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Concise Guide to Geriatric Psychiatry, Second Edition
Book Reviews DONNA B. GREENBERG, M.D. BOOK REVIEW EDITOR
Concise Guide to Geriatric Psychiatry, Second Edition By James E. Spar and Asenath La Rue Washington, DC, American Psychiatric Press, Inc., 1997 326 pages, ISBN 0–88048–796–8, $21 Reviewed by William E. Falk, M.D.
T
he first thing that strikes me about this book is its fluid and readable style. I was able to read most of it in one comfortable evening. The authors are authoritative without being pedantic. They include, for example, research findings about a given disorder but inform the discussion further by clinical examples from their own extensive experiences. Because of the wellorganized table of contents and fairly complete index, particular topics of interest have been easy to find. The book is divided into nine chapters, each containing a number of useful tables and figures. After introductory chapters on epidemiology, general issues of working with geriatric patients, and a succinct review of normal aging, the authors review the major psychiatric disorders of the elderly, including two chapters each on depression and dementia. The authors then cover, in less detail, anxiety disorders, late-onset psychoses, and other psychiatric disorders. DSMIV criteria are used throughout the text, and ample tables of the criteria are provided. Other diagnostic and therapeutic issues are covered as well. I particularly liked the two chapters on dementia, which were easy to follow and yet touched upon some of the cutting-edge issues in recent journal articles. For example, the book offers a succinct but thoughtful discussion on genetics and Alzheimer’s disease. Not only do the authors summarize the rapidly changing data on early-onset disease, but they also discuss the 388
current debate about the utility of determining apolipoprotein E alleles in the diagnosis of lateonset disease. On this issue and others, the authors synthesize the data but are not hesitant to provide their own opinions, reinforced by their experiences treating patients. Since over half the text is devoted to mood disorders and dementia, there is not enough space to cover other psychiatric disorders as extensively. Nonetheless, Drs. Spar and La Rue do briefly cover important subjects like sleep disturbance, sexual dysfunction, and alcohol/substance abuse. Each chapter includes a number of primary source references and additional suggested reading in other textbooks. The size of this book makes it an ideal fit for carrying in a jacket pocket, unlike some of the other spiral-bound manuals that require a bookbag. The book also has some useful screening instruments consolidated in an appendix, such as the Instrumental Activities of Daily Living Scale, the Neuropsychiatric Inventory, and the Geriatric Depression Scale. However, some scales are copyrighted, so the authors can only whet the reader’s appetite with examples from these instruments, not the complete version. A small quibble is that the Mini-Mental State Exam is incorporated into the text, while its instructions are in the appendix. Overall, this “concise guide” delivers what it promises and would be a useful clinical resource for some medical students, residents, and practicing psychiatrists. The concise guide does not replace some of the other excellent comprehensive texts now available in geriatric psychiatry, but its portability, ease of use, and succinct style make it ideal for the busy clinician.
Dr. Falk is Director of Geriatric Psychopharmacology, Department of Psychiatry, Massachusetts General Hospital, and assistant professor of psychiatry, Harvard Medical School. PSYCHOSOMATICS
Concise Guide to Geriatric Psychiatry, Second Edition By James E. Spar and Asenath La Rue Washington, DC, American Psychiatric Press, Inc., 1997 326 pages, ISBN 0–88048–796–8, $21 Reviewed by William E. Falk, M.D.
T
he first thing that strikes me about this book is its fluid and readable style. I was able to read most of it in one comfortable evening. The authors are authoritative without being pedantic. They include, for example, research findings about a given disorder but inform the discussion further by clinical examples from their own extensive experiences. Because of the wellorganized table of contents and fairly complete index, particular topics of interest have been easy to find. The book is divided into nine chapters, each containing a number of useful tables and figures. After introductory chapters on epidemiology, general issues of working with geriatric patients, and a succinct review of normal aging, the authors review the major psychiatric disorders of the elderly, including two chapters each on depression and dementia. The authors then cover, in less detail, anxiety disorders, late-onset psychoses, and other psychiatric disorders. DSMIV criteria are used throughout the text, and ample tables of the criteria are provided. Other diagnostic and therapeutic issues are covered as well. I particularly liked the two chapters on dementia, which were easy to follow and yet touched upon some of the cutting-edge issues in recent journal articles. For example, the book offers a succinct but thoughtful discussion on genetics and Alzheimer’s disease. Not only do the authors summarize the rapidly changing data on early-onset disease, but they also discuss the 388
current debate about the utility of determining apolipoprotein E alleles in the diagnosis of lateonset disease. On this issue and others, the authors synthesize the data but are not hesitant to provide their own opinions, reinforced by their experiences treating patients. Since over half the text is devoted to mood disorders and dementia, there is not enough space to cover other psychiatric disorders as extensively. Nonetheless, Drs. Spar and La Rue do briefly cover important subjects like sleep disturbance, sexual dysfunction, and alcohol/substance abuse. Each chapter includes a number of primary source references and additional suggested reading in other textbooks. The size of this book makes it an ideal fit for carrying in a jacket pocket, unlike some of the other spiral-bound manuals that require a bookbag. The book also has some useful screening instruments consolidated in an appendix, such as the Instrumental Activities of Daily Living Scale, the Neuropsychiatric Inventory, and the Geriatric Depression Scale. However, some scales are copyrighted, so the authors can only whet the reader’s appetite with examples from these instruments, not the complete version. A small quibble is that the Mini-Mental State Exam is incorporated into the text, while its instructions are in the appendix. Overall, this “concise guide” delivers what it promises and would be a useful clinical resource for some medical students, residents, and practicing psychiatrists. The concise guide does not replace some of the other excellent comprehensive texts now available in geriatric psychiatry, but its portability, ease of use, and succinct style make it ideal for the busy clinician.
Dr. Falk is Director of Geriatric Psychopharmacology, Department of Psychiatry, Massachusetts General Hospital, and assistant professor of psychiatry, Harvard Medical School. PSYCHOSOMATICS