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Suicide in children and adolescents
380
Book Reviews
The authors need to be congratulated on attempting this rather difficult task. by using a lucid unbiased approach that will appeal to both lay and professional readers. The book is divided into two parts, the first focuses on basic information and succeeds in providing a fairly complete picture of the different aspects of the disorder and its psychological and social implications. One of the messages that emerges quite strongly is the importance of medication in addition to counselling and family therapy in the management of this condition. This is often a concern for the carers who may feel unsure of the benefits of powerful neuroleptics. The importance of the immediate friends or family in identification and prevention of relapses is clearly spelt out hence encouraging a vigilant role on the part of the carer. The second section deals with personal accounts of patients, famthes and doctors. The psychtatrists account addresses the medical professions dilemma in coping with the applicatmn of a traditmnal model of disease management whilst trying to fulfil the requirements and emotional needs of the patient which are often contrary to most care programmes in operation. It is clear from these accounts that the expectations and anxieties of the patients, their carers and the medical profession are often quite different and this could be best resolved by good communication between these three groups. Current research has focused on the importance of families, friends and close contacts in the long term outcome of schizophrenia but until now most education of carers was ill defined and patchy in its application. This book seems to till this gap, and is a must for all those dealing with schizophrenia.
University
Violence and Suicidality.
DK IKWIN NALAKETH Lecturer Dcpt of Primary Health Care College and Middlesex School of Medicine London. U.K.
Perspectives in Clinical and Psychobiological Research. Edited by H M FAN PKAA~;,
R PI r:TVHIK and A APTEK. New York:
Brunner
Mazel,
1990. 352 pp. Price S10.
Tm: papers collected in this volume result from two symposia; they are tenuously hnked by the fact that all deal with violence, suicide or both. The orientation is predominantly biological. attempting to link nemotransmitters to a variety of behaviours. It is likely to be of greatest appeal to those working in this area: the clinical and epidemiological chapters, there to provide balance, add nothing to the existing literature. One fault runnmg throughout the book is a tendency to indulge in the ktnd of speculation that speaks of ant colonies and serotonin in one sentence and the origins of the Second World War in the next; sociobiology has a lot to answer for. Them is also a striking contrast between the precise measurement of brain chemicals and the loose w’ay in vvhich psy,chological terms are used: no distinction is made between suicide and parasuicidc, lumped together as ‘sutcidality’. Some chapters provide a useful introduction to the recent literature in their parttcular field, although their value as a review is limited by an uncritical approach. Hinde’s contribution on ethological tssues is a partial exception. starting well with a critical discussion of the problems involved in defining concepts such as aggression or violence---not to mention suicidality. Unfortunately. before the end of the chapter. even he starts talking about the War. DR A. MAor-r+ Research Fellow Institute of Psychiatry London, U.K.
Suicide
1990.
in Children
and Adolescents.
Edited
hy GFOKG~ MA~.L~~AN. Toronto:
Hogrefe
and Huber.
Price f19.00.
Trrts hooh sets out to provide a condensation of the available knowledge about suictde in childhood and adole\ccnce. and succeeds admirably in achieving that aim. It is clear and succinct, its chapters neatly \ub-divtded. with helpful recommended further reading. The fact that a number of its chapters are written by the editor htmsell. or by his collaborators on the Ontario Child Health Study. is probably responsible for the integrated feel of the book. The emphasis on clinical practice is particularly welcome, as is the presznce tn one small book of a wade range of theoretrcal perspectives.
Book Reviews
381
This book can be recommended highly to those, like its editor 15 years ago, heading to the library in search of knowledge about childhood and adolescent suicide. The book is written and published in North America and thus there are one or two problems for those who might contemplate buying it in other countries. For example, it is unlikely that clinicians in Britain would find the recommended clinical interviews and checklists readily available, or DSM-III diagnoses widely used. outside a research setting. More seriously. it means that the cost of importing the book, in the absence of a British distributor. approaches fl9.00-rather exorbitant for a mere 132 pages.
Watford
Conceptual Routledge.
Issues in Psychological Medicine. 1990. 335~~. Price f40.00.
