 854 \200\2235 psychodynamic 820, risperidone 202, 214, 217, 326, 331, 959 \200\22379 rivastigmine 138, 139 Rogers, Carl 827 Rohypnol see \202 unitraz epam rootwork 919 Rubenstein \200\223Taybi syndrome 747 rumination 103, 638 running comment ary 103 Russell sign 103 102 840 \200\2231 pseudologica fantastica 102 pseudoscience 20 psychiatrists supportive 820 training 821 psychotic disorders, acute and transient 226 \200\2237 psychotic symptoms 782 punding 103 p unishment 845 P-value 114 pyromania 409 clarity of roles 6 \200\2237 role of 6 \200\2237 psychiatry future of 30 \200\2231 history of 26 \200\2239 perceptions of 18 \200\22319 27_Semple_Index.indd 1054 12/7/2012 5:37:01 PM INDEX 1055 S Sacks, Oliver 19 sadomasochism 481 St John \200\231s wort 274 saka 920 \200\2231 San \201 lippo disease 750 sangue dormido 919 sar 920 Scale for the Assessment of Positive/Nega tive Symptoms 81 Scheff, Thomas J. 25 schizoaffective disorder 218 schizophasia 103 schizop hrenia 173 \200\223216 and alcohol abuse 570 assessment sexuality 462 \200\2233, 480 sexual masochism 481 sexual myths 473 sexual offenses 682 selective mutism 645 selective serotonin reuptake inhibitors 276 discontinuation indecent exposure 682 rape 682 \200\2233 recorded 685 sexual preference disorders 480 syndrome 964 self-harm asking about 52 children and adolescents 654, 655 etiology 480 classi \201 cation 480, 481 de \201 nition 480 epidemiology 480 \200\2231 dealing with 986 elderly people 525 self-help 41 semantic memory 67 senile plaques 514 sensate focus 475 \200\22387 sensitivity of a diagnostic sexual sadism 481 shaping 845 \200\2236 shenjian shuairuo 920 shenk-k \200\231uei/shenkui 9 20 shift work sleep disorder 437 shin-byung 920 shinkeishitsu 920 short sleeper 452 short-t erm memory 66 test 121 sensory distortions 104 separation anxiety 640 serotonin antagonist/ instruments 81 cultural context 910 diagnosis 178 \200\2239 differential reuptake inhibitors 279 serotonin/noradrenaline diagnosis 180 \200\2231 discharge planning 196 \200\2237 disorders related to 218 \200\2231 9 reuptake inhibitors 278 serotonin syndrome 960 \200\2231 sertindole 204 \200\22330 sertrali ne 268 \200\2239, 274 severe behavioral disturbance 988 pharmacological assessment 68 sickness 6 \200\2237 six-item Cognitive epidemiology 184 \200\2235 examination 186 \200\2237 \201 rst-rank symptoms 62 \200\2233, Impairment Test 70 sleep, psychiatric medication effects on 458 \200\2239 95 \200\2236 approach 990 \200\2231 sleep apnoea \201 tness to drive 905 historical views 176 \200\2237 initial assessment 190 \200\2231 i nitial treatment 192 \200\2233 investigations 187 learning disability 764 maintenance phase 194 \200\2235 motor symptoms 100 negative symptoms 100 and offending 690 outpatient treatm ent and follow-up 198 \200\2239 positive symptoms 102 presentations 188 \200\2239 prevalenc e 353 sleep disturbance 456 theories of 182 \200\2233 transsexualism 484 \200\2235 treatmen t-resistant 208 \200\2239 sexsomnia 445 sexual dysfunction 462 \200\2233, syndromes 428 sleep cycles 419 sleep diary 421 sleep disorders 413 \200\22359 assessment 420 \200\2233 br eathing disorders 428 \200\2239 children and 472 de \201 nition 472 elderly people 524 \200\2235 excessive sexual desire 475 lack/loss of s exual desire 474 adolescents 638 circadian rhythm 436 history of men \200\231s problems 478 \200\2239 erectile failure 478 non-organic research 415 \200\22359 hypersomnia 430 insomnia see insomnia International dyspareunia 479 orgasmic dysfunction 478 Classi \201 cation 414 \200\22317 movement premature disorders 450 \200\2231 ejaculation 478 \200\2239 prevalence 474 and psychiatric parasomnias see parasomnias schizophrenic speech disorder 104 schizophrenic thought disorder 65, 104 related to psychiatric disorders 454 medication 938 \200\22340 sensate focus 475 \200\22387 sexual