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Book reviews / Journal of Psychosomatic Research 53 (2002) 837–840
Textbook of Neuropsychiatry Third Edition. Edited by Stuart C. Yudofsky and Robert E. Hales. 1140 pp., Illustrated. Washington, DC, American Psychiatric Press, 1997. US$189. ISBN 0-88048-787-9 A specialty that has moved from the outskirts of our understanding into the mainstream, neuropsychiatry is now seen as a much-needed, holistic integration of psychiatry and neurology. This field represents a natural reunion of structure and function and of brain and thought. Indeed, the notion of compartmentalizing psychiatry and neurology can be said to be almost counter-intuitive. Evolving alongside the field it writes about, Yudofsky and Hale present us with the third edition of the Textbook of Neuropsychiatry. The authors have accommodated the ever-increasing presence of neuroscience by including a larger proportion of cellular and subcellular neuropsychiatry material in this volume. However, the text remains a practical clinical guide for psychiatrists, neurologists, internists and residents, from clinical, research and diagnostic imaging perspectives. The third edition is also compatible with the DSM-IV. This text has expanded from 33 chapters in the second edition to the current 37 chapters, which span six thematic sections. Eight new chapter subjects have been added, including pharmacotherapy, clinical and functional neuroimaging and neuropsychiatry aspects of headaches, attention disorders, impulsivity/aggression, rheumatic diseases and chemical dependencies. In addition, 39 new authors were recruited from fields including neuroscience, neuropsychiatry and neuropsychology. The text is beautifully illustrated with more than 180 tables and over 200 figures, many of which are of full-colour. The first section provides a comprehensive overview of basic principles of neuroscience. The cellular and molecular biology of the neuron, human electrophysiology, pharmacotherapy and neuroanatomy are covered within this section. The third chapter of this section, one of the new additions to this text, provides coverage on intra- and intercellular principles of pharmacotherapy, a much-needed resource in the ever-expanding role the biological model plays in mental disorders. This chapter is embellished with easy-to-comprehend colour illustrations of the neuron and neuromuscular junctions, a welcome change from the line drawings of other texts. The four chapters comprising this section may be too advanced for novices to neuropsychiatry, but it does provide a strong introduction for those with some previous knowledge in the field. The next seven chapters are devoted to the second section of the text, Neuropsychiatry Assessment. This section, particularly the first chapter, Bedside Neuropsychiatry, will be of great benefit to medical students, while remaining a valuable resource for all clinicians. Disorders of speech, movement, language, content and form of thought and orientation are described in well-organized segments. Further chapters in this section describe the physical examination and imaging techniques used in neuropsychiatry. Of particular note, how-
ever, is the coverage of the increasing role of diagnostic imaging in neuropsychiatry. Neuroradiological images are beautifully correlated with anatomy and various mood, anxiety, psychotic and dementia disorders. The third section of the text includes seven chapters devoted to Neuropsychiatry Symptomatologies. This section is broken into various clinical presentations, including headache, aphasia, and dementia, and discusses the neuropsychiatry aspects of each presentation. Many clinical scenarios are illustrated with case examples, followed by a discussion of the diagnostic and treatment methodologies. The fourth and largest section of the Textbook of Neuropsychiatry covers 15 chapters of Neuropsychiatry Disorders. Each disorder is comprehensively discussed covering epidemiology, etiology, examination, investigation, differential diagnosis and treatment. Covered are a full range of neurological, psychiatric, rheumatological and endocrinological disorders, including a chapter on disorders of childhood and adolescence. Rarer disorders are given ample attention while the more common presentations are more heavily weighted within the text. Disappointingly, many of the references date to the early 1990’s and late 1980’s. Finally, Neuropsychiatry Treatments, spanning psychopharmacology, psychotherapy and rehabilitation, and a section on Ethical and Legal Issues in Neuropsychiatry close off the textbook. This textbook brings together another authoritative collection of topics in brain and behaviour, written and edited by some of the most celebrated authors in this field. Easy to read and well organized, this text is highly recommended for those interested in neuropsychiatry from either a clinical or a research standpoint. As the field of psychiatry continues to develop, one can be certain that the Textbook of Neuropsychiatry won’t be far behind. Michael Tseng Faculty of Medicine, University of Calgary c/o MER, Calgary, Alberta, Canada T2N 4M1 Tel.: +1-403-289-7070 E-mail address:
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Treatment-Resistant Mood Disorders Edited by JD Amsterdam, M Hornig, and AA Nierenberg. Cambridge University Press, Cambridge 2001. £65 hardback, 535 pages. ISBN: 0521 59341 7 Treatment resistance as applied to mood disorders is a slippery concept — what is an adequate treatment trial, how many different treatments need to be tried, and when can someone be said to have fully recovered? A broad definition of treatment-resistant depression (TRD) could include up to 70% of patients while a narrow definition may only identify 10%. The editors of this book point out that,