Eating disorders (EDs) are common and life-threatening psychiatric disorders that cause psychological impairment and substantial dysfunction. EDs are treatable, but many do not receive the care needed due to lack of accessibility and understanding. Anorexia nervosa (AN) is characterized by food restriction leading to low body weight or lack of appropriate weight milestones, disturbance in body image, and poor insight regarding the seriousness of their low body weight. Bulimia nervosa (BN) is characterized by binge-eating followed by compensatory behavior to prevent weight gain. Binge-eating disorder (BED) is characterized by binge eating behavior but with an absence of compensatory behaviors. Avoidant/restrictive food intake disorder (ARFID) is characterized by eating or feeding disturbance leading to consequences including significant weight loss, poor growth, nutritional deficiency, psychosocial dysfunction, or the need for supplemental nutrition. Other specified feeding or eating disorder (OSFED) is a given when someone is experiencing eating disturbances that cause clinical distress or life impairment but the behaviors do not meet full DSM-5 criteria for an eating disorder.

Digital processes need to have wellbeing at their core. Rather than focusing on burnout and distress, digital can be considered as an enabler of wellness. Using key concepts such as user-centred design, reimagining processes and education, digital can enhance the lives of staff and patients. Many solutions to digital distress involve taking a break from technology. These solutions are temporary and do not address the root cause of the issue. As technology embeds itself into every facet of our lives, we have an opportunity to take control of how we engage with digital. Instead of translating paper processes into digital equivalents there is an opportunity to leverage the power digital brings to reduce the burden rather than add to it. Clinician and patient engagement are key to digital wellbeing and the success of digital in our healthcare systems. Increasing autonomy and providing flexible support can reduce burnout with digital systems. Involvement must be meaningful and not acceptability testing at the end of system design. Critically, we must remember that people are the most important determinant of the success of any digital project.

Functional abdominal pain (FAP) is one of the most common medical complaints children present to their pediatricians. Despite the prevalence of FAP as well as its early onset, treatments for young children are particularly rare. Young children are just beginning to learn about the complex messages that their body communicates. Yet, pain can contribute to a fear of the body and an attempt to avoid these important signals. This chapter describes the background and rationale for a new approach to pain for young children, one that conceptualizes the sensitivity to pain and other experiences of the body as a superpower rather than a vulnerability - “sensory superpowers!” We train children to be Feeling and Body Investigators (FBI), individuals who have awe-inspiring curiosity and responsivity towards the many wise communications from their bodies and who respond to these messages with dexterity and skill. The end result is children who are not only fearless about pain, but also who are adept at emotion awareness and regulation. They are Feeling and Body Investigators!

Cells are the fundamental units of tissues in multicellular organisms. Animal cells are sealed sacs constructed of extremely thin (≈5 nm) lipid bilayer plasma membranes, spanning across which are various membrane proteins. Crucially, the membrane separates an intracellular biochemical compartment, the cytoplasm, from the extracellular environment. This separation enables gradients, or differences in concentration, of ions and small molecules to be maintained across the membrane, and acts to contain the cytoplasmic proteins and enzymes involved in metabolism, as well as organelles, or intracellular membrane compartments. Particularly importantly for the nervous system, the membrane is also an excellent electrical insulator: it is energetically very unfavourable for charged entities like free ions and electrons to jettison their interactions with polar water molecules in order to cross through the uncharged, non-polar hydrocarbon interior of the lipid bilayer membrane, and so transporting them across the membrane is normally very difficult. This high resistance allows an electrical potential difference to be maintained across the membrane – the membrane potential. An electrical potential difference is equivalent to a difference in the ‘concentration’ of unbalanced charges between the two sides of the membrane.

Acute Mania; Rapid Cycling Bipolar Disorder; Bipolar II Disorder and Bipolar Depression; Bipolar Disorder Prophylaxis, Response Predictors; Unipolar Depression; Suicidality; Aggressive or Impulsive Behavior in Child/Adolescent Patients with Conduct Disorder, in Borderline Personality Disorder or in Patients with Intellectual Disability; Neuroprotective Properties; Elevation of Neutrophil Counts; Mechanisms of Action

A purposeful, conscientious and well-intentioned mental health volunteer needs to be informed about the background, principles and ethics of global mental health in order to be impactful. This chapter provides background to aid such efforts and introduces global mental health within the wider voluntary context.

Which of the following represents an evidence-based intervention for a patient with treatment-resistant anxiety?

This grouping reflects the prominence that external events have in the aetiology of certain psychiatric conditions. In response to developments in research and theory, allied to the importance of clinical utility in a wide variety of health settings, significant changes have been made to the comparable grouping in ICD-10. These include a reformulation of PTSD aimed at highlighting what differentiates it from other disorders, and the introduction of a distinction between PTSD and a new disorder, Complex PTSD. Prolonged Grief Disorder is another new addition based on what is now extensive research on how grief differs from depression and responds to different kinds of treatment. Like PTSD, Adjustment Disorder has been reformulated to highlight specific symptoms and processes.

This chapter will cover some of the key theoretical and practice issues associated with how social media impact on group and individual behaviour. The chapter will also address practical issues of relevance to professionals considering using social media as part of their efforts to promote mental health. In the opening section, we set out an introduction to relevant behavioural theory and its implications for social media practice and how it can be used to promote positive engagement with social media. The chapter will also examine how social media can be harnessed to promote mental health and provide guidance about the design and use of social media in the field of mental health promotion. It will provide practitioners with understanding about how social media can have negative influence on both personal and group behaviour and how this can be minimized. The chapter will conclude with practical examples about how to utilize social media in mental health promotion and guidance that can be given to clients about how best to use social media as part of their own mental health promotion. The chapter will be illustrated with case studies and examples from a variety of countries.

Opium, manufactured from the sap of the opium poppy (Papaver somniferum), has been cultivated by humans for centuries. It has been used, in one form or another, for medicinal as well as recreational purposes, and is the precursor to all modern-day opiate pharmaceutical agents. Morphine, the active ingredient in opium, was isolated from opium in 1803, and very quickly became widely used as strong painkiller. As a result of its effectiveness and widespread use many people began to become addicted to the medication. In an attempt to create a safer and less addictive alternative to morphine, heroin was synthesized from morphine in 1874 and marketed by pharmaceutical company Bayer as a morphine substitute, and so the modern world’s struggle with opioid misuse continued. Over a century ago the world recognized that opioid addiction was a significant problem that needed to be addressed, and yet today we are faced with an escalating epidemic of opioid misuse and addiction, a world in which few, if any of us, have remained unscathed. This chapter focuses on the specific factors which have led to the exponential increase in opioid misuse throughout the world over the last century

This chapter provides a concise but comprehensive overview of body focused repetitive behaviors (BFRBs), focusing on the two disorders recognized in the American Psychiatric Association’s diagnostic manual (DSM 5), hairpulling disorder (HPD), also known as trichotillomania, and skin picking disorder (SPD), also known as excoriation disorder. It addresses diagnostic issues, causation, demographics, course of the disorders, comorbidity, prevalence, emotional and interpersonal sequelae, and phenomenology. Furthermore, common misconceptions about BFRBs are addressed, providing the reader with a solid information base upon which to build effective treatment.

Multidimensional Grief Therapy (MGT) is a strength-based intervention designed to carry out a range of important therapeutic tasks with bereaved children and adolescents. These tasks include (1) reducing unhelpful grief reactions (grief that keeps kids “stuck” and unable to adjust); (2) promoting adaptive grief reactions (grief that helps kids to feel and cope better after a death); (3) reducing associated symptoms of psychological distress (e.g., posttraumatic stress and depressive symptoms), and (4) helping bereaved children and adolescents to lead healthy, happy, productive lives. Consistent with its assessment-driven, flexibly tailored design, MGT is divided into a pretreatment assessment interview and an assessment feedback interview, followed by a two-phased treatment approach.

This chapter looks at the many different ways we think about resilience. We describe how we became interested in resilience as researchers and clinicians, and some of the events that tested our personal reslience. We introduce some of the essential lessons we have learned from resilient people over several decades of work. We also describe important parts of the brain and body involved in helping us cope with and recover from stressful experiences, and what we know about the genetics of resilience.

The basic principle of nutrition is the provision of adequate nutrients for populations or groups within populations. Adequate nutrition requires that all nutrients are consumed in adequate amounts and in the correct proportions. Energy is one of the most important things we obtain from food. In the body, energy consumed is used to support metabolic processes. Energy expenditure is made up of three components: basal metabolic rate, thermic effect of food and physical activity. Within the diet, the role of carbohydrates is to be a source of fuel, but overall carbohydrates are also part of energy stores, structural components of cell walls, part of nucleic acids (RNA and DNA) and part of many proteins and lipids. Protein is the most abundant nitrogen-containing compound in the diet. It is a major functional and structural component of all body cells. Fats, also known as lipids, are composed of a carbon skeleton with hydrogen and oxygen substitutions. Understanding the pathway for each nutrient allows for the development of dietary reference values, which aim for optimal levels of a nutrient for each population group. The types of foods eaten in different countries are influenced by factors such as ethnicity, culture, dietary habits, food preferences, intake patterns and food availability, and so the classification and types of foods contained in the major ‘food groups’ can vary somewhat from country to country.

This chapter traces the origins of psychodynamic psychotherapy back to the late eighteenth century and to the development of ‘moral treatment’ by Pinel in Paris and William Tuke in York. It also considers the contribution of Mesmer’s theory of animal magnetism, and its revival as hypnotism in the second half of the nineteenth century by Jean-Martin Charcot and others. It then goes on to consider the work of Freud and the various critiques of his theories. Next the chapter considers the phenomenon of shell shock in the First World War and how it led to further developments in psychotherapy. It then looks at the creation of the Tavistock Clinic in the early twentieth century and the work of Anna Freud and Melanie Klein. Object relations theory is outlined, and the work of therapists such as Fairbairn, Bowlby, and Winnicott is examined. Finally the chapter briefly considers ‘the turn to the child’ in psychotherapy, the development of group psychotherapy, and the attempts to treat psychosis with psychotherapeutic methods.

The purpose of this chapter is to give a brief overview of some of the clinical features of dementia. A level of knowledge is assumed and there are other texts that comprehensively examine general aspects of dementia diagnosis, neurobiology, current interventions, etc. We will provide an overview of the range of cognitive systems and how impairments in these systems relate to the clinical presentation. While decision-making capacity and cognitive abilities are related, they are not the same thing. The first refers to the patient’s ability to make a particular decision (at a particular point in time) and the latter encompasses a broad range of processes, including a person’s memory, problem-solving, language, attention and visuospatial abilities. Understanding different cognitive domains and how they interact is necessary for accurate clinical assessment and in determining disease severity. Also, in relation to legal considerations, characterising specific deficits may also help to explain why decision-making capacity is impaired or, just as importantly, in identifying how to apply measures to support an individual’s decision-making.

Figure 2 represents approximately what we see year-on-year. The majority of applications for CESR in psychiatry are in general adult, with Child and Adolescent Mental Health Services (CAMHS) and old age varying between second and third places year-on-year. Medical psychotherapy, intellectual disability and forensic see comparatively fewer applications and hence the percentages can become quite skewed. It is only very rarely that we see ‘non-CCT’ specialty applications.

The Black Women and Psychotherapy Study lays a foundation for our ideas. We report findings from a mixed-method study of the psychotherapy viewpoints and experiences of Black women. This research involved more than 227 Black women of varied ages, from all across the United States, who responded to our survey on psychotherapy. This chapter reporting study results and provides an empirical basis for the approach we take to improving the therapy experiences of Black women. Several key metrics from the study are also integrated into other chapters.

Schema therapy could have very easily been named as ‘needs therapy’, so central is the concept of core emotional needs to the practice of modern schema therapy. Borrowing from the basic needs concept and theories of attachment that had been well developed in the developmental psychology literature, Young described the following core domains as pivotal to understanding problems that emerge in the developmental period: (1) Secure attachments to others (includes safety, stability, nurturance, and acceptance); (2) Autonomy, competence, and sense of identity; (3) Freedom to express valid needs and emotions; (4) Spontaneity and play; (5) Realistic limits and self-control. Need satisfaction during childhood leads to the development of healthy schemas and related functional affective and behavioural patterns, while early need frustration leads directly to the development of early maladaptive schemas (EMS) and related negative patterns of behaviour and maladaptive coping styles. This chapter describes the central theories and concepts which underpin schema therapy practice including the original set of eighteen schemas, as well as schema modes and the schema mode model.