aversion 474 triggers for 473 women \200\231s problems 476 \200\2237 sleep driving 445 sleep drunkenness 442 sleep EEG 418 sleep hygiene 426 inadequate 424 \200\230sleeping blood \200\231 919 sleep myoclonus of infancy, schizophreniform disorder 219 failure of genital response 476 schizotypal disorder 218 \200\22319 SCOFF questions 407 Scull, Andrew T. 25 seasonal affect ive disorder 263 secure hospitals/ units 694 \200\2235 non-organic dyspareunia 477 benign 453 non-organic vaginismus 476 sleep-onset dissociation disorder 424 sleep paralysis 447 orgasmic dysfunction 476 27_Semple_Index.indd 1055 12/7/2012 5:37:02 PM INDEX 1056 sleep restriction 426, 427 sleep stages 418 sleep starts 452 \200\2233 sleep state stupor 104 Sturge \200\223Weber tau protein 514 teleological hallucinations 104 temazepam, diazepam equivalent dose 600 temporal lobe surgery 148 tetrac yclic syndrome 748 subdural haematoma, misperception 424 chronic 151 subjective doubles delusion 230 sleep-talking 452 sleep terrors 442 \200\2233 sleep \200\223wake pattern, irregular 436 \200\2237 antidepressants 278 \200\2239 reverse 230 sublimation 831 substance misuse 535 \200\223607 alcohol abuse see alcohol -thalassaemia mental retardation 746 therapeutic relationship, establishing a 40 thiorida zine 959 \200\22379 third sex 484 thought blocking 105 thought broadcasting 105 thought con tent 45 thought echo 105 thought form 45 thought form sleepwalking (somnambulism) 444 \200\2235 Smith \200\223Magenis abuse assessment syndrome 747 snapping off 104 snoring 452 social phobia 370 \200\2231 adolescents and children 644 sleep disturbance 455 instruments 82 children and adolescents 660 cultural context 911 dependence syndrome 542 disorders of 540 \200\2231 drug misuse see drug sodium valproate see disorders 64 \200\2235 valproate solution-focused therapy 860 \200\2231 somatic anxiety 54 somatic delusion 221 so matization 104 somatization accelerated tempo 64 assessment of misuse harm reduction 544 prevalence 353 psychiatry of 536 \200\2237 psychotic illnesses 604 stage s of change 544 suicidal thoughts, asking symptoms 65 \200\22382 content and form 64 decelerated tempo 64 \200\2235 schizophrenic tho ught disorder 65 thought disorder 64 thought insertion 105 thought processes 829 tiagabine 331 t ics 105, 172, 633 disorder 802 \200\2233 cultural context 911 about 52 suicide somatoform pain disorder 804 alcohol abuse 570 attempted 986 \200\2237 children and speci \201 city of a diagnostic test 121 speech 44, 49 speech and language delay and disorder 634 Tourette \200\231s syndrome 632 adolescents 654 elderly people 525 in prison 703 threats 997 sulpiride 201 supportive topiramate 327, 331 topographical model of the mind 828 spell 920 splitting 830 Tourette \200\231s syndrome 632 trail-making test 72 tranquillization, rapid 991 transcrani al magnetic of perception 104 psychotherapy 820 spontaneous recovery 844 stalking 686 \200\2237 Steele \200\223Richardson \200\223 Olszewsk i syndrome 167 susto 920 Sydenham, Thomas 4 \200\2235 symptoms 84 \200\2235 stimulation, repetitive 298 transcultural dictionary of 86 \200\223105 psychiatry 907 \200\22321 cultural context 910 \200\2231 cultural formulation of psychiatri c disorders 912 stereotypy 104 stiff-person syndrome 993 stigma 22 \200\2233 stimulant effects on synaesthesia 104 systematic desensitization 845, 848 systematic reviews 112 \200\22313 systemic lupus sleep 457 culture-bound stock phrases/stock words 104 erythematosus 166 Szasz, Thomas 4 \200\2235, 25 syndromes 914 \200\22315 transference 828 \200\2239, 837 stress and the placebo effect 15 \200\22331 acute stress T tabanka 920 tacrine 138 taijin kyofusho 920 tangentiality 104 Tarasoff judgment 901 tardi ve dyskinesia 104, disorder 384 \200\2235 transient global amnesia 149 acute stress reaction 382 \200\2233 transition periods 770 \200\2231 