Hong Kong J Psychiatry. 2001;11(3):23-24
BOOK REVIEW
Editors: Benjamin J Sadock ,MD, Virginia A Sadock, MD.
Lippincott Williams &Wilkins, Philadelphia, USA, 2000; 7th edition; Volumes 1 and 2
US$279; pp 3500; ISBN: 0-683-30128-4
This new edition follows the framework of previous editions but has been expanded signif icantly — it is 15% larger than the 6th edition and 60% of the contributors are new. Moreover, there are major additions to chapters covering neurosciences, neuropsychiatry, and behavioural neurology in volume 1, including developmental neurobiol- ogy, neurotrophic factors, and the use of radiotracers and magnetic resonance imaging. Neuropsychiatric aspects of neuromuscular diseases, traumatic brain injury, and brain tumours are also discussed, and there is a section on psychiatric aspects of child neurology. Important new sections have also been added on genetic linkage analysis of psychiatric disorders, and neuropsychiatric aspects of HIV and AIDS.
This edition is printed in soft-tone and delightful colour. The text is organised under clear and logical subheadings. The highly informative illustrations and tab ulations hav e made diff icult concepts easy to comprehend. Clinical materials are largely syndrome- oriented, based on the Diagnostic and Statistical Manual of Mental Disorders – IV (DSM-IV) classif ication with references to International Classif ication of Diseases Tenth Revision (ICD-10) from time to time. Other particularly commendable features of the book are the ‘cross-references’ given at the end of each subsection with the 6 most important references highlighted, as well as the inclusion of many psychiatric rating scales, which researchers will f ind extremely useful.
The text opens with in-depth chapters on basic neurosciences, psychology, and sociology, which will be, particularly useful for Member of the Royal College of Psychiatry Part II examination candidates. Following these are chapters on ‘bread and butter’ clinical psychiatry. Chapter 7 describes the examination of psychiatric patients, encompassing the psychiatric interview, history taking, mental status assessment, the psychiatric report, and typical signs and symptoms of psychiatric illnesses. Subsequent sections on personality and neuropsychological assessments for children and adults will be of great relevance to researchers.
Supplementing standard sections on medical assessment, laboratory testing, and psychiatric rating scales, there is a new section titled Computer-based Testing of the Psychiatric Patient. In the historical section, a fascinating chronology of famous psychiatric cases is given.
With DSM-IV in use for some time, this edition’s Classif ication of Mental Disorders focuses more on nosological systems and the theory of classification than did the 6th edition. The chapters on Schizophrenia and Other Psychotic Disorders provide up-to-date clinical information, while the chapter on Mood Disorders has been expanded to include psychotherapy and the treatment of bipolar and depressive disorders. The cur rent chapter on Anxiety Disorder is greatly expanded, providing an introduction and overview, and subsections on epidemiology, biochemical aspects, genetics, psychodynamic aspects, clinical features, somatic treatment, and psychological treatments. Dissocia- tive disorders are covered in 5 distinct sections in accordance with the DSM-IV clinical entities.
While volume 1 deals with the more serious and common clinical problems, volume 2 covers topics at the interface between psychiatry and physical medicine. It starts with a comprehensive account of eating and sleep disorders, impulse control, adjustment, and personality disorders. In the chapter on Psychological Factors Affecting Medical Conditions, psychosomatic disorders are covered along with the topics of stress, behaviour and immunity, psycho- oncology, and consultation-liaison psychiatry.
This chapter is relevant to both psychiatrists and physicians/surgeons making requests for consultation. Other clinical scenarios commonly encountered within the consultation-liaison service or the interface between primary and tertiary care are dealt with in detail in subsequent chapters, as follows:
- Chronic Pain and the Placebo Effect
- Physical and Sexual Abuse of Adults
- Alternative and Complementary Health Practices
- Nonprofessional Therapies, Quacks, and Cults
- Death, Dying, and Bereavement.
There is also a section on psychiatric emergencies, including suicide. A comprehensive table outlining presenting symptoms, emergencies, and treatment issues supplements the full text.
Although therapeutic issues are discussed alongside disorders throughout, there are a further 2 large sections devoted to psychotherapies and biological therapies, which offer busy readers an up-to-date summary of clinical management in different modalities. The chapter on psychotherapies includes new sections on interpersonal psychotherapy, and Eriksonian clinical theory, while the large chapter on biological treatment reflects the many new pharmacological agents available during the past decade. A particularly useful inclusion is a summary table outlining the major mental disorders and their common pharmacotherapies. Medication-induced developmental disorder is discussed in a separate section, and there are also novel sections including one on combined psychother- apy and pharmacotherapy, which bridges the gap between these 2 major arms of management.
The 18 chapters on child and adolescent psychiatry form the main bulk of volume 2 and span the standard syllabus of the subject, from infancy to late adolescence. New inclusions in this area include coverage of adult mani- festations of attention def icit hyperactivity disorder, and anxiety disorders in children. In addition, the chapter on the Psychiatric Examination of the Infant, Child, and Adolescent now has an Infant and Toddler Mental Status Exam, reflecting developments in the assessment of very young children.
The chapter on Special Areas of Interest in Child Psychiatry discusses a wide range of issues — day care, adoption, foster care, child maltreatment, children’s reaction to illness and hospitalisation, the sequelae of HIV and AIDS, antisocial behaviour, dissociative disorders, gender identity and sexual issues, identity problems and borderline disorders, adolescent substance abuse, forensic child and adolescent psychiatry, ethical issues in child and adolescent psychiatr y, school consultation, community-based treatments, and psychiatric prevention.
The revised chapter on geriatric psychiatry has new sections on special issues in neuroimaging, health care delivery systems, and managed care. Long-term care as well as forensic, ethical, socio-cultural, minority, gender and abuse, neglect, and exploitation issues are also addressed. Practical information for US-trained psychiatrists is given in a concise chapter entitled Psychiatric Education, which contains a new section on examining psychiatrists and trainees. A chapter on Ethics and Forensic Psychiatry deals with a range of relevant topics, including confidentiality, and boundary guidelines for psychotherapy, as well as matters such as physician-assisted suicide, and the insanity defence. The book concludes with a chapter on Psychiatry: Past and Future that includes a new section on world aspects of psychiatry.
It may seem unreasonable to f ind fault with the content and format of this book, which has served as an outstanding psychiatric encyclopaedia and textbook for decades. However, it is worth noting that there are still gaps to be bridged by the next edition. For instance, psychiatric care in correctional facilities is omitted despite the large mental illness caseload in prisons worldwide. Moreover, within the section on Forensic Child and Adolescent Psychiatry, juvenile competency is inadequately addressed. Although this edition appropriately includes the Chinese classif ication of mental disorders, as well as the psychiatric and social problems of Chinese Americans, and epidemiological and mental health care data from China, this is covered in less than 30 pages in total. Hopefully by the time of the next edition, the current robust research undertaken in China on the nosology and epidemiology of psychiatric illnesses will be seen in a major expansion of this encyclopedia. This would serve to not only increase our material knowledge but also to deepen our insight into sociocultural aspects of psychiatry.
Dr Sandra Chan Assistant Professor Department of Psychiatry
Chinese University of Hong Kong
Hong Kong, China