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  • Book
    by David Mintz.
    Summary: "The troubling increase in treatment resistance in psychiatry has many culprits: the rise of biomedical psychiatry and corresponding sidelining of psychodynamic and psychosocial factors; the increased emphasis on treating the symptoms rather than the person; and a greater focus on the electronic medical record rather than the patient, all of which point to a breakdown in the person-centered prescriber-patient relationship. Psychodynamic Psychopharmacology illuminates a new path forward. It examines the psychological and interpersonal mechanisms of pharmacological treatment resistance, integrating research on evidence-based prescribing processes with psychodynamic insights and skills to enhance treatment outcomes for patients who are difficult to treat. The first part of the book explores the evidence base that guides how, rather than simply what, to prescribe. It describes precisely what psychodynamic psychopharmacology is and why its emphasis on combining the often-neglected psychosocial aspects of medication with biomedical considerations provides a more optimized approach to addressing treatment resistance. Part II delves into the psychodynamics that contribute to pharmacological treatment resistance, both when patients' ambivalence about their illness, the medication itself, or their prescriber manifests in nonadherence and when medications support a negative identity or are used as replacements for healthy capacities. Readers will gain basic skills for addressing the psychological and interpersonal dynamics that underpin both scenarios and will be better positioned to ameliorate interferences with the healthy use of medications. The final section of the book offers detailed technical recommendations for addressing pharmacological treatment resistance. It tackles issues that include countertransference-driven irrational prescribing; primitive dynamics, such as splitting and projective identification; and the overlap between psychopharmacological treatment resistance and the dynamics of treatment nonadherence and nonresponse in integrated and collaborative medical care settings. By putting the individual patient back at the center of the therapeutic equation, psychodynamic psychopharmacology, as outlined in this book, offers a model that moves beyond compliance and emphasizes instead the alliance between patient and prescriber. In doing so, it empowers patients to become more active contributors in their own recovery"-- Provided by publisher.

    Contents:
    What Is Psychodynamic Psychopharmacology?
    Why Psychodynamic Psychopharmacology?
    What Is Psychodynamic About Psychodynamic Psychopharmacology?
    Psychodynamics of Pharmacological Treatment Resistance
    Treatment Resistance to Medications
    Treatment Resistance From Medications
    The Prescriber's Contribution to Treatment Resistance
    Avoid a Mind-Body Split
    Know Who the Patient Is
    Attend to Patients' Ambivalence
    Cultivate the Pharmacotherapeutic Alliance
    Attend to Countertherapeutic Uses of Medications
    Identify, Contain, and Use Countertransference
    Who Is Psychodynamic Psychopharmacology For? Patient Characteristics
    Before Initiating Treatment
    The Engagement Phase
    The Maintenance Phase
    Split and Combined Treatments
    Psychodynamic Psychopharmacology and Integrated Care.
    Digital Access ProQuest Ebook Central 2022
  • Article
    Holdsworth SR, de Kretser DM, Atkins RC.
    Clin Nephrol. 1978 Oct;10(4):146-50.
    A comparative study of the capacity of maintenance hemodialysis and renal transplantation to reverse the uremic damage to testicular function in 27 men with chronic renal failure was performed over a two year period. Despite two years of stable hemodialysis there was only minor improvement in sexual activity. Testosterone levels failed to improve and luteinising hormone (LH) levels remained high. Elevation of serum follicle stimulating hormone (FSH) together with severe spermatogenic damage persisted. Transplant patients showed a significant improvement in sexual activity, a return of testosterone to normal, and a significant fall in LH levels. Fertility, as assessed by sperm count, was improved in 50% of transplant patients. Thus while renal transplantation may restore reproductive function in men with chronic renal failure maintenance hemodialysis has no effect.
    Digital Access Access Options