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Doody's Review ServiceReviewer: William Scheftner, MD (Rush University Medical Center)
Description: This book is the third edition (the second edition was published in 1994) of an edited, multi-authored textbook that now comes with a CD-ROM. With 1762 pages, it purports to be both a textbook for residents and a reference book for any clinician. Twenty-five selected chapters will be published as the Essentials of Clinical Psychiatry with a separate study guide.
Purpose: Its purpose is to be a "...clinically oriented, comprehensive textbook of psychiatry for use primarily by senior psychiatry residents and practicing psychiatrists ... a standard educational reference for physicians in other specialties" and to be "scholarly and authoritative, yet of practical, clinical utility for treating patients." While such a goal is laudable, it is uncertain whether it is possible to meet those widely disparate objectives in 1762 pages. As a comprehensive basic textbook for psychiatric residents it is excellent, but as a reference book for practicing psychiatrists it falls short of the mark.
Audience: The editors target virtually everybody who wants knowledge of psychiatric disorders, treatment, and organization from any perspective. It does best for the psychiatric resident at any level and anyone else who desires an introduction to a subject within psychiatry. The contributors and editors are well recognized experts in their respective areas.
Features: The book starts with sections covering a combination of observed facts (neuroscience, genetics, epidemiology, developmental milestones) but moves quickly to psychoanalytically based theories of mental functioning. A section on assessment covers the clinical method and laboratory measurements used in psychiatry. Thereafter the book is grouped into descriptions of psychiatric disorders, treatment, and a section with topics as diverse as suicide, violence, cultural psychiatry, neuropsychiatry, law and psychiatry, and managed care for psychiatry. The best quality of this book is its capacity to provide information at the level of a graduating psychiatric resident on virtually any aspect of clinical psychiatry. A unique feature is the inclusion of DSM-IV, APA Practice Guidelines, and Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry in a CD-ROM. The illustrations vary markedly in quantity, quality, and utility. In general, as a textbook, more should have been included. Tables are used appropriately and convey information succinctly. There are absences. For example, brain derived neurotrophic factor is missing in the neuroscience section, as is ECT in treatment of neuroleptic malignant syndrome, as well as a discussion of the choice of antihypertensive to be used in treatment of MAOI hypertensive crises (rather than a flat statement that nifedipine is the most commonly used drug), and the absence of ACE inhibitors in a list of medications interacting with lithium is notable.
Assessment: The editors have succeeded in producing a first rate textbook for residents and medical students planning to go into psychiatry. It is difficult to imagine a topic not addressed in this textbook, which is appropriate for this level. The practicing psychiatrist may use it for an overview, but will want more specialized texts for information. Comparing this textbook with Tasmans' Psychiatry, 2 Volume Set (WB Saunders, 1997) at 1901 pages, this book devotes much more space to traditional psychoanalytic developmental theories and explanations and less to biologic substrates of psychopathology, but has larger sections on natural history and more focused material on treatments. The new edition is justified by progress in the field.