DR. RACHEL BROWN Consultant Psychiatrist Child & Family Clinic
MITHAEI. SHEPHERD. London and New York: Tavistock/
NINE ~EFN reprinted addresses and reviews make up this selection of writings on the many conceptual issues which have occupied Michael Shepherd’s powerful intellect. More than one-third of the volume is devoted to his 1961 paper on morbid jealousy: searching, closely reasoned, illustrated by 80 case histories. it has worn well and indeed remains unsurpassed as an account of a clinical theme which every psychiatrist meets from time to time. In aJoint paper (1974) with the historian Christopher Hill. we find a demonstration of the uses of psychiatric and historical method applied to the case of Arise Evans. a godly man who became ill and involved with social care and political events of the 1640s. ‘years of unprecedented freedom’. The story is fascinating in itself and as an excursion into the methods of disciplined historico-psychiatric study. The other papers date from the 1980s. and together set out Shepherd’s appraisal of the rise and fall of social medicine and social psychiatry, the development of epidemiological method and the emergence of the epidemiological psychiatrist. primary care as the middle ground of psychiatry, and classificatory systems. These essays are reminiscent of those of Shepherd’s great mentor Aubrey Lewis, whose legacies he eloquently calls to mind; and there is also a moving tribute to John Ryle. The author argues persuasively. and with reason. that Karl Jahpers’ Gerlrrrrl Psvchoprrrhology is ‘the most important single book to have been published on the aims and logic of psychological medicine’. He describes the background and objectives associated with the journal I?~~c~ho/ogiccr/ Medicine with the clarity one would expect from its founder. And we can read his jeu d’esprit which turns out to be a deadly serious object lesson--not published elsewhere-concerning Sherlock Holmes and the case of Dr Freud. Thi\ I\ a marvellou\ book because Shepherd writes with immense grace and wit, sticks to the facts and utilize5 his imagination In interpreting them. and cites his sources. He helps us to see instances as important in themaelvcs and even more important in leading to the broad perspectives. It has much of value for the whole panoply of psychiatrists from those starting their training to the senior consultants and professors. There is much. too, for people who are not psychiatrists. Yet it may be that those who might have the most to gain are the least likely to read the book. It may fail to teach where teaching is most needed. ‘I envy the reader who will encounter these essays for the first time’ writes Leon Eisenberg in a pretty foreword. ‘The experience is one to be savoured.’ Quite so. These writings have many of the features of belletrism: the graceful and resourceful prose and beautifully woven modes of argument are prone to deflect attention from the reader’s search for explanation and truth. It is fine writing, donnish in the best sense, and far-perhaps too far-removed from the blunt recitals. simple revelations. and plain language of the good postgraduate textbooks and journal re\,icws. It has to be said that the average student, examination candidate, and even teacher of psychiatry may tind the patrician style too lofty and ungenerous, even irritating or intimidating. Can it be that the presentation is an example of mandarin writing directed at those possessing or aspiring to mandarin ztatus: those who may become drunk with bliss on this heady stuff! Shepherd’s writings show that for him nothing but the best will do. Then can he be an educator? Judging from what is written in these pages, he IS indeed: one of the best-for the very beat and most discriminating students. Ordinary folk may feel challenged. frightened and outclassed, for they receive few concessions. Where truths arc revealed by one with God-given gifts. disciples may be needed to interpret the style and the message to the common man and woman. Although the style can evoke these and other dangerous thoughts. I recommend the book unreservedly to all who seek to understand some of the concepts central to psychological medicine, and explore others on their own initiative. The price is awful and there is no paperback. R. H. CAWL~Y
Book Reviews
The authors need to be congratulated on attempting this rather difficult task. by using a lucid unbiased approach that will appeal to both lay and professional readers. The book is divided into two parts, the first focuses on basic information and succeeds in providing a fairly complete picture of the different aspects of the disorder and its psychological and social implications. One of the messages that emerges quite strongly is the importance of medication in addition to counselling and family therapy in the management of this condition. This is often a concern for the carers who may feel unsure of the benefits of powerful neuroleptics. The importance of the immediate friends or family in identification and prevention of relapses is clearly spelt out hence encouraging a vigilant role on the part of the carer. The second section deals with personal accounts of patients, famthes and doctors. The psychtatrists account addresses the medical professions dilemma in coping with the applicatmn of a traditmnal model of disease management whilst trying to fulfil the requirements and emotional needs of the patient which are often contrary to most care programmes in operation. It is clear from these accounts that the expectations and anxieties of the patients, their carers and the medical profession are often quite different and this could be best resolved by good communication between these three groups. Current research has focused on the importance of families, friends and close contacts in the long term outcome of schizophrenia but until now most education of carers was ill defined and patchy in its application. This book seems to till this gap, and is a must for all those dealing with schizophrenia.
University
Violence and Suicidality.
DK IKWIN NALAKETH Lecturer Dcpt of Primary Health Care College and Middlesex School of Medicine London. U.K.
Perspectives in Clinical and Psychobiological Research. Edited by H M FAN PKAA~;,
R PI r:TVHIK and A APTEK. New York:
Brunner
Mazel,
1990. 352 pp. Price S10.
Tm: papers collected in this volume result from two symposia; they are tenuously hnked by the fact that all deal with violence, suicide or both. The orientation is predominantly biological. attempting to link nemotransmitters to a variety of behaviours. It is likely to be of greatest appeal to those working in this area: the clinical and epidemiological chapters, there to provide balance, add nothing to the existing literature. One fault runnmg throughout the book is a tendency to indulge in the ktnd of speculation that speaks of ant colonies and serotonin in one sentence and the origins of the Second World War in the next; sociobiology has a lot to answer for. Them is also a striking contrast between the precise measurement of brain chemicals and the loose w’ay in vvhich psy,chological terms are used: no distinction is made between suicide and parasuicidc, lumped together as ‘sutcidality’. Some chapters provide a useful introduction to the recent literature in their parttcular field, although their value as a review is limited by an uncritical approach. Hinde’s contribution on ethological tssues is a partial exception. starting well with a critical discussion of the problems involved in defining concepts such as aggression or violence---not to mention suicidality. Unfortunately. before the end of the chapter. even he starts talking about the War. DR A. MAor-r+ Research Fellow Institute of Psychiatry London, U.K.
