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Suicide
Mayo Clio Proc, November 1986, VoI61
used by family members who live with a problem drinker to begin the important task of self-change. This approach, in turn, may create the proper environment for the problem drinker to begin to move toward appropriate treatment and eventual sobriety. One could be critical of the author's rather arbitrary and stepwise approach to this acknowledged complicated disorder. Moreover, readers could argue with his assumption that an emotional disorder precedes problem drinking in most persons. ("Many problem drinkers chose to drink in the first place because they lack positive feelings of self-worth.") The usefulness of this book, however, overshadows any minor criticism. It is a valuable office guide, not only for physicians but also as a source to recommend and make available to troubled patients. Robert M. Morse, M.D. Department of Psychiatry and Psychology
Suicide, edited by Alec Roy, 205 pp, with illus, $29.50, Baltimore, Williams & Wilkins, 1986 An attempt to review the subject of suicide by conducting a literature search would disclose reams of writings, representing a recent explosion in publications on topics that range from the effects of phases of the moon to an entire book on definition. Thus, this concise collection of articles is welcome as it covers the main points of interest to the physician (particularly the psychiatrist) and is written by leading authorities in the field of suicidology. Most of the 13 chapters are in-depth, well-referenced reviews of specific issues such as biologic factors and suicide associated with alcoholism, adolescence, and physical illness; however, several chapters-for example, chapter 9, "Completed Suicide"-are independent overviews and could provide a good general review in less than 30 minutes ofreading. Physicians would find many of the articles directed to them and would be particularly rewarded by reading chapter 12, "The Physician's Role in Suicide Prevention." Unavoidably, when numerous authors contribute to a collection of articles such as this, some redundancy occurs; however, even though I read the entire book in a short time, I found the
BOOK REVIEWS
921
repetition generally helpful through reinforcement of key points, not tedious. Another common consequence of this multiauthorship format is contradiction in one article of something stated in another. For example, the decline of suicide in England in the 1960s is thought by some to correspond to a change from the popular (for suicide by carbon monoxide) coal gas to less lethal natural gas. This hypothetical relationship with the attendant social-policy implications-for instance, on firearms-is both endorsed and refuted by different authors within the covers of this collection. I found only a few contradictions though, and the foregoing case is illuminating, a reflection ofthe general overall high quality ofthe contributions. One frequently repeated "bottom line" message that emerges for physicians is this: Recognition and management or referral of two treatable clinical disorders-depression and alcoholism, which account for the majority of suicides-would probably be the most substantial contribution the general physician can make. Inasmuch as at least half of the persons who commit suicide consult a physician within a month before their death whereas only 3 to 6% contact a suicide-prevention center, the physician's office is perhaps the primary prevention center. Donald E. McAlpine, M.D. Department of Psychiatry and Psychology
Our Patients' Future in a Changing World, edited by John A. Talbott, 158 pp, with illus, $18.50, Washington, D.C., American Psychiatric Press, 1986 The American Psychiatric Association developed a Presidential Symposium at their annual meeting in 1985. This publication is a product of that symposium, which specifically addressed the future from the standpoint ofthe patient in presentations by 10 persons who represented various aspects of psychiatry. The focus of this material ranges from the basic sciences to economics and the public system; one contribution is from a former patient. Unfortunately, most of the presentations fall short of the goal of concentrating on the future of
used by family members who live with a problem drinker to begin the important task of self-change. This approach, in turn, may create the proper environment for the problem drinker to begin to move toward appropriate treatment and eventual sobriety. One could be critical of the author's rather arbitrary and stepwise approach to this acknowledged complicated disorder. Moreover, readers could argue with his assumption that an emotional disorder precedes problem drinking in most persons. ("Many problem drinkers chose to drink in the first place because they lack positive feelings of self-worth.") The usefulness of this book, however, overshadows any minor criticism. It is a valuable office guide, not only for physicians but also as a source to recommend and make available to troubled patients. Robert M. Morse, M.D. Department of Psychiatry and Psychology
Suicide, edited by Alec Roy, 205 pp, with illus, $29.50, Baltimore, Williams & Wilkins, 1986 An attempt to review the subject of suicide by conducting a literature search would disclose reams of writings, representing a recent explosion in publications on topics that range from the effects of phases of the moon to an entire book on definition. Thus, this concise collection of articles is welcome as it covers the main points of interest to the physician (particularly the psychiatrist) and is written by leading authorities in the field of suicidology. Most of the 13 chapters are in-depth, well-referenced reviews of specific issues such as biologic factors and suicide associated with alcoholism, adolescence, and physical illness; however, several chapters-for example, chapter 9, "Completed Suicide"-are independent overviews and could provide a good general review in less than 30 minutes ofreading. Physicians would find many of the articles directed to them and would be particularly rewarded by reading chapter 12, "The Physician's Role in Suicide Prevention." Unavoidably, when numerous authors contribute to a collection of articles such as this, some redundancy occurs; however, even though I read the entire book in a short time, I found the
BOOK REVIEWS
921
repetition generally helpful through reinforcement of key points, not tedious. Another common consequence of this multiauthorship format is contradiction in one article of something stated in another. For example, the decline of suicide in England in the 1960s is thought by some to correspond to a change from the popular (for suicide by carbon monoxide) coal gas to less lethal natural gas. This hypothetical relationship with the attendant social-policy implications-for instance, on firearms-is both endorsed and refuted by different authors within the covers of this collection. I found only a few contradictions though, and the foregoing case is illuminating, a reflection ofthe general overall high quality ofthe contributions. One frequently repeated "bottom line" message that emerges for physicians is this: Recognition and management or referral of two treatable clinical disorders-depression and alcoholism, which account for the majority of suicides-would probably be the most substantial contribution the general physician can make. Inasmuch as at least half of the persons who commit suicide consult a physician within a month before their death whereas only 3 to 6% contact a suicide-prevention center, the physician's office is perhaps the primary prevention center. Donald E. McAlpine, M.D. Department of Psychiatry and Psychology
Our Patients' Future in a Changing World, edited by John A. Talbott, 158 pp, with illus, $18.50, Washington, D.C., American Psychiatric Press, 1986 The American Psychiatric Association developed a Presidential Symposium at their annual meeting in 1985. This publication is a product of that symposium, which specifically addressed the future from the standpoint ofthe patient in presentations by 10 persons who represented various aspects of psychiatry. The focus of this material ranges from the basic sciences to economics and the public system; one contribution is from a former patient. Unfortunately, most of the presentations fall short of the goal of concentrating on the future of