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Chronic Pain
Mayo Clin Proc, November 1988, Vol 63
example was confirmed by histologic or other laboratory techniques. All the illustrations are of superior quality and clearly demonstrate the in dicated findings. Common diseases are appro priately emphasized with longer discussions and more numerous illustrations. The authors devoted special attention to discussing and illustrating disorders of motility in the small intestine. Within the authors' intended limitations, the book has few weaknesses. They stated that their experience with children is small; thus, few pediatric examples are included. Although the discus sion of various diseases of the small bowel and the diversity of radiologic manifestations is lim ited, the coverage is appropriate for an introduc tory text. Overall, this book would be a helpful text for radiologists learning the technique of small bowel enema or for those interested in a quick review of the radiologic manifestations of common small bowel disease. Clinicians outside the field of radi ology should also find this a valuable resource. C. Daniel Johnson, M.D. Department of Diagnostic Radiology Chronic Pain, edited by Randal D. France and K. Ranga Rama Krishnan, 561 pp, with illus, $32, Washington, DC, American Psychiatric Press, 1988 This well-organized, multiauthored volume was designed to assist clinicians—especially psychia trists—in treating patients with chronic pain. The editors contributed to more than half the chapters, and nearly all the authors are from the Duke University Medical Center. The introduction of the text indicates that 50 million people in the United States are disabled to some degree by chronic pain, at a cost of $60 billion per year in addition to the personal angst involved. This statement certainly catches the reader's attention and justifies the interest in the entity of chronic pain during the past 20 years. In terms of financial burden, chronic pain ranks up there with the Russians, the balance of the trade deficit, and acquired immunodeficiency syndrome (AIDS). The book is divided into four sections: Basic Concepts, Clinical Concepts, Assessment, and Management. Every area of chronic pain is ad
BOOK REVIEWS
1161
dressed, and although some unevenness in cov erage is evident, the effort is generally laudable. The three chapters on the neurochemical aspects of pain provide an excellent summary, including a comprehensive bibliography, of this rapidly changing area. The authors extensively review psychoanalytic aspects of chronic pain, the rela tionship of chronic pain to conversion disorder, the complexity (confusion?) encountered with such an entity as "psychogenic pain," and the relationship between chronic pain and depres sion. I particularly liked the discussion of the difficult topic of malingering. In one section, the authors attempt to discuss the initial manifestations of pain due to a host of disorders involving peripheral organic disease, from angina pectoris to cancer. Unfortunately, this effort at completeness tries to cover too much ground. The book addresses all areas of treatment, but pharmacologic management and the complica tions thereof receive the most attention—nearly 100 pages. The bibliographies of these chapters are indeed extensive. For example, one chapter has 198 references, and the material on the man agement of cancer-related pain consists of five pages of text and four pages of bibliography. What has the computerized library search wrought? I recommend this book to psychiatrists and other medical and paramedical personnel who deal with patients with chronic pain. For psychia trists, it is likely the best source available on the subject. In addition, purchase of this volume provides support for the American Psychiatric Association, which is the publisher. David W. Swanson, M.D. Department of Psychiatry and Psychology Textbook of Psychiatry, edited by John A. Talbott, Robert E. Hales, and Stuart C. Yudofsky, 1,324 pp, with illus, $85, Washington, DC, American Psychiatric Press, 1988 In the introduction of this text, Melvin Sabshin, M.D., president and chairman of the board of the American Psychiatric Press, states: "Psychiatry is in one of the most exciting, creative, and productive phases of its long history. Fueled by
example was confirmed by histologic or other laboratory techniques. All the illustrations are of superior quality and clearly demonstrate the in dicated findings. Common diseases are appro priately emphasized with longer discussions and more numerous illustrations. The authors devoted special attention to discussing and illustrating disorders of motility in the small intestine. Within the authors' intended limitations, the book has few weaknesses. They stated that their experience with children is small; thus, few pediatric examples are included. Although the discus sion of various diseases of the small bowel and the diversity of radiologic manifestations is lim ited, the coverage is appropriate for an introduc tory text. Overall, this book would be a helpful text for radiologists learning the technique of small bowel enema or for those interested in a quick review of the radiologic manifestations of common small bowel disease. Clinicians outside the field of radi ology should also find this a valuable resource. C. Daniel Johnson, M.D. Department of Diagnostic Radiology Chronic Pain, edited by Randal D. France and K. Ranga Rama Krishnan, 561 pp, with illus, $32, Washington, DC, American Psychiatric Press, 1988 This well-organized, multiauthored volume was designed to assist clinicians—especially psychia trists—in treating patients with chronic pain. The editors contributed to more than half the chapters, and nearly all the authors are from the Duke University Medical Center. The introduction of the text indicates that 50 million people in the United States are disabled to some degree by chronic pain, at a cost of $60 billion per year in addition to the personal angst involved. This statement certainly catches the reader's attention and justifies the interest in the entity of chronic pain during the past 20 years. In terms of financial burden, chronic pain ranks up there with the Russians, the balance of the trade deficit, and acquired immunodeficiency syndrome (AIDS). The book is divided into four sections: Basic Concepts, Clinical Concepts, Assessment, and Management. Every area of chronic pain is ad
BOOK REVIEWS
1161
dressed, and although some unevenness in cov erage is evident, the effort is generally laudable. The three chapters on the neurochemical aspects of pain provide an excellent summary, including a comprehensive bibliography, of this rapidly changing area. The authors extensively review psychoanalytic aspects of chronic pain, the rela tionship of chronic pain to conversion disorder, the complexity (confusion?) encountered with such an entity as "psychogenic pain," and the relationship between chronic pain and depres sion. I particularly liked the discussion of the difficult topic of malingering. In one section, the authors attempt to discuss the initial manifestations of pain due to a host of disorders involving peripheral organic disease, from angina pectoris to cancer. Unfortunately, this effort at completeness tries to cover too much ground. The book addresses all areas of treatment, but pharmacologic management and the complica tions thereof receive the most attention—nearly 100 pages. The bibliographies of these chapters are indeed extensive. For example, one chapter has 198 references, and the material on the man agement of cancer-related pain consists of five pages of text and four pages of bibliography. What has the computerized library search wrought? I recommend this book to psychiatrists and other medical and paramedical personnel who deal with patients with chronic pain. For psychia trists, it is likely the best source available on the subject. In addition, purchase of this volume provides support for the American Psychiatric Association, which is the publisher. David W. Swanson, M.D. Department of Psychiatry and Psychology Textbook of Psychiatry, edited by John A. Talbott, Robert E. Hales, and Stuart C. Yudofsky, 1,324 pp, with illus, $85, Washington, DC, American Psychiatric Press, 1988 In the introduction of this text, Melvin Sabshin, M.D., president and chairman of the board of the American Psychiatric Press, states: "Psychiatry is in one of the most exciting, creative, and productive phases of its long history. Fueled by