transsexualism stressors, exceptional 380 \200\2231 structural model of the diagnosis 484 \200\2235 management 486 \200\2237 transvestic fetishism 481 transvestism 484 mind 828 950 \200\2232 Structured Clinical Interview tardive dystonia 954 \200\2235 for DSM-IV 80 \200\2231 27_Semple_Index.indd 1056 12/7/2012 5:37:02 PM INDEX 1057 Wernicke \200\231s tranylcypromine 268 \200\2239, venlafaxine 268 \200\2239, 278, encephalopathy 148, 572 273 959 \200\22379 verbigeration 105 verschmelzung 105 vimbuza 921 violence 678 traumatic events 380 \200\2231 trazodone 268 \200\2239, 279 wihtigo/whitigo/witiko/ windigo/wendigo 921 \200\230wild man behavior \200\231 917 Williams syndrome 747 Wilson \200\231s disease 171 wind illness 921 Winnicott, Donald W. 826 Wisconsin card sorting priapism 943 treatment without consent 872 \200\2233 aggression 678 \200\2239 causes 680 de \201 nition 678 domestic 680 elder abuse 526 \200 \2237, tremor 172 trichotillomania 105, 410 \200\22311 tricyclic task 72 withdrawal 105 withdrawal of antidepressants 268 \200\2239, 270 680 \200\2231 psychiatric assessment and management 680 rates of 680, 681 \200\223724 risk assessment 692 \200\2233 sleep-related 44 8 \200\2239, 449 types of offenses 680 tri \202 uoperazine 200 trimipramine 271, 959 \200\22379 trisomy X 755 L-tryptophan 261 tu berculosis 164 tuberous sclerosis 748 Turner \200\231s syndrome 755 treatment 533 Wolf \200\223Hirschhorn syndrome 747 wool-hwa-bung 918 word salad 105 working memory 66 assessment 68 viral encephalitis 164 visual hallucinations 57 volatile substances, misuse written expression, disorder of 589 U ufufuyane 920 \200\2231 undoing 831 uquamairineq 921 of 634 Von Hippel \200\223Lindau syndrome 749 vorbeigehen 105 vorbeireden 105 voyeurism 481 X XYY male 755 V vagus nerve stimulation 299 valproate 326, 327, 331, 342 Y Yale \200\223Brown Obsessive \200\223 Compulsive Scale 81 W wacinko 921 Waxman \200\223Geshwind syndrome 158 waxy \202 exibility see effects on sleep 458 plasma levels 928 preparations 344 side-effects Young Mania Rating Scale 81 catalepsy weight gain with sexual dysfunction 940 weight gain 932 \200\2233 Z zar 921 zotepine 204 \200\22330 zuclopenthixol 200, 217 medication 930 \200\2233 Wernicke \200\223Korsakoff syndrome 572 \200\2233 Wernicke \200 \231s dysphasia 105 treatment guidelines 343 vascular dementia 144 \200\2235 vascular disease 148 27_Semple_Index.indd 1057 12/7/2012 5:37:02 PM This page intentionally left blank Urgent detention under mental health legislation Which section? Outpatient1 Inpatient2 Jurisdiction Legislation s.5(2)* can be used immediately. In some cases s. 2 or 3 would be used directly instead. England and Wales (p000) Mental Health Act 1983 s.2 or 3 should be used rather than s.4* unless the situation is such an emergency that to do so would be unsafe. Scotland (p000) Mental Health Emergency Detention Certi \201 cate* (part 5, section 36) if arranging Short Term Detentio n (part 6, section 44) would involve undesirable delay. Same procedure for in- and out- pat ients. (Care and Treatment) (Scotland) Act 2003 Northern Ireland (NI) (p000) Mental Health (Northern Ireland) Order 1986 a.4** a.7(2)* In some cases patient may be detained directly under a.4** Republic of Ireland (RoI) (p000) Mental Health Act 2001 s.9 and 10** s.23* 1 Patients not currently admitted to hospital \200\224includes day hospital, outpatient dep artment, accident and emergency, and patients attending wards who have not been admitted to a bed yet. 2 Patient in psychiatric or non-psychiatric units, except for RoI where patient must be in an approved center (i.e. a psychiatric unit). * Indicates procedures where medi cal recommendation does not need to be by an approved doctor (England and Wales, Scotland)/ appointed doctor (NI) or consultant psychiatrist (RoI). ** Indicates procedures which may b e