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Infant Depression: Paradigms and Paradoxes
426
BOOK REVIEWS
Pathogenesis of Liver D i s e a s e (International Academy of Pathology Monograph, No. 28), edited by Emmanuel Färber and M. James Phillips, 384 pp, with illus, $84.50, Baltimore, Williams & Wilkins, 1987 This is the latest volume in a series of monographs produced by the International Academy of Pathology, based on the courses presented at their annual meetings. Edited by the eminent Drs. Emmanuel Färber and M. James Phillips of the University of Toronto, the 384-page text is handsome and amply illustrated. Each of the 11 chapters reviews a major topic in liver disease and can be read as an independent unit. Some of the contributors are such experts as Hans Popper, John Färber, Michael Gerber, David Shafritz, and Kamal Ishak. This volume will be of greatest interest to gastroenterologists and hepatologists who already have some familiarity with the pertinent literature. Most of the chapters, however, will appeal to others who want in-depth information on a particular aspect of liver disease. In general, medical students will find more information than they need, but interested residents and internists should find their reading time well spent on this publication. Hans Popper leads off in his usual wordy but delightful style, with an essay in which he uses developments in the discovery and elucidation of delta hepatitis to illustrate disturbances of regulatory networks in hepatic diseases. The review of drug metabolism and liver injury by John Färber is short but replete with new information that suggests that many xenobiotics exert their hepatotoxic effects not directly but through the generation of activated oxygen species in the cytochrome P450 system. The chapter on cholestasis by Phillips and Siria Poucell is as good a review as I have seen on this subject; it combines recent information, good illustrations, and a concise review of previous data. Shafritz and Hadziyannis provide a succinct review of the molecular pathophysiologic mechanisms of chronic hepatitis B infection, including the recent proof that hepatitis B carriers show cloning of hepatocytes that carry integrated hepatitis B virus DNA. Finally, the chapter by Ishak, "New Developments in Diagnostic Liver Pathology," proves not to be a review of recent techniques but an encyclopedic, 150-page handbook of
Mayo Clin Proc, May 1987, Vol 62
histopathology that, by itself, is worth the price of the book. Other chapters cover hepatic ultrastructure, the hepatocyte cytoskeleton, the effect of ethanol on biologic membranes, the pathologic features of viral hepatitis, and the pathogenesis of hepatocellular carcinoma. In summary, this excellent collection of information by expert authors undoubtedly will become a key reference source in hepatology. John B. Gross, Jr., M.D. Division of Gastroenterology and Internal Medicine
Infant Depression: Paradigms and Para doxes, by Paul V. Trad, 340 pp, $45, New York, Springer-Verlag, 1986 Dr. Trad espouses a "developmental psychology paradigm" to integrate a broad spectrum of observations derived from his prodigious review of the literature in infant psychiatry. He points out that beyond the seminal work of Spitz and Wolf in the mid 1940s, the study of depression in infancy and early childhood has followed an evanescent course. As recently as the 1960s, it was generally assumed that depression, analogous to the syndrome seen in adults, did not exist in childhood. In one perspective, depressive-like phenomena were viewed as normal concomitants of various phases of childhood development. Alternatively, numerous behaviors (for example, aggression, hyperactivity, enuresis, sleeping and eating disturbances, and miscellaneous somatic symptoms) were judged to be "masked depressions" or "depressive equivalents" of childhood as entities unto them : selves, not to be equated with adult depressive disorders. Not until the third edition of the Diagnostic & Statistical Manual (DSM-III) was published (in 1980) did the American Psychiatric Association recognize depression among young age groups as a distinct clinical entity. Trad notes, however, that by delineating identical symptomatic criteria for the diagnosis in children and in adults, the DSM-III gave inadequate consideration to the fundamental developmental processes that influence the origin and behavioral expression of depression in childhood.
