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The global burden of neurological infectious diseases is huge. Sometimes the diagnosis is straightforward. On other occasions it may be difficult, especially because of the overlap with inflammatory neurological conditions. Delays or missed diagnoses can have devastating consequences for patients. This book brings together adult and pediatric clinical cases in neurological infection and inflammation, including important conditions for both developed countries and resource-poor settings. Clinical case studies are recognized as a useful learning tool for clinicians at all stages in their careers. Each real case works through the history, examination, and investigation findings to the diagnosis and treatment pathway. This is followed by discussion of the key issues, with the inclusion of historical or quirky facts. Many cases are supported online by a certified post-case quiz, testing the reader's clinical reasoning, integrative thinking, and problem-solving.
Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate.
To describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsellors in primary healthcare.
The treatment was developed in three stages using a variety of methods: (a) identifying potential strategies; (b) developing a theoretical framework; and (c) evaluating the acceptability, feasibility and effectiveness of the psychological treatment.
The Healthy Activity Program (HAP) is delivered over 6–8 sessions and consists of behavioral activation as the core psychological framework with added emphasis on strategies such as problem-solving and activation of social networks. Key elements to improve acceptability and feasibility are also included. In an intention-to-treat analysis of a pilot randomised controlled trial (55 participants), the prevalence of depression (Beck Depression Inventory II ⩾19) after 2 months was lower in the HAP than the control arm (adjusted risk ratio = 0.55, 95% CI 0.32–0.94, P = 0.01).
Our systematic approach to the development of psychological treatments could be extended to other mental disorders. HAP is an acceptable and effective brief psychological treatment for severe depression delivered by lay counsellors in primary care.
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