initiated by recommendations from doctors who are not appointed (NI) or consultant psychi atrists (RoI), although soon after admission an assessment from such a doctor is required f or the order to stand. N.B. for the procedures marked * and ** the doctor should be a regis tered medical practitioner, but need not be a psychiatrist or psychiatric trainee. Other issues to consider when detaining patients \200 Patients should only be detained if it is necessary and there is no alternative less restri ctive option Before seeing a patient (especially an outpatient), if it seems likely from th e available information that detention will be necessary, make appropriate arrangements (e. g. booking a bed, arranging for the necessary medical and social work personnel to arrive a t the same time, having staff available to convey the patient, liaising with the police if indicated) 29_Semple_Back.indd 1023 12/7/2012 8:36:38 PM In some cases getting the person to hospital will be straightforward. However in more dif \201 cult cases nursing staff and an ambulance, and where there is potential for violence, the police will be required. A guide to rapid tranquillisation (see also b p. 912) \200 There are often local protocols for rapid tranquillisation and for control and restraint an d these should be followed where available. In situations requiring rapid tranquillisation or control and restraint, discuss management with a senior colleague as soon as possible. I n the following guide the doses quoted are appropriate for young, physically \201 t patie nts who have previously received antipsychotic medication. In patients who are elderly, hav e physical health problems, or are \200\230antipsychotic na ve \200\231, dosage should at least be halved (refer to BNF for further guidance). First Line (Allow suf \201 cient time between doses for assessing clinical response) Non-p sychotic context Consider oral lorazepam 1 \200\2232mg Psychotic context Consider oral lora zepam 1 \200\2232mg and oral antipsychotic \200\224 e.g. haloperidol 10 \200\22320mg, chlor promazine 50 \200\223100mg Second Line - oral medication failed/refused/not indicated (Allow suf \201 cient time betw een doses for assessing clinical response) Non-psychotic context Consider IM lorazepam 1 \200\2232mg. Psychotic context \200 Consider IM lorazepam 1 \200\2232mg + IM haloperidol 10 \200\22320mg Consider IM olanzapine for moderate disturbance (do not give IM lorazepam within 1 hr of IM olanzapine) Consider IM chlorpromazine 25 \200\223100mg (N.B. danger of postural hypotension and fatality if giv en inadvertently by IV injection. Consider IM depot zuclopenthixol acetate (Clopixol Acupha se 50 \200\223150mg \200\224repeat every 2 \200\2233days if necessary up to max total dose 400mg. (This is rapidly acting, sedating, depot antipsychotic which is best avoided in anti psychotic na ve or inexperienced patients because of its long half-life.) ) Exceptional Circumstances \200\223immediate tranquillisation necessary Consider IV benzodia zepines \200\224e.g. Diazepam 10mg by slow intravenous bolus (n.b. ensure \202 umazenil a vailable in case of respiratory depression.) Consider IV haloperidol 2 \200\22310mg (high r isk of dystonia \200\224max daily dose 18mg may sometimes be given as single dose.) Third-line treatments Other treatments (e.g. paraldehyde) or combinations of the above may be suggested in some c enters. Always seek senior medical advice before administering these interventions. 29_Semple_Back.indd 1024 12/7/2012 8:36:38 PM Aftercare \200 Respiration, pulse, and blood pressure should be monitored within an hour of drug administr ation and regularly thereafter. Look for extrapyramidal side-effects, particularly acute dy stonia; possible NMS. Remember: fatalities have occurred during emergency restraint. 29_Semple_Back.indd 1025 12/7/2012 8:36:38 PM