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Doody's Review ServiceReviewer: Robert Hung, MD, MPH (Rush University Medical Center)
Description: This is a compilation of topical reviews addressing the unique relationship between metabolic derangements and severe mental illnesses (SMI) such as schizophrenia and bipolar disorder.
Purpose: The purpose is to synthesize existing clinical research and to translate it into a meaningful approach to care for psychiatric patients with metabolic conditions such as obesity or hyperglycemia. The book comes at a crucial time when many patients with SMI have cardiovascular comorbidities, and treatments with psychiatric medications are inducing metabolic conditions.
Audience: Written for psychiatrists and mental health providers, the book is especially relevant for those who only intermittently screen for metabolic conditions (i.e., fasting glucose or lipid panel) or rarely seek guidance on treatment options to prevent metabolic complications.
Features: The book opens with a review of diabetes and metabolic syndrome. The next three chapters summarize the extensive amount of research on SMI as it relates to obesity, diabetes, and cardiovascular disease. The subsequent chapters focus on antipsychotic medications and their effect on weight, glucose metabolism, and serum lipids. The final chapter offers a clinical strategy to assess and monitor metabolic parameters in psychiatric patients.
Assessment: The authors use tables to summarize the numerous studies. Algorithms are presented for the treatment of obesity, risk stratification of cardiovascular risk, and choosing an antipsychotic. Proposed etiologic links between SMI, cardiovascular disease, and diabetes are expounded. The chapters are well written, but the litany of studies distracts the reader from the main goal of obtaining clinical recommendations. More synthesis of the research and less emphasis on the biologic mechanisms leading to metabolic problems would benefit practicing clinicians. The final chapter is a superb synthesis of clinical guidelines and can stand alone as the pearl of the book.