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Doody's Review ServiceReviewer: Richelle Strauss, MD (Rush University Medical Center)
Description: This is a review of available evidence, augmented by the author's own clinical research, about the most common comorbid conditions of ADHD: ODD and conduct disorder, impulsive aggression, bipolar disorder, depressive disorders, anxiety disorders, OCD, and intellectual disability and autism spectrum disorders. It summarizes clinically relevant literature (e.g. full discussions of the MTA and CMAP studies including CMAP algorithm) and includes helpful descriptions of commonly used statistics terms and calculations. Appendix I is structured clinical interviews and Appendix II is a summary of pertinent psychopharmacology. This is a clinical case-based version of an earlier book, ADHD with Comorbid Disorders: Clinical Assessment and Management by this author with two others (Guilford, 2001).
Purpose: The author sought to provide an evidence-based clinical guide that combined medical evidence with clinical judgment. He addresses many common clinical challenges, such as characterizing mood dysregulation and many psychiatric symptoms shared by several DSM diagnoses (e.g. aggression/explosive behavior). He intended to provide a toolkit for practicing clinicians dealing with difficult clinical cases and he has accomplished this goal with this readable and clinically applicable book.
Audience: The author appears to target clinicians dealing with the difficult presentations in children with ADHD and comorbid conditions. However, the book appears to be most appropriate for fellow-level trainees. It would likely be a review for individuals already established in clinical practice. The author draws from his two decades of experience in traditional outpatient and residential settings which obviously supplies the clinical judgment he lends to the book.
Features: The book is organized into chapters named for the various comorbidities with ADHD. Discussions of evidence and clinical problems are interrupted at a comfortable pace by case examples, algorithms, diagrams, and educational points on how to calculate odds ratios, powers, and other relevant statistics. Among the book's strengths are the way it presents an easily consumable amount of the most clinically relevant evidence, provides education on how to evaluate the evidence, and illustrates the concepts with refreshingly complex clinical cases. Some could criticize its restraint in not listing every piece of evidence on each topic, but this would have made it far more difficult to read.
Assessment: This book really does serve as a complete toolkit to help readers attend to the most clinically relevant evidence on the subject, analyze the evidence, and apply it to clinical situations as complex as any I have encountered in practice. I was grateful to be able to take away not only an education on basic and controversial clinical topics in ADHD and comorbid disorders with a complete discussion of relevant psychopharmacology, but also a review of how to analyze a piece of literature and how to structure a complete initial evaluation interview. I would strongly recommend it to any fellow-level trainee or new clinician in child and adolescent psychiatry.