Neurosis: Understanding Common Mental Illness

Common mental illnesses have been diagnosed separately in recent years, but what is seldom understood is that they are all linked together, often much more closely than other disorders. In particular, combined anxiety and depression linked to personality disturbance, generally known as neuroticism, is very common. In the absence of awareness of its importance, this frequently leads to wrong clinical decisions and poor outcomes for patients. This book focuses on the concept of neurosis, tracing its history as a concept, its abolition from the DSM, the purpose and importance of the Nottingham Study of Neurotic Disorder, the re-definition of neurosis as the general neurotic syndrome, and its recently updated evidence base. Written for psychiatrists, psychologists and researchers, this book shows how recognising these combined common disorders is absolutely necessary for mental health practice, and urges that it is time that we re-examine our treatment priorities.

Table of Contents:
Foreword; Introduction; 1. The general neurotic syndrome; 2. DSM-III and the generation of new diagnoses; 3. The hypotheses of the Nottingham Study of Neurotic Disorder; 4. Interpretation of the results of the 1988 Lancet randomised trial; 5. The medium term outcome of the general neurotic syndrome; 6. The general neurotic syndrome at 12 years; 7. The last phase: the general neurotic syndrome after thirty years; 8. Is the notion of the general neurotic syndrome useful?; Index.

About the Author :
Peter Tyrer is Emeritus Professor of Community Psychiatry, Imperial College, London, and Consultant in Transformation Psychiatry, Lincolnshire Partnership NHS Foundation Trust, UK.

Review :
'Psychiatry cannot advance without a good classification. We have failed to achieve this, most particularly with common mental disorders. This important book by Peter Tyrer shows a way forward, giving special attention to mixed anxiety and depressive disorders, the most important diagnosis of all. It should be mandatory reading for all psychiatrists.' David Goldberg, Professor Emeritus, Institute of Psychiatry, King's College London, United Kingdom 'DSM-5 & ICD-11 are splitter systems that artificially divide the diagnostic pie into tiny slices. The resulting artificial and misleading 'comorbidity' often leads to fragmented and excessive treatments. Tyrer beautifully demonstrates the clinical realities that patients are necessarily more complicated than diagnostic systems and that flexible formulation is more important than rigid adherence to criteria sets. This is an extremely valuable book for all mental health professionals at all levels of training and experience.' Allen Frances, MD, Professor and Chair Emeritus, Department of Psychiatry, Duke University, Durham, NC, USA, and Chair, DSM-IV Task Force 'This highly readable book has long been needed. It is an essential reference for improving clinical thinking, whether you are a physician or a psychologist. It helps building unitary perspectives that may shed light on phenomena that would otherwise remain scattered in the patient's story. What is shared by syndromes such as anxiety, panic, phobic disturbances and irritability may be as important as the differences between them and conditions that are apparently comorbid could be part of the same general neurotic syndrome.' Giovanni A. Fava, MD, Clinical Professor of Psychiatry, University at Buffalo, State University of New York, Buffalo, NY, USA