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Doody's Review ServiceReviewer: Adam Kaplin, MD, PhD (Johns Hopkins University School of Medicine)
Description: When I was in medical school a respected senior member of the neurology department was fond of pointing out to the residents and medical students that "the most common setting for functional disorders is in the context of organic illnesses." Modern research has confirmed this observation and extended it by investigating the organic etiology of functional (i.e. psychiatric) disorders. In this book, the editors have assembled an impressive group of authors to flesh out the syllabus of a graduate level course on the neuroscientific basis of neurologic and psychiatric illnesses that Dr. Schetz still teaches to this day.
Purpose: Although the specific reasons are not made explicit for producing a book that focuses on the chosen three neurologic and seven psychiatric disorders (for example, multiple sclerosis is omitted despite being commonly regarded as having one of the highest comorbid rate of depression), one of the author's goals is to facilitate MD, PhD and PharmD candidates' mastery of their qualifying exams.
Audience: To be sure, there is now a growing awareness of the need for neurologists and psychiatrists to understand one another's clinical discipline as it impacts their patients. There is also a need for these sister disciplines to stay well informed about the rapidly growing role of neuroscience in explaining and rationalizing their understanding of the way insults to the nervous system result in neurological and psychiatric disorders. But the editors' exuberant suggestion that their book will allow their readers to "effectively and safely practice their future health care professions" is patently misleading, and care should be taken by readers to understand the book's limitations.
Features: The two chapters devoted to mood disorders illustrate the limitations of the book's general organization. The chapter on unipolar depression is written by two PhDs who, in 15 pages, provide a remarkably informative overview of the contemporary understanding of the neuroscientific basis of major depression. Their discussion of the clinical aspects of depression is often misleading (e.g. citing "concerns about the safety and efficacy" of ECT treatment) and occasionally wrong (e.g. defining atypical depression as "depression with a greater expression of anxiety or agitation"). By contrast, the chapter on bipolar disorder written by a premier group of MDs, provides an excellent summary of the clinical aspects of this mood disorder while devoting two of 23 pages to a limited discussion of the current neuroscientific research in this area. The editors would have enhanced their book considerably by requesting their PhDs to focus on neuroscience and the MDs on clinical aspects of these disorders.
Assessment: Whereas there is much information that is timely and succinct in this survey of these 10 disorders, the book suffers the most from its over-reaching goal to "promote a systematic, comprehensive, and advanced understanding of each disorder from molecules to human behavior." Ultimately, this occasionally stretches the authors beyond the limits of their expertise and too often makes their discussions so dense as to be impenetrable for many in their target audience.