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Doody's Review ServiceReviewer: Michael Joel Schrift, D.O., M.A.(University of Illinois at Chicago College of Medicine)
Description: (Note: I must warn readers of this review that I cannot do an unbiased assessment of this book, since I have been trained and mentored by one of the authors. Both Dr. Taylor and Dr. Fink have been influential in the fields of psychiatry, neuropsychiatry, and convulsive therapy. They (especially Dr. Taylor) have also been a major influence on my way of thinking about psychopathology and its treatments. With this caveat in mind, the review follows.) This is a comprehensive new book on an important area that has seemingly been neglected in the current psychiatric nosology, melancholic depression. Written and edited by internationally recognized clinician-researchers, this is an outstanding addition to the psychiatric literature and the information in this book should be part of all practicing psychiatrists' knowledge base if they want to help their patients who suffer from these maladies.
Purpose: The purpose is to impart to readers a reintroduction of "melancholia as the classic depressive illness with definable diagnostic criteria and effective treatment algorithms." This book is "in response to weakened criteria and confusing classification." The authors rightly note that the DSM "lacks supporting psychopathological or psychophysiological evidence and, as a consequence, the taxonomy lacks validity."
Audience: The intended audience is practicing psychiatrists. Any clinician who diagnoses and treats patients with psychiatric disorders, as well as trainees, should be fluent with the information presented in this book.
Features: Topics include a conceptual history of melancholia, the definition and psychopathology of melancholia, laboratory tests, the examination of patients with melancholia, differential diagnosis, suicide in melancholia, ECT and melancholia, optimizing ECT in melancholia, a critique of the pharmacologic literature in melancholia, basic pharmacotherapy and treatment in complicating circumstances, review of proposed treatments including light therapy, rTMS, MST, and VNS, pathophysiology of melancholia, with a concluding chapter on future directions in regards to changes in classification and diagnosis, education, research, and prevention. The case vignettes are extremely instructive and would be wonderful teaching tools. This is a scholarly book with notes and annotations at the end of each chapter and a tremendous list of pertinent references (150 pages worth!) of the classic and contemporary scientific literature.
Assessment: This is an outstanding work focusing on all aspects of melancholia. It has been said, "To know syphilis is to know medicine." A corollary statement could be, "To know melancholia is to know psychiatry." This book is a giant step in crumbling the currently flawed paradigm in psychiatric thinking and initiating a shift to an empirically based nosology.