دانلود کتاب روان شناسی – راهنمای اصول و تجربیات

Patients with chronic kidney disease, including end-stage kidney disease, face various comorbid psychiatric illnesses, in addition to personal and social burdens, during the time leading up to dialysis and/or renal transplantation1. These patients may experience high levels of distress due to their chronic complex health issues, including a high risk for comorbid depressive disorder, delirium, and vascular major neurocognitive disorder (formerly vascular dementia). They also frequently suffer from medication side effects, from both systemic and central nervous system-active medications. In renal transplant patients, specific stressors commonly include situational anxiety associated with placement on the transplant wait list, ongoing health complications and hospitalizations, worry of eventual organ rejection and subsequent graft failure, plus a significant risk of psychiatric side effects of the required post-transplant immunomodulators. It is the duty of all nephrology clinicians to be aware of these problems and to inquire about them, so that the appropriate involvement of psychiatric consultants and other mental health clinicians can be coordinated for optimally collaborative multispecialty and multidisciplinary care. Moreover, dialysis patients have high rates of comorbid depressive disorder, anxiety disorder, delirium, and other neurocognitive disorders. As a result, they have three times higher risk of hospitalization, compared to those with other chronic systemic illnesses, resulting in significantly higher overall mortality rates2. However, even acknowledging this likely still underestimates the burden of comorbid psychiatric illness in this population. Patients with end-stage kidney disease have a high central nervous system symptom comorbidity burden. These patients experience multiple psychiatric symptoms, which significantly impact their quality of life, health outcomes, and overall daily function. “Psychonephrology” is a term encompassing concepts from the specialties of nephrology and psychiatry, mainly based on the concept of consultation-liaison psychiatry within the biopsychosocial model of mind-body unity. Norman B. Levy, a leading authority on the psychological aspects of kidney transplantation and dialysis treatment, is considered the “father of psychonephrology.”3 The editors and chapter authors owe Dr. Levy a debt of gratitude for the original conceptualization and nomenclature describing psychonephrology3. In the decades since the term was introduced, it has become evident that psychiatry and nephrology have significant clinical intersection far beyond the original focus on psychological factors and psychiatric illness in the context of chronic kidney disease and dialysis. There has been a great deal of advancement in the availability of kidney transplant, making it available to a broader range of patients, including those with chronic psychiatric illness antedating their kidney disease. The specific nephrotoxic effects of the important psychotropic medication lithium are commonly seen and appreciated clinically. The numerous psychiatric side effects of immunomodulators are now well understood in the post-op kidney transplant patient. Several psychotropic medications are either avoided or dosed more conservatively in renal disease patients. The editors of this book, therefore, take a modern, expansive, and inclusive stance on psychonephrology to reflect the current clinical literature and practice. Ultimately, it is their hope that this book will lead to more regular conceptual focus on the term and the field, beyond the clinical pragmatism which also is emphasized.