Suicide
1990.
in Children
and Adolescents.
Edited
hy GFOKG~ MA~.L~~AN. Toronto:
Hogrefe
and Huber.
Price f19.00.
Trrts hooh sets out to provide a condensation of the available knowledge about suictde in childhood and adole\ccnce. and succeeds admirably in achieving that aim. It is clear and succinct, its chapters neatly \ub-divtded. with helpful recommended further reading. The fact that a number of its chapters are written by the editor htmsell. or by his collaborators on the Ontario Child Health Study. is probably responsible for the integrated feel of the book. The emphasis on clinical practice is particularly welcome, as is the presznce tn one small book of a wade range of theoretrcal perspectives.
Book Reviews
381
This book can be recommended highly to those, like its editor 15 years ago, heading to the library in search of knowledge about childhood and adolescent suicide. The book is written and published in North America and thus there are one or two problems for those who might contemplate buying it in other countries. For example, it is unlikely that clinicians in Britain would find the recommended clinical interviews and checklists readily available, or DSM-III diagnoses widely used. outside a research setting. More seriously. it means that the cost of importing the book, in the absence of a British distributor. approaches fl9.00-rather exorbitant for a mere 132 pages.
Watford
Conceptual Routledge.
Issues in Psychological Medicine. 1990. 335~~. Price f40.00.
DR. RACHEL BROWN Consultant Psychiatrist Child & Family Clinic
MITHAEI. SHEPHERD. London and New York: Tavistock/
NINE ~EFN reprinted addresses and reviews make up this selection of writings on the many conceptual issues which have occupied Michael Shepherd’s powerful intellect. More than one-third of the volume is devoted to his 1961 paper on morbid jealousy: searching, closely reasoned, illustrated by 80 case histories. it has worn well and indeed remains unsurpassed as an account of a clinical theme which every psychiatrist meets from time to time. In aJoint paper (1974) with the historian Christopher Hill. we find a demonstration of the uses of psychiatric and historical method applied to the case of Arise Evans. a godly man who became ill and involved with social care and political events of the 1640s. ‘years of unprecedented freedom’. The story is fascinating in itself and as an excursion into the methods of disciplined historico-psychiatric study. The other papers date from the 1980s. and together set out Shepherd’s appraisal of the rise and fall of social medicine and social psychiatry, the development of epidemiological method and the emergence of the epidemiological psychiatrist. primary care as the middle ground of psychiatry, and classificatory systems. These essays are reminiscent of those of Shepherd’s great mentor Aubrey Lewis, whose legacies he eloquently calls to mind; and there is also a moving tribute to John Ryle. The author argues persuasively. and with reason. that Karl Jahpers’ Gerlrrrrl Psvchoprrrhology is ‘the most important single book to have been published on the aims and logic of psychological medicine’. He describes the background and objectives associated with the journal I?~~c~ho/ogiccr/ Medicine with the clarity one would expect from its founder. And we can read his jeu d’esprit which turns out to be a deadly serious object lesson--not published elsewhere-concerning Sherlock Holmes and the case of Dr Freud. Thi\ I\ a marvellou\ book because Shepherd writes with immense grace and wit, sticks to the facts and utilize5 his imagination In interpreting them. and cites his sources. He helps us to see instances as important in themaelvcs and even more important in leading to the broad perspectives. It has much of value for the whole panoply of psychiatrists from those starting their training to the senior consultants and professors. There is much. too, for people who are not psychiatrists. Yet it may be that those who might have the most to gain are the least likely to read the book. It may fail to teach where teaching is most needed. ‘I envy the reader who will encounter these essays for the first time’ writes Leon Eisenberg in a pretty foreword. ‘The experience is one to be savoured.’ Quite so. These writings have many of the features of belletrism: the graceful and resourceful prose and beautifully woven modes of argument are prone to deflect attention from the reader’s search for explanation and truth. It is fine writing, donnish in the best sense, and far-perhaps too far-removed from the blunt recitals. simple revelations. and plain language of the good postgraduate textbooks and journal re\,icws. It has to be said that the average student, examination candidate, and even teacher of psychiatry may tind the patrician style too lofty and ungenerous, even irritating or intimidating. Can it be that the presentation is an example of mandarin writing directed at those possessing or aspiring to mandarin ztatus: those who may become drunk with bliss on this heady stuff! Shepherd’s writings show that for him nothing but the best will do. Then can he be an educator? Judging from what is written in these pages, he IS indeed: one of the best-for the very beat and most discriminating students. Ordinary folk may feel challenged. frightened and outclassed, for they receive few concessions. Where truths arc revealed by one with God-given gifts. disciples may be needed to interpret the style and the message to the common man and woman. Although the style can evoke these and other dangerous thoughts. I recommend the book unreservedly to all who seek to understand some of the concepts central to psychological medicine, and explore others on their own initiative. The price is awful and there is no paperback. R. H. CAWL~Y