Mayo Clin Proc, May 1987, Vol 62
BOOK REVIEWS
427
The author asserts that a developmental frame- tical that infant and early childhood experiences work is crucial to devising accurate criteria for are of singular importance in basic personality childhood depression, because consideration is development. thereby given to the child's age and phaseappropriate abilities and limitations imposing Eric K. Milliner, M.D. their characteristic stamp on affect, dysphoric Section of Child and experiences, and symptom formation. Multiple Adolescent Psychiatry factors, including the infant's neuroendocrinologic endowment, temperament, attachment behaviors, emerging self-awareness, capacity for object permanence, and development of empathy, are correlated with depressive phenomena in chapters that Trad devotes to each of these topics. Percutaneous Biopsy, Aspiration and DrainAs a primary thesis, Trad posits that "maternal age, by Janis G. Letourneau, Morteza K. Elydeprivation" (that is, the lack of appropriate senaderani, and Wilfrido R. Castafieda-Zufiiga, sory, perceptual, reciprocal, or consistent interac168 pp, with illus, $44.95, Chicago, Year Book tion of caretaker with infant) correlates signifiMedical Publishers, 1987 cantly with depressive phenomena in infancy and early childhood. He emphasizes, through consid- The goal of the authors of this book is to offer "a eration of the "face-to-face" and "learned helpless- concise, practical guide to biopsy, aspiration and ness" paradigms, that it is the cumulative effect of drainage for the practicing radiologist" and to separation traumas and lack of attunement that serve as a "reference for clinicians interested in gradually erodes the infant's resilience and allows these procedures." Thoracic, abdominal, retrodepressive symptoms to supervene. Several clini- peritoneal, and pelvic percutaneous biopsy and cal vignettes demonstrate the application of the aspiration-drainage procedures are discussed, developmental psychology paradigm in clinical and radiologic localization, techniques, successes, situations. failures, and potential resultant complications are Trad states that it is "the ambition of the child emphasized. and infant psychiatrist to prevent later psychoIn general, the book accomplishes the goal of the pathology by developing a keen awareness of authors. The highlights of the text are a chapter the vulnerabilities to depression encountered in on general considerations for percutaneous proceyoung patients." The fact that his book neither dures, including a rather extensive description of documents the predictive validity of infant obser- the instrumentation and equipment available vations nor convincingly demonstrates childhood from a variety of companies, and an excellent correlates of adult psychopathologic conditions is chapter on percutaneous drainage of abscesses. less a criticism of the author than a reflection of The illustrations are good. The arrangement of the the reality that infant psychiatry is still in an book, however, is somewhat cumbersome, as some infancy of its own. chapters are organized both by organ system The material in the book is somewhat redun- and by radiographic modality. For example, the dant and lacking in cohesiveness. These disad- thorax is discussed in three chapters, each of vantages are more than offset by its major value which addresses similar biopsy-drainage techas an important compilation and summary of the niques by the separate imaging modalities of literature in infant psychiatry pertaining to pre- fluoroscopy, ultrasonography, and computed toverbal integration of affective experiences. In mography. Thus, some of the information is resuch a rapidly expanding discipline, Trad's bibli- dundant and less concise than desirable. ography is also a valuable resource, containing Overall, the book does provide a "guide" to more than 730 articles and books, 128 of which percutaneous biopsy and drainage procedures for were published in the past 4 years. radiologists. I doubt that many clinicians would I recommend this book to child psychiatrists find it of much use. and developmental pediatricians who are interested in a basic introduction to infant psyMichael J. Kiely, M.D. chiatry and to any reader who may still be skepDepartment of Diagnostic Radiology
BOOK REVIEWS
Pathogenesis of Liver D i s e a s e (International Academy of Pathology Monograph, No. 28), edited by Emmanuel Färber and M. James Phillips, 384 pp, with illus, $84.50, Baltimore, Williams & Wilkins, 1987 This is the latest volume in a series of monographs produced by the International Academy of Pathology, based on the courses presented at their annual meetings. Edited by the eminent Drs. Emmanuel Färber and M. James Phillips of the University of Toronto, the 384-page text is handsome and amply illustrated. Each of the 11 chapters reviews a major topic in liver disease and can be read as an independent unit. Some of the contributors are such experts as Hans Popper, John Färber, Michael Gerber, David Shafritz, and Kamal Ishak. This volume will be of greatest interest to gastroenterologists and hepatologists who already have some familiarity with the pertinent literature. Most of the chapters, however, will appeal to others who want in-depth information on a particular aspect of liver disease. In general, medical students will find more information than they need, but interested residents and internists should find their reading time well spent on this publication. Hans Popper leads off in his usual wordy but delightful style, with an essay in which he uses developments in the discovery and elucidation of delta hepatitis to illustrate disturbances of regulatory networks in hepatic diseases. The review of drug metabolism and liver injury by John Färber is short but replete with new information that suggests that many xenobiotics exert their hepatotoxic effects not directly but through the generation of activated oxygen species in the cytochrome P450 system. The chapter on cholestasis by Phillips and Siria Poucell is as good a review as I have seen on this subject; it combines recent information, good illustrations, and a concise review of previous data. Shafritz and Hadziyannis provide a succinct review of the molecular pathophysiologic mechanisms of chronic hepatitis B infection, including the recent proof that hepatitis B carriers show cloning of hepatocytes that carry integrated hepatitis B virus DNA. Finally, the chapter by Ishak, "New Developments in Diagnostic Liver Pathology," proves not to be a review of recent techniques but an encyclopedic, 150-page handbook of
Mayo Clin Proc, May 1987, Vol 62
histopathology that, by itself, is worth the price of the book. Other chapters cover hepatic ultrastructure, the hepatocyte cytoskeleton, the effect of ethanol on biologic membranes, the pathologic features of viral hepatitis, and the pathogenesis of hepatocellular carcinoma. In summary, this excellent collection of information by expert authors undoubtedly will become a key reference source in hepatology. John B. Gross, Jr., M.D. Division of Gastroenterology and Internal Medicine
Infant Depression: Paradigms and Para doxes, by Paul V. Trad, 340 pp, $45, New York, Springer-Verlag, 1986 Dr. Trad espouses a "developmental psychology paradigm" to integrate a broad spectrum of observations derived from his prodigious review of the literature in infant psychiatry. He points out that beyond the seminal work of Spitz and Wolf in the mid 1940s, the study of depression in infancy and early childhood has followed an evanescent course. As recently as the 1960s, it was generally assumed that depression, analogous to the syndrome seen in adults, did not exist in childhood. In one perspective, depressive-like phenomena were viewed as normal concomitants of various phases of childhood development. Alternatively, numerous behaviors (for example, aggression, hyperactivity, enuresis, sleeping and eating disturbances, and miscellaneous somatic symptoms) were judged to be "masked depressions" or "depressive equivalents" of childhood as entities unto them : selves, not to be equated with adult depressive disorders. Not until the third edition of the Diagnostic & Statistical Manual (DSM-III) was published (in 1980) did the American Psychiatric Association recognize depression among young age groups as a distinct clinical entity. Trad notes, however, that by delineating identical symptomatic criteria for the diagnosis in children and in adults, the DSM-III gave inadequate consideration to the fundamental developmental processes that influence the origin and behavioral expression of depression in childhood.
Mayo Clin Proc, May 1987, Vol 62
BOOK REVIEWS
427
The author asserts that a developmental frame- tical that infant and early childhood experiences work is crucial to devising accurate criteria for are of singular importance in basic personality childhood depression, because consideration is development. thereby given to the child's age and phaseappropriate abilities and limitations imposing Eric K. Milliner, M.D. their characteristic stamp on affect, dysphoric Section of Child and experiences, and symptom formation. Multiple Adolescent Psychiatry factors, including the infant's neuroendocrinologic endowment, temperament, attachment behaviors, emerging self-awareness, capacity for object permanence, and development of empathy, are correlated with depressive phenomena in chapters that Trad devotes to each of these topics. Percutaneous Biopsy, Aspiration and DrainAs a primary thesis, Trad posits that "maternal age, by Janis G. Letourneau, Morteza K. Elydeprivation" (that is, the lack of appropriate senaderani, and Wilfrido R. Castafieda-Zufiiga, sory, perceptual, reciprocal, or consistent interac168 pp, with illus, $44.95, Chicago, Year Book tion of caretaker with infant) correlates signifiMedical Publishers, 1987 cantly with depressive phenomena in infancy and early childhood. He emphasizes, through consid- The goal of the authors of this book is to offer "a eration of the "face-to-face" and "learned helpless- concise, practical guide to biopsy, aspiration and ness" paradigms, that it is the cumulative effect of drainage for the practicing radiologist" and to separation traumas and lack of attunement that serve as a "reference for clinicians interested in gradually erodes the infant's resilience and allows these procedures." Thoracic, abdominal, retrodepressive symptoms to supervene. Several clini- peritoneal, and pelvic percutaneous biopsy and cal vignettes demonstrate the application of the aspiration-drainage procedures are discussed, developmental psychology paradigm in clinical and radiologic localization, techniques, successes, situations. failures, and potential resultant complications are Trad states that it is "the ambition of the child emphasized. and infant psychiatrist to prevent later psychoIn general, the book accomplishes the goal of the pathology by developing a keen awareness of authors. The highlights of the text are a chapter the vulnerabilities to depression encountered in on general considerations for percutaneous proceyoung patients." The fact that his book neither dures, including a rather extensive description of documents the predictive validity of infant obser- the instrumentation and equipment available vations nor convincingly demonstrates childhood from a variety of companies, and an excellent correlates of adult psychopathologic conditions is chapter on percutaneous drainage of abscesses. less a criticism of the author than a reflection of The illustrations are good. The arrangement of the the reality that infant psychiatry is still in an book, however, is somewhat cumbersome, as some infancy of its own. chapters are organized both by organ system The material in the book is somewhat redun- and by radiographic modality. For example, the dant and lacking in cohesiveness. These disad- thorax is discussed in three chapters, each of vantages are more than offset by its major value which addresses similar biopsy-drainage techas an important compilation and summary of the niques by the separate imaging modalities of literature in infant psychiatry pertaining to pre- fluoroscopy, ultrasonography, and computed toverbal integration of affective experiences. In mography. Thus, some of the information is resuch a rapidly expanding discipline, Trad's bibli- dundant and less concise than desirable. ography is also a valuable resource, containing Overall, the book does provide a "guide" to more than 730 articles and books, 128 of which percutaneous biopsy and drainage procedures for were published in the past 4 years. radiologists. I doubt that many clinicians would I recommend this book to child psychiatrists find it of much use. and developmental pediatricians who are interested in a basic introduction to infant psyMichael J. Kiely, M.D. chiatry and to any reader who may still be skepDepartment of Diagnostic Radiology