Psychiatric Illness in Women
Emerging Treatments and Research
For most of its history, medicine has been male oriented. Doctors, research subjects, and patients were nearly all men, and medication dosages were considered to be one size fits all.
That orientation has changed dramatically. The medical profession now recognizes that women's physiology is different and realizes that women's health is one of its leading issues.
Our relatively recent efforts to understand sex differences in the onset, presentation, course, and treatment of mental illnesses are yielding sometimes striking results. Why is schizophrenia so much more common in men, and why does it have an earlier onset and a more malignant course? Do estrogens protect against schizophrenia? Why do women have higher rates of mood disorders and increasing rates of substance abuse?
Representing the work of 60 distinguished contributors, this comprehensive summary answers these and many other questions concerning the psychological and pharmacological treatment of psychiatric illnesses in women, including useful information about recent developments in psychopharmacology, physiology, course and manifestation, and the interaction between social and biological factors. This eye-opening book is divided into five parts:
- Anxiety disorders and other related disorders—Panic, agoraphobia, obsessive-compulsive disorder, posttraumatic stress disorder (PTSD), and substance abuse disorder associated with PTSD, featuring research that continues to uncover promising hypotheses to explain gender differences in prevalence and treatment rates
- Major depressive disorder and related disorders—The role of women's reproductive cycle in precipitating or exacerbating mood instability; psychopharmacology of antidepressants; effects of hormones (especially estrogen); sex differences in brain structure and function; and pharmacokinetic differences in rates of drug absorption, distribution, metabolism, and elimination
- Schizophrenia and related disorders—Origins and progression; neurocognition and symptom expression, with the central role of gonadal hormones; the effect of estrogen (menopause coincides with worsening symptoms); neuroleptic-induced hyperprolactinemia; quality-of-life considerations and systems of care; and schizophrenia's impact on the family in our post-institutionalization age
- Dementia and related disorders—Overview of Alzheimer's disease (AD) research from the National Institute on Aging, recent clinical trials that suggest the treatment efficacy of estrogen replacement, the central role of gonadal steroids in preventing and treating AD, and the challenges faced by women caregivers
- Other psychiatric illnesses and special topics—Epidemiology of substance abuse disorders, victimization, and PTSD; dissociative disorders (by far more prevalent in women than men); factors in the pathogenesis of anorexia nervosa and bulimia nervosa; treatment challenges during pregnancy; and women, ethnicity, and psychopharmacology
Clinicians and laypersons alike will welcome this clearly written, definitive guide on the most recent developments in our understanding of the major differences in the brain anatomy, physiology, and epidemiology of psychiatric illnesses between women and men.
- Part I: Anxiety Disorders and Other Related Disorders
- Chapter 1. Sex Differences in Anxiety Disorders
- Chapter 2. Panic Disorder With Agoraphobia: Women's Issues
- Chapter 3. Sex Differences in Posttraumatic Stress Disorder
- Part II: Major Depressive Disorder and Related Disorders
- Chapter 4. Women and Depression: Special Considerations in Assessment and Management
- Chapter 5. Effect of Sex on Psychopharmacology of Antidepressants
- Chapter 6. Postpartum Mood Disorders: Identification and Treatment
- Chapter 7. Premenstrual Syndromes
- Part III: Schizophrenia and Related Disorders
- Chapter 8. Sex Differences in the Origins and Premorbid Development of Schizophrenia
- Chapter 9. Sex Differences in Neurocognitive Function in Schizophrenia
- Chapter 10. Does Menopause Intensify Symptoms in Schizophrenia?
- Chapter 11. Sex-Related Differences in Antipsychotic-Induced Movement Abnormalities
- Chapter 12. Women and Antipsychotic Drugs: Focus on Neuroleptic-Induced Hyperprolactinemia
- Chapter 13. Can Estrogens Account for Sex Differences in Schizophrenia?
- Chapter 14. Women's Issues in the Treatment of Schizophrenia
- Chapter 15. Role of the Severely Mentally Ill in the Family
- Part IV: Dementia and Related Disorders
- Chapter 16. Overview of Alzheimer's Disease Research From the National Institute on Aging
- Chapter 17. Estrogen Replacement as a Prospective Treatment for Alzheimer's Disease
- Chapter 18. Gonadal Steroid Influences on Adult Neuropsychological Function
- Chapter 19. Women as Caregivers for Patients With Alzheimer's Disease
- Part V: Other Psychiatric Illnesses and Special Topics
- Chapter 20. Effects of Victimization and Posttraumatic Stress Disorder on Substance Use Disorders in Women
- Chapter 21. Sex Differences in Substance Use Disorders
- Chapter 22. Sex Composition and Sex Differences in the Dissociative Disorders: Relationship to Trauma and Abuse
- Chapter 23. Serotonin Neuronal Function in Anorexia Nervosa and Bulimia Nervosa
- Chapter 24. Pharmacological Management of Psychiatric Illness During Pregnancy: Weighing the Risks
- Chapter 25. Women, Ethnicity, and Psychopharmacology
- Concluding Remarks
About the Authors
Freda Lewis-Hall, M.D., is Team Leader of the Primary Care Product Team at Eli Lilly and Company in Indianapolis, Indiana.
John M. Herrera, Ph.D., is Professor of Psychiatry at Howard University in Washington, D.C.
Jill A. Panetta, Ph.D., is Chief Scientific Officer at InnoCentive in Indianapolis, Indiana.
Teresa S. Williams, B.Sc., is a Clinical Development Associate at Eli Lilly and Company in Indianapolis, Indiana.
This is a very useful and well written book, the kind you keep on your desk and refer to over and over again because of the practical information it contains.—Miriam B. Rosenthal, M.D., Journal of Nervous and Mental Disease, 1/1/2003
It gives a useful overview of established information, summarizes hypotheses that need further research and discloses false dichotomies that have misled the management of women with psychiatric illnesses in the past. It is a timely addition to the literature on women's mental health and deserves to be widely read.—Dora Kohen, British Journal of Psychiatry, 1/1/2003
Psychiatric Illness in Women provides a comprehensive look at the medical and biological issues in the current treatment of women's mental illness. For this reason, it stands out as a valuable resource for those physicians and researchers whose focus is to effectively diagnose and treat women patients.—Marla Somova, Psychology of Women Quarterly, 1/1/2003
Overall, I found the book to be an excellent resource for clinicians and researchers alike. . . . [The] book is a fascinating read, and accessible to a range of audiences, lay, and professional alike.—Yvonne Melia, Metapsychology Online Book Reviews, 1/1/2003
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