Source 1

uepresslon
Plghly prevalenL 1hey are also assoclaLed wlLh huge losses of quallLy of llfe ln paLlenLs and Lhelr
relaLlves

lncreased morLallLy raLes

hlgh levels of servlce use and enormous economlc cosLs

Ma[or
depresslon ls currenLly Lhe fourLh dlsorder worldwlde ln Lerms of dlsease burden and ls expecLed Lo be
Lhe dlsorder wlLh Lhe hlghesL dlsease burden ln hlghlncome counLrles by Lhe year 2030
MosL dlsorders LreaLed ln prlmary care and many prescrlbe anLldepressanL medlcaLlons ma[orlLy of
paLlenLs prefer psychologlcal LreaLmenLs (Lherapy)
aLlenLs ln prlmary care have a less severe or less progressed verslon of depresslon Lhan Lhose ln
speclallzed healLhcare seLLlngs
1herapy ls more effecLlve ln prlmary care paLlenLs wlLh depresslon
Cu l [ p e r s l m An n e ml e k e v a n S L r a L e n An n e k e v a n S c h a l k a n d Ce r h a r d An d e r s s on
l s y c bo l oq l c o l t t e ot me o t o f J e p t e s s l oo l o p t l mo t y c o t e o me t o o oo l y s l s S we d e n
ue p a r L me n L of 8 e h a v l ou r a l S c l e n c e s a n d L e a r n l n g 20 09 We b 7 nov 2011
l or p or L f ol l o h L L p / / www n c b l n l m n l h g ov / p mc / a r L l c l e s / MC2629842 /
$4:7 . 0
Sc h i z op h r e n i a :
International research eIIorts have demonstrated the success oI community outreach and
education regarding the schizophrenia symptoms and it is now possible to use empirically
deIined criteria to identiIy individuals at a substantially increased risk Ior a psychotic illness.
Preliminary treatment studies have demonstrated initial success in reducing the severity oI
symptoms and improving Iunctional outcome in clinical high-risk samples.
82.1 oI clinical high-risk patients have a liIetime history oI receiving psychotropic
medications. OI those who received therapy, the majority received psychotherapy or school
support.
Finally, clinical trials oI both psychosocial and pharmacologic interventions are needed to better
inIorm treatment decisions. For now the best recommendation Ior clinicians encountering
clinical high risk patients is to monitor symptoms careIully in all patients and judiciously to
oIIer treatment using a needs based approach, recognizing that the symptoms may either be
transient or evolve into a more serious condition with a range oI diagnostic and Iunctional
ouLcomes
Ca d e n h e a d k r l s L l n ! e a n Ad d l n g L on 1 y r on e Ca n n on 8 a r b a r a Cor n b l a L L 1 h oma s
Mc Cl a s h a n ul a n a e r k l n s L a r r y S e l d ma n a n d Wood s S c oL L nl P u bl l c Ac c e s s
@ t e o t me o t nl s t o t y l o t b e ls y c bo s l s l t oJ t o me cb o t o c t e t l s t l c s o f t b e No t t b Ame t l c oo
l t o J t o me l oo q l t oJ l oo l 5 t o J y co bo t t 2010 r l n L 7 nov 2011
or L f ol l o h L L p / / www n c b l n l m nl h g ov / p mc / a r L l c l e s / MC3063330 /

Source 3
3000 8C LrephlnaLlon a prlmlLlve braln surgery when a hole ls cuL Lhrough Lhe s[ull up Lhrough Lhe
mlddle ages used Lo LreaL selzures and headaches
11001300 across Lurope clalm you can cure menLal lllness by removlng sLones of madness" from Lhe
braln
1949 LlLhlum ls found effecLlve LreaLmenL for blpolar
1987 rozac approved as a LreaLmenL for depresslon
vlcLorlan era laudanum a hlgh ocLane mlx of eLhanol and oplum LhaL was used as a palnklller an
anLldepressanL and an anLlhysLerlc lL was wlldly addlcLlve and frequenLly leLhal
LaLe 19
Lh
Lo early 20
Lh
cenLury llLhlum used Lo ease manlc cycles ln blpolar
AnLlpsychoLlcsLhorazlne for schlzophrenla
uepressanLsvallum for anxleLy
SLlmulanLsrlLalln for adhd
SeroLonln reupLake lnhlblLorsprozac for depresslon
All Lhese drugs have been reflned meanlng subLler and more preclse mulaLlons LhaL work beLLer and
cause fewer slde effecLs Worry LhaL we may become Loo dependenL on chemlcal cruLches unable Lo
geL Lhrough lL wlLhouL relylng on a plll 1he Lrlck ls undersLandlng whaL medlclnes are ouL Lhere and
when lL ls wlse Lo avall yourself of Lhe help Lhey offer

AnLldepressanLs faLlgue welghL galn reduced llbldo sulcldal LhoughLs qulLLlng Lhls drug musL be done
gradually
SedaLlves addlcLlon ls Lhe maln rlsk overdoses are common parLlcularly when alcohol ls also consumed
SLlmulanLs addlcLlon chesL paln cardlac sympLoms mood swlngs anorexlc welghL loss deluslons
AnLlpsychoLlcs numerous even lnvolunLary muscle movemenLs welghL galn selzures leLhargy
Mood sLablllzers Lremors welghL galn sleeplness rashes vomlLlng dlzzlness llver LoxlclLy

kluger !effrey Medlclne ChesL for Lhe Mlnd ?our 8raln A users Culde 2011 3433 rlnL
Source 4
1he medlcal model of healLh care use ls Lhe mosL wldely accepLed and ofLen LesLed model of Lhe
paLhways Lo Lherapy MosL slmply lL ls a casual relaLlonshlp beLween lllness and care When someone
becomes slck Lhe seek care from oLhers 1hls can be applled for any lllness any Lype of healLh care any
Llme ln hlsLory PealLh sLaLus has been Lhe besL predlcLor of use of healLh servlces 1he number of
lllnesses can change over Llme arLly because as new lllnesses arlse oLhers are cured SomeLlmes
because dlscoverles and expandlng knowledge can change Lhe landscape of Lhe fleld A look aL Lhe uSM
flrsL edlLlon Lo Lhe fourLh edlLlon wlll readlly demonsLraLe Lhls phenomenon 1he number of people Lo
whom Lhe lllness applles expands as well such as Lhe recenL surge ln soclal anxleLy dlsorders Lhls Lrend
lf due ln parL Lo beLLer speclflcaLlons of Lhe medlcal model g 227230 an lnLegraLed model(lncludlng
elemenLs of medlcal soclal and culLural models) of paLhways Lo care looks aL an lllness whlch leads Lo a
dlagnosls made up or soclal lnequallLy dr/paLlenL relaLlonshlp culLural values and bellefs soclal
neLworks and soclal supporL all flnally leadlng Lo care or an alLernaLlve Lo care for Lhe lllness g 247
Wlldman 8eLh C and 1erry SLancln 1reaLlng Chlldrens sychosoclal roblems ln rlmary Care unlLed
SLaLes of Amerlca lnformaLlon Age ubllshlng lnc 2004 rlnL
Source S
PorvaLh and Creenberg found research evldence of Lhe cenLral role of Lhe relaLlonshlp ln successful
Lheraples Ma[or advances(accordlng Lo Lhem) have been made ln havlng an lncreased awareness of
varlables prlor Lo LreaLmenL LhaL suggesL poLenLlal for a successful LherapeuLlc relaLlonshlp and
undersLandlng Lhe ways ln whlch Lhe relaLlonshlp may change as LreaLmenL progresses lncludlng cracks
ln Lhe relaLlonshlp 8renL and kolko say LhaL from Lhe paLlenLs polnL of vlew provlslon of supporL
undersLandlng and advlce have been reporLed as mosL crlLlcal Lo good ouLcomes
AA resldenL nlck Cummlngs' predlcLlon LhaL ln Lhe nexL Len years half of Loday's LheraplsLs wlll be ouL
of work MosL wlll be aL a masLer's level and Lhose hlgher levels wlll do research buL llLLle Lherapy
1reaLmenLs wlll be lnLermlLLenL wlLh cllenLs comlng back for LreaLmenL only as needed 1reaLmenL done
over a longlasLlng perlod of Llme wlll noL be Lhe norm ln lLs place LheraplsLs and physlclans wlll creaLe
group pracLlces LhaL provlde medlcal and emoLlonal LreaLmenLs new Lherapy approaches wlll evolve
buL lL wlll be gradual and new approaches wlll bulld on raLher Lhan break wlLh currenL approaches
racLlces wlll seek coheslon raLher Lhan fragmenLaLlon
Cllcken Morley u lmprovlng Lhe LffecLlveness of Lhe Pelplng rofesslons 1housand Caks Sage
ubllcaLlons lnc 2003 rlnL