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The Impact of Biology on Modern Psychiatry
BOOK REVIEWS The Impact of Biology on Modem Psychiatry Edited by Elliot S. Gershon, Robert H. Belmalter, Seymour S. Kety, and Milton Bosenbaum, 276 pp, $25, New York, Plenum Press, 1977.
• This volume comprises the proceedings of a symposium honoring the 80th anniversary of the Jerusalem Mental Health CenterEzrath Nashim, which was held in Jerusalem, Israel in 1975. Its publication commemorates the perseverance of leaders in the mental health movement that culminated in the development ofa progressive mental health center in Jerusalem. The well-presented manuscripts affirm -the commitment of a number of notable scholars to the relevance of biologic psychiatry to a progressive mental health movement. The first of three sections, entitled "Neurochemical Studies in Human Psychopathology," consists of eight chapters. The first chapter, by H. M. van Praag, provides a lucid presentation of the significance of nervous system dopamine metabolism to the pathogenesis and treatment of schizophrenia. Although this area has received considerable attention in the current psychiatric literature, Dr. van Praag provides us with one of the most readable overviews on this subject that I have seen. The third chapter, by Sedvall and associates, provides interesting data indicating that the change in the ratio of CSF catecholamine metabolites induced by antipsychotic drugs correlates with clinical efficacy. A subsequent chapter by Gershon, Angrist, and Shopsin provides us with a sagacious commentary on the role of JUNE 1978· VOL 19· NO 6
pharmacologic agents as tools in psychiatric research. Of particular interest is the section devoted to the role of multiple transmitter systems in the psychoses. The chapter by Rimon and Halonen on viral antibody levels provides relevant comments concerning the potential role of viral infections in psychiatric illness. The second section, entitled "Catecholamines and Behavior," contains six chapters that cover diverse areas of this broad topic. Several chapters are of particular interest, including the first, by Moussa Youdim, which provides us with an easily readable, in-depth commentary on the relationship of the enzyme monoamine oxidase to psychopathology at the chemical, pharmacologic, and behavioral levels. The chapter by Arnold Mandell on old and new theories in biochemical psychiatry is an elegant dissertation by this brilliant and accomplished man. The third section, entitled "Genetic Studies in Psychiatry," is authored by recognized experts in this field, such as Seymour S. Kety, Elliot Gershon, and Julien Mendlewicz. Topics covered include the evidence for a genetic contribution to the schizophrenias, affective illnesses, and schizo-affective disorders. The chapter by Belmaker and Ebstein on the search for genetic polymorphisms of human biogenic-amine-related enzymes is of particular interest, since considerable evidence has acculD1Jlated that reduced platelet monoamine oxidase activity is associated with psychopathology. One criticism of the text is the rather loose organization of the
chapters within each of the sections, particularly the first two. In this regard, the volume suffers from an organizational deficit that characterizes many texts based on symposium proceedings. Despite this caveat, I recommend that The Impact ofBiology on Modern Psychiatry be placed high on the list for all well-balanced and progressive libraries of psychiatric literature. John L. Sullivan, M.D. Durham, N. C.
Practical Psychiatry in Medicine By John B. Imboden and John C. Urbaitia, 320 pp, $9.50, New York, Appleton-Century-Crofts, 1977.
• This text is geared to meet the needs of the general physician. Part I considers introductory concepts. These include psychologic reactions to illness, as well as the influence of psychologic factors on physiologic processes. Coping behavior is illustrated by a series of clinical vignettes. In part 2, the psychologic aspects of physical illness are considered, starting with perception of initial symptoms. The meaning of illness in both physical and psychologic terms is seen in the light of the patient's past experiences and unconscious fantasies and emotions. Patient non-compliance and psychologic reactions to hospitalization are discussed in detail. Part 3 is concerned with psychologic problems in disorders encountered in medical practice. Suicidal behavior and sexual dysfunction receive major emphasis. Organic brain syndromes are considered in detail. The chapters 371
• This volume comprises the proceedings of a symposium honoring the 80th anniversary of the Jerusalem Mental Health CenterEzrath Nashim, which was held in Jerusalem, Israel in 1975. Its publication commemorates the perseverance of leaders in the mental health movement that culminated in the development ofa progressive mental health center in Jerusalem. The well-presented manuscripts affirm -the commitment of a number of notable scholars to the relevance of biologic psychiatry to a progressive mental health movement. The first of three sections, entitled "Neurochemical Studies in Human Psychopathology," consists of eight chapters. The first chapter, by H. M. van Praag, provides a lucid presentation of the significance of nervous system dopamine metabolism to the pathogenesis and treatment of schizophrenia. Although this area has received considerable attention in the current psychiatric literature, Dr. van Praag provides us with one of the most readable overviews on this subject that I have seen. The third chapter, by Sedvall and associates, provides interesting data indicating that the change in the ratio of CSF catecholamine metabolites induced by antipsychotic drugs correlates with clinical efficacy. A subsequent chapter by Gershon, Angrist, and Shopsin provides us with a sagacious commentary on the role of JUNE 1978· VOL 19· NO 6
pharmacologic agents as tools in psychiatric research. Of particular interest is the section devoted to the role of multiple transmitter systems in the psychoses. The chapter by Rimon and Halonen on viral antibody levels provides relevant comments concerning the potential role of viral infections in psychiatric illness. The second section, entitled "Catecholamines and Behavior," contains six chapters that cover diverse areas of this broad topic. Several chapters are of particular interest, including the first, by Moussa Youdim, which provides us with an easily readable, in-depth commentary on the relationship of the enzyme monoamine oxidase to psychopathology at the chemical, pharmacologic, and behavioral levels. The chapter by Arnold Mandell on old and new theories in biochemical psychiatry is an elegant dissertation by this brilliant and accomplished man. The third section, entitled "Genetic Studies in Psychiatry," is authored by recognized experts in this field, such as Seymour S. Kety, Elliot Gershon, and Julien Mendlewicz. Topics covered include the evidence for a genetic contribution to the schizophrenias, affective illnesses, and schizo-affective disorders. The chapter by Belmaker and Ebstein on the search for genetic polymorphisms of human biogenic-amine-related enzymes is of particular interest, since considerable evidence has acculD1Jlated that reduced platelet monoamine oxidase activity is associated with psychopathology. One criticism of the text is the rather loose organization of the
chapters within each of the sections, particularly the first two. In this regard, the volume suffers from an organizational deficit that characterizes many texts based on symposium proceedings. Despite this caveat, I recommend that The Impact ofBiology on Modern Psychiatry be placed high on the list for all well-balanced and progressive libraries of psychiatric literature. John L. Sullivan, M.D. Durham, N. C.
Practical Psychiatry in Medicine By John B. Imboden and John C. Urbaitia, 320 pp, $9.50, New York, Appleton-Century-Crofts, 1977.
• This text is geared to meet the needs of the general physician. Part I considers introductory concepts. These include psychologic reactions to illness, as well as the influence of psychologic factors on physiologic processes. Coping behavior is illustrated by a series of clinical vignettes. In part 2, the psychologic aspects of physical illness are considered, starting with perception of initial symptoms. The meaning of illness in both physical and psychologic terms is seen in the light of the patient's past experiences and unconscious fantasies and emotions. Patient non-compliance and psychologic reactions to hospitalization are discussed in detail. Part 3 is concerned with psychologic problems in disorders encountered in medical practice. Suicidal behavior and sexual dysfunction receive major emphasis. Organic brain syndromes are considered in detail. The chapters 371