Handbook of Medical Psychiatry
http://www.100md.com
《新英格兰医药杂志》
The title of this book is something of a misnomer. At nearly 1000 pages, with 130 contributors, this is not the kind of "handbook" that will fit into the side pocket of one's laboratory coat. Moreover, the term "medical psychiatry," as used here, appears to delineate content that most cognoscenti would identify as "biologic psychiatry." This is not a book that one will pick up for tips on treating puzzling or difficult cases.
Rather, the title appears to underscore a concept of psychiatry that is firmly grounded in modern biomedical research. The editors' goal was to "summarize . . . the main advances in the understanding of the basic mechanisms and therapeutics of the major psychiatric illnesses that have taken place in recent years." Their organizational approach was to group 60 chapters into nine sections covering research methodology, disorders in children and adolescents, major disorders in adults (including substance abuse and the dementias), and pharmacotherapy. A positive consequence of this breadth is that the reader can find in one book detailed information that might ordinarily be spread out among several. A downside is that the book can seem disjointed and unfocused, especially given the marked stylistic disparities among chapters.
Although this is not a compendium of clinical pearls, it does contain many gems for the reader who seeks a deeper understanding of current themes in psychiatric research. Some of the most productive research in the past decade has been in the areas of genetics and neuroimaging, and there are many outstanding chapters that address these topics. A chapter on neuroimaging findings in schizophrenia, for example, is the best summary I have read to date in an area that is both fast-moving and riddled with contradictions. There are other strong contributions on topics ranging from the basic mechanisms of mood disorders in children to advances in the development of drugs for depression and anxiety.
The book has three principal drawbacks. The first one, which is perhaps inevitable, is the redundancy and unevenness among chapters. The redundancy may be more problematic for a reviewer than for a typical reader, who will probably browse and sample rather than read straight through the entire text. The unevenness, however, particularly as exhibited by authors with more zeal than perspective, can be disconcerting. The second limitation involves the editing and the illustrations. Both are so poor as to be distracting.
Finally, there is the lack of attention to the underpinnings of modern psychiatric practice in the behavioral sciences. This recalls my quibble with the title. