La psychothérapie dans la prise en charge de la dépression mineure

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ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (141 download)

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Book Synopsis La psychothérapie dans la prise en charge de la dépression mineure by : Damien Roland

Download or read book La psychothérapie dans la prise en charge de la dépression mineure written by Damien Roland and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : La prise en charge de la dépression est un enjeu majeur de santé publique. La psychothérapie fait partie des éléments de cette prise en charge. Surtout dans la forme d'expression « mineure » de l'épisode dépressif où les thérapeutiques médicamenteuses n'ont pas leur place. Dès lors nous nous sommes intéressés aux pratiques du médecin traitant sur ce sujet, comment celui-ci conseille et oriente ses patients. Méthode : Nous avons interrogé 154 médecins de 3 départements (Ille-et-Vilaine, Maine-et-Loire et Morbihan). L'idée était de recueillir leur pratique de prise en charge dans le cas d'un 1er épisode dépressif caractérisé mineur. Résultat/Discussion : Il en ressort que peu de médecins pratiquent eux-mêmes une psychothérapie mais la plupart proposent un suivi régulier. Pour évaluer la sévérité de la dépression, l'utilisation d'une échelle de score n'est pas une pratique majoritaire. La psychothérapie de soutien est la psychothérapie la plus conseillée à ce stade. Le conseil d'un professionnel psychologue reposait essentiellement sur des critères plus pragmatiques (proximité géographique, bon retour...). Les 3 principaux obstacles dans l'instauration d'une psychothérapie sont dans l'ordre décroissant d'importance : le non remboursement des consultations des psychologues libéraux, le refus du patient à initier une psychothérapie et l'incapacité de ce dernier à pouvoir suivre une psychothérapie. On décèle également dans le questionnaire l'intérêt que portent les praticiens du Morbihan pour l'expérimentation de la sécurité sociale sur le remboursement des soins psychologiques. Conclusion : Le médecin traitant est un acteur majeur de la prise en charge des patients présentant un épisode dépressif caractérisé. Les médecins interrogés se sentent efficaces dans la gestion de cette pathologie, ils instaurent un suivi particulier pour leurs patients et possèdent des connaissances permettant le conseil et l'orientation en psychothérapie. Ils s'appuient sur le réseau de soin local. Parmi les obstacles identifiés à l'instauration d'une psychothérapie, le premier est le non remboursement. Il fait l'objet d'une expérimentation actuelle de la sécurité sociale, dont les résultats sont attendus en 2023. Les autres obstacles pourraient également être considérés.

Parcours de soins du mineur atteint de dépression

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ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (141 download)

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Book Synopsis Parcours de soins du mineur atteint de dépression by : Pierre-Olivier Henrio

Download or read book Parcours de soins du mineur atteint de dépression written by Pierre-Olivier Henrio and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : L'Organisation Mondiale de la Santé (OMS) identifie la prise en charge de la dépression chez le mineur comme un enjeu majeur de santé publique, compte tenu de ses effets sur le développement physique, affectif, intellectuel et social à long terme. En 2014, la Haute Autorisé de Santé (HAS) proposait pour la première fois des recommandations afin d'aider les médecins de premiers recours à établir un diagnostic initial et proposer ainsi une prise en charge adaptée à chaque situation. Entre 2018 et 2022, la pédopsychiatrie en France a été confrontée à de nombreuses difficultés. En effet de nombreux rapports ont mis l'accent sur la nécessité d'améliorer la prise en charge des enfants et adolescents souffrant de troubles psychiques. Dans le contexte français de saturation du réseau de soins, comment les différents acteurs articulent-ils leurs prises en charge de la dépression chez le mineur ? Quelles sont les limites et les difficultés qu'ils rencontrent au quotidien ? Comment améliorer localement la prise en charge de la dépression de l'enfant ? Objectifs : L'objectif est de déterminer les obstacles à la prise en charge du mineur atteint de dépression dans la Loire, pour en dégager des pistes d'amélioration. Méthode : Une revue narrative de la littérature a permis la réalisation d'un guide d'entretien semi-structuré. Onze entretiens ont ensuite été conduits et analysés par une méthode qualitative. Résultats et discussion : Plusieurs obstacles sont identifiés par les acteurs interrogés : la gestion de la consultation, l'accès aux soins, la pathologie elle-même. Les premiers défis sont retrouvés à l'intérieur du cabinet. Les consultations pour des symptomatologies polymorphes (hostiles, opposantes, mutiques) sont jugées chronophages. Les difficultés dans la relation avec les patients, en particulier lorsque cela implique un tiers ou des discussions intimes avec un mineur, altèrent également la gestion du cabinet. La dépression est perçue comme un diagnostic ambigu, entaché de représentations sociales négatives, qui incite les professionnels à une certaine réserve à la fois dans leur démarche diagnostique et thérapeutique. Des carences sont identifiées dans le dépistage et la prévention en première ligne comme dans l'accès à une prise en charge spécialisée (délai, coût, distance, moyens). Il est possible de s'inspirer de modèles étrangers proposant par exemple le remboursement des soins de psychothérapie ou la réalisation de campagnes médiatiques de sensibilisation pour améliorer notre prise en charge. De plus, les technologies avec l'utilisation de la téléconsultation et des hotlines téléphoniques peuvent être envisagées pour soulager la pression sur le réseau de soins. Conclusion : Le parcours de soins des mineurs atteints de dépression est complexe, confronté à des difficultés qui dépassent la seule problématique du manque d'accès aux soins et de la formation des professionnels de la santé. Il semble nécessaire de réévaluer l'efficacité et la faisabilité de l'organisation des soins de premiers recours et la collaboration entre les différents professionnels de santé impliqués. De plus, il est essentiel de reconnaître l'importance fondamentale de changer les mentalités autour de la santé mentale.

Manuel de psychoéducation

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Publisher : Dunod
ISBN 13 : 2100873261
Total Pages : 302 pages
Book Rating : 4.1/5 (8 download)

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Book Synopsis Manuel de psychoéducation by : Christian Gay

Download or read book Manuel de psychoéducation written by Christian Gay and published by Dunod. This book was released on 2024-06-05 with total page 302 pages. Available in PDF, EPUB and Kindle. Book excerpt: La psychoéducation propose aux patients un accompagnement personnalisé visant à améliorer le suivi thérapeutique et la qualité de vie. Ce manuel présente 15 séances de psychoéducation clefs en main pour stabiliser la maladie. - Un outil vivant qui conjugue rigueur scientifique et accessibilité pour mettre en lumière et décrypter les techniques, méthodes et possibilités de traitements. - Un recueil d’informations complet et précis sur le sujet qui s’adresse à tous ceux qui sont concernés par ces troubles et souhaitent en comprendre les mécanismes, les signes et symptômes, ainsi que les différentes formes. Des questionnaires, grilles d’activités, et graphiques à compléter pour observer au quotidien l’évolution de son trouble. - Des conseils et des recommandations qui permettent d’anticiper, d’adapter son rythme de vie ou de faire comprendre les troubles de l’humeur à son entourage.

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Publisher : Odile Jacob
ISBN 13 : 2738182194
Total Pages : 174 pages
Book Rating : 4.7/5 (381 download)

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Book Synopsis by :

Download or read book written by and published by Odile Jacob. This book was released on with total page 174 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Postpartum Depression and Child Development

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Publisher : Guilford Press
ISBN 13 : 9781572305175
Total Pages : 340 pages
Book Rating : 4.3/5 (51 download)

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Book Synopsis Postpartum Depression and Child Development by : Lynne Murray

Download or read book Postpartum Depression and Child Development written by Lynne Murray and published by Guilford Press. This book was released on 1999-07-01 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt: One in ten women suffers from an episode of significant depression following the birth of a baby. These depressions can have a profoundly negative effect on the quality of the mother infant relationship and, in turn, on the course of child development itself. The first book in a decade to deal exclusively with the impact of postpartum depression on child development, this groundbreaking volume brings together rigorous and sophisticated research from eighteen of the leading authorities in the field.

Treatment Resistant Depression

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Publisher : American Psychiatric Pub
ISBN 13 : 1585624098
Total Pages : 366 pages
Book Rating : 4.5/5 (856 download)

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Book Synopsis Treatment Resistant Depression by : John F. Greden

Download or read book Treatment Resistant Depression written by John F. Greden and published by American Psychiatric Pub. This book was released on 2011 with total page 366 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique book presents the treatment "roadmap" implemented by the University of Michigan Comprehensive Depression Center's Treatment Resistant Depression Program, step-by-step guidance that has long eluded clinicians, patients, and their families. Writing across discipline, modality, lifespan, and patient demographics, the authors have compiled the most current thinking on TRD and distilled it into a highly readable, imminently practical, and brilliantly organized source of hope. The authors believe that early intervention is critical, and they advocate strategies for renewed focus on identifying youths who are at risk or already symptomatic. Similarly, they devote chapters to special populations such as pregnant women, older people, and those with comorbidities. Perhaps most useful to patients and their families, the book has a strong self-care orientation, emphasizing the importance of exercise, nutrition, and healthy sleep guidelines. Patients who are actively engaged in managing their disease often have better outcomes. Treatment Resistant Depression is frequently a lifetime diagnosis. The book acknowledges that fact and offers a systematic course of treatment grounded in evidence-based research that is current and comprehensive. Treatment Resistant Depression: A Roadmap for Effective Care offers a new way of conceptualizing an old enemy, and should prove to be an indispensable weapon in the battle.

Psychiatrie, Psychanalyse, Culture

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Publisher :
ISBN 13 :
Total Pages : 466 pages
Book Rating : 4.F/5 ( download)

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Book Synopsis Psychiatrie, Psychanalyse, Culture by :

Download or read book Psychiatrie, Psychanalyse, Culture written by and published by . This book was released on 2003 with total page 466 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Parental Alienation, DSM-5, and ICD-11

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Publisher : Charles C Thomas Publisher
ISBN 13 : 0398079455
Total Pages : 264 pages
Book Rating : 4.3/5 (98 download)

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Book Synopsis Parental Alienation, DSM-5, and ICD-11 by : William Bernet

Download or read book Parental Alienation, DSM-5, and ICD-11 written by William Bernet and published by Charles C Thomas Publisher. This book was released on 2010 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: Parental alienation is an important phenomenon that mental health professionals should know about and thoroughly understand, especially those who work with children, adolescents, divorced adults, and adults whose parents divorced when they were children. In this book, the authors define parental alienation as a mental condition in which a child - usually one whose parents are engaged in a high- conflict divorce - allies himself or herself strongly with one parent (the preferred parent) and rejects a relationship with the other parent (the alienated parent) without legitimate justification. This process leads to a tragic outcome when the child and the alienated parent, who previously had a loving and mutually satisfying relationship, lose the nurture and joy of that relationship for many years and perhaps for their lifetimes. We estimate that 1 percent of children and adolescents in the U.S. experience parental alienation. When the phenomenon is properly recognized, this condition is preventable and treatable in many instances. The authors of this book believe that parental alienation is not simply a minor aberration in the life of a family, but a serious mental condition. Because of the false belief that the alienated parent is a dangerous or unworthy person, the child loses one of the most important relationships in his or her life. This book contains much information about the validity, reliability, and prevalence of parental alienation. It also includes a comprehensive international bibliography regarding parental alienation with more than 600 citations. In order to bring life to the definitions and the technical writing, several short clinical vignettes have been included. These vignettes are based on actual families and real events, but have been modified to protect the privacy of both the parents and children.

PROMOTION DE LA SANTE ET AUTONOMISATION DANS LE CONTEXTE AFRICAIN

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Publisher : Lulu.com
ISBN 13 : 1291761152
Total Pages : 327 pages
Book Rating : 4.2/5 (917 download)

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Book Synopsis PROMOTION DE LA SANTE ET AUTONOMISATION DANS LE CONTEXTE AFRICAIN by : David HouŽto

Download or read book PROMOTION DE LA SANTE ET AUTONOMISATION DANS LE CONTEXTE AFRICAIN written by David HouŽto and published by Lulu.com. This book was released on 2014-02-26 with total page 327 pages. Available in PDF, EPUB and Kindle. Book excerpt: Le terme promotion de la santé en Afrique, près de 30 ans après l'adoption de la Charte d'Ottawa, continue d'avoir des connotations complètement hors du sens que lui confère cette charte. Cela n'est pas étonnant quand on sait que la notion de santé dans ce contexte africain équivaut à la lutte contre la maladie à travers les soins de santé dispensés par des professionnels de la santé dans des formations sanitaires et les hôpitaux. L'évolution que connait le continent depuis quelques décennies est de donner un peu plus de place à la communauté à travers les relais communautaires dans une participation communautaire vidée de son contenu, car le pouvoir n'est jamais passé entre les mains des communautés.C'est au vu de tout ceci que le présent ouvrage à sa raison d'être pour expliquer les fondements de l'autonomisation communautaire et de la promotion de la santé avec leur importance pour la région africaine en proie aux mauvais indicateurs de santé comparativement aux autres régions du monde.

Handbook of Psychiatry in Palliative Medicine

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Publisher :
ISBN 13 : 0195301072
Total Pages : 591 pages
Book Rating : 4.1/5 (953 download)

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Book Synopsis Handbook of Psychiatry in Palliative Medicine by : Harvey Max Chochinov

Download or read book Handbook of Psychiatry in Palliative Medicine written by Harvey Max Chochinov and published by . This book was released on 2009 with total page 591 pages. Available in PDF, EPUB and Kindle. Book excerpt: Psychiatric, or psychosocial, palliative care has transformed palliative medicine. Palliation that neglects psychosocial dimensions of patient and family experience fails to meet contemporary standards of comprehensive palliative care. While a focus on somatic issues has sometimes overshadowed attention to psychological, existential, and spiritual end-of-life challenges, the past decade has seen an all encompassing, multi-disciplinary approach to care for the dying take hold. Written by internationally known psychiatry and palliative care experts, the Handbook of Psychiatry in Palliative Medicine is an essential reference for all providers of palliative care, including psychiatrists, psychologists, mental health counselors, oncologists, hospice workers, and social workers.

Entertainment Computing - ICEC 2015

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Publisher : Springer
ISBN 13 : 3319245899
Total Pages : 594 pages
Book Rating : 4.3/5 (192 download)

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Book Synopsis Entertainment Computing - ICEC 2015 by : Konstantinos Chorianopoulos

Download or read book Entertainment Computing - ICEC 2015 written by Konstantinos Chorianopoulos and published by Springer. This book was released on 2015-09-24 with total page 594 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book constitutes the refereed proceedings of the 14th International Conference on Entertainment Computing, ICEC 2015, held in Trondheim, Norway, in September/October 2015. The 26 full papers, 6 short papers, 16 posters, 6 demos and 6 workshops/tutorial descriptions presented were carefully reviewed and selected from 106 submissions. The multidisciplinary nature of Entertainment Computing is reflected by the papers. They focus on computer games; serious games for learning; interactive games; design and evaluation methods for Entertainment Computing; digital storytelling; games for health and well-being; digital art and installations; artificial intelligence and machine learning for entertainment; interactive television and entertainment.

PASCAL.

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Publisher :
ISBN 13 :
Total Pages : 806 pages
Book Rating : 4.:/5 (3 download)

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Book Synopsis PASCAL. by :

Download or read book PASCAL. written by and published by . This book was released on 1990 with total page 806 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Your Mindful Compass

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Publisher :
ISBN 13 : 9780615928791
Total Pages : 318 pages
Book Rating : 4.9/5 (287 download)

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Book Synopsis Your Mindful Compass by : Andrea Maloney Schara

Download or read book Your Mindful Compass written by Andrea Maloney Schara and published by . This book was released on 2013-12-01 with total page 318 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Your Mindful Compass" takes us behind the emotional curtain to see the mechanisms regulating individuals in social systems. There is great comfort and wisdom in knowing we can increase our awareness to manage the swift and ancient mechanisms of social control. We can gain greater flexibility by seeing how social controls work in systems from ants to humans. To be less controlled by others, we learn how emotional systems influence our relationship-oriented brain. People want to know what goes on in families that give rise to amazing leaders and/or terrorists. For the first time in history we can understand the systems in which we live. The social sciences have been accumulating knowledge since the early fifties as to how we are regulated by others. S. Milgram, S. Ashe, P. Zimbardo and J. Calhoun, detail the vulnerability to being duped and deceived and the difficulty of cooperating when values differ. Murray Bowen, M.D., the first researcher to observe several live-in families, for up to three years, at the National Institute of Mental Health. Describing how family members overly influence one another and distribute stress unevenly, Bowen described both how symptoms and family leaders emerge in highly stressed families. Our brain is not organized to automatically perceive that each family has an emotional system, fine-tuned by evolution and "valuing" its survival as a whole, as much as the survival of any individual. It is easier to see this emotional system function in ants or mice but not in humans. The emotional system is organized to snooker us humans: encouraging us to take sides, run away from others, to pressure others, to get sick, to blame others, and to have great difficulty in seeing our part in problems. It is hard to see that we become anxious, stressed out and even that we are difficult to deal with. But "thinking systems" can open the doors of perception, allowing us to experience the world in a different way. This book offers both coaching ideas and stories from leaders as to strategies to break out from social control by de-triangling, using paradoxes, reversals and other types of interruptions of highly linked emotional processes. Time is needed to think clearly about the automatic nature of the two against one triangle. Time and experience is required as we learn strategies to put two people together and get self outside the control of the system. In addition, it takes time to clarify and define one's principles, to know what "I" will or will not do and to be able to take a stand with others with whom we are very involved. The good news is that systems' thinking is possible for anyone. It is always possible for an individual to understand feelings and to integrate them with their more rational brains. In so doing, an individual increases his or her ability to communicate despite misunderstandings or even rejection from important others. The effort involved in creating your Mindful Compass enables us to perceive the relationship system without experiencing it's threats. The four points on the Mindful Compass are: 1) Action for Self, 2) Resistance to Forward Progress, 3) Knowledge of Social Systems and the 4) The Ability to Stand Alone. Each gives us a view of the process one enters when making an effort to define a self and build an emotional backbone. It is not easy to find our way through the social jungle. The ability to know emotional systems well enough to take a position for self and to become more differentiated is part of the natural way humans cope with pressure. Now people can use available knowledge to build an emotional backbone, by thoughtfully altering their part in the relationship system. No one knows how far one can go by making an effort to be more of a self-defined individual in relationships to others. Through increasing emotional maturity, we can find greater individual freedom at the same time that we increase our ability to cooperate and to be close to others.

Circadian Rhythm Sleep-Wake Disorders

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Publisher : Springer Nature
ISBN 13 : 3030438031
Total Pages : 251 pages
Book Rating : 4.0/5 (34 download)

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Book Synopsis Circadian Rhythm Sleep-Wake Disorders by : R. Robert Auger

Download or read book Circadian Rhythm Sleep-Wake Disorders written by R. Robert Auger and published by Springer Nature. This book was released on 2020-05-26 with total page 251 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book resolves to bridge the communication gap between research and clinical practice for circadian rhythm sleep-wake disorders. Beginning with a scientific background on biological timekeeping, opening chapters describe the crucial nature of maintaining delicate temporal organization of physiological and molecular events within the body. Following this are discussions on circadian physiology and methods of circadian assessments. Subsequent chapters then relay comprehensive information regarding the International Classification of Sleep Disorders-defined circadian rhythm sleep-wake disorders (CRSWDs), specifically discussing etiology and epidemiology, but focusing on evidence-based treatment data. Concluding discussions provide guidance for the application of light therapy and discuss future roles for optimized lighting environments. Nuanced and market-demanded, Circadian Rhythm Sleep-Wake Disorders: An Evidence-Based Guide for Clinicians and Investigators is an invaluable resource for Sleep Medicine clinicians, circadian researchers, and other interested parties.

Problem-Solving Therapy

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Publisher : Springer Publishing Company
ISBN 13 : 9780826114884
Total Pages : 280 pages
Book Rating : 4.1/5 (148 download)

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Book Synopsis Problem-Solving Therapy by : Thomas D'Zurilla, PhD

Download or read book Problem-Solving Therapy written by Thomas D'Zurilla, PhD and published by Springer Publishing Company. This book was released on 2006-09-18 with total page 280 pages. Available in PDF, EPUB and Kindle. Book excerpt: MAXIMIZE POSITIVE PATIENT OUTCOMES Enhance Function--Avert Relapses--Present New Problems In this new updated edition, authors Thomas J. D'Zurilla and Arthur M. Nezu, present some of the most useful advances in problem-solving therapy (PST) today. An excellent resource for maximizing positive patient outcomes, this all-inclusive guide helps enhance your problem solving skills and apply successful clinical techniques to help your clients improve their lives. Known for its presentation of solid research results and effective PST training tools, this best-selling guide has been fully updated to include: NEW research data on social problem solving and adjustment NEW studies on the efficacy of PST NEW social problem solving models NEW updated and more user-friendly therapist's training manual Written for a wide audience, from therapists and counselors to psychologists and social workers, this highly readable and practical reference is a must-have guide to helping your patients identify and resolve current life problems. The book set is designed to be read alongside its informal "manual" accompaniment, Solving Life's Problems: A 5-Step Guide to Enhanced Well-Being by D'Zurilla, Nezu, and Christine Maguth Nezu. Purchase of the two books as a set will get you these life-changing texts at an $7.00 savings over the two books bought individually.

The Hamilton Scales

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Publisher : Springer Science & Business Media
ISBN 13 : 3642753736
Total Pages : 139 pages
Book Rating : 4.6/5 (427 download)

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Book Synopsis The Hamilton Scales by : Per Bech

Download or read book The Hamilton Scales written by Per Bech and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 139 pages. Available in PDF, EPUB and Kindle. Book excerpt: The European College of Neuropsychopharmacology (ECNP) is a scientific and educational association which represents a variety of disciplines. The first ECNP congress took place in Copenhagen, May 1985, where a working group of European scientists within the field of psychopharmacology was elected to prepare a constituent ECNP congress in Brussels, 1987. Among the most active members of this group was Max Hamilton. At the second ECNP congress in Brussels Max Hamilton was elected as the first honorary member of the ECNP. When we received the message of his death we decided at once to arrange a Max Hamilton memorial symposium at the third ECNP congress, May 1989, in Gothenburg, Sweden. This monograph contains the proceedings of the Max Hamilton symposium which was chaired by the editors. The opening lecture of the third ECNP congress was a Max Hamilton lecture: "A life devoted to science in psychiatry" which was presented by Sir Martin Roth. It seemed obvious to include Sir Martin's lecture as the opening article of this monograph. Although G .E. Berrios was unable to participate in the ECNP congress we have found it logical to include his manuscript on "The Hamilton Depression Scale and the Numerical Description of the Symptoms of Depression" as another personal contribution to Max Hamilton and his rating scales.

Stages and Pathways of Drug Involvement

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Publisher : Cambridge University Press
ISBN 13 : 9780521789691
Total Pages : 404 pages
Book Rating : 4.7/5 (896 download)

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Book Synopsis Stages and Pathways of Drug Involvement by : Denise Bystryn Kandel

Download or read book Stages and Pathways of Drug Involvement written by Denise Bystryn Kandel and published by Cambridge University Press. This book was released on 2002-03-04 with total page 404 pages. Available in PDF, EPUB and Kindle. Book excerpt: (Publisher-supplied data) This book represents the first systematic discussion of the Gateway Hypothesis, a developmental hypothesis formulated to model how adolescents initiate and progress in the use of various drugs. In the United States, this progression proceeds from the use of tobacco or alcohol to the use of marijuana and other illicit drugs. This volume presents a critical overview of what is currently known about the Gateway Hypothesis. The authors of the chapters explore the hypothesis from various perspectives ranging from developmental social psychology to prevention and intervention science, animal models, neurobiology and analytical methodology. This volume is original and unique in its purview, covering a broad view of the Gateway Hypothesis. The juxtaposition of epidemiological, intervention, animal and neurobiological studies represents a new stage in the evolution of drug research, in which epidemiology and biology inform one another in the understanding of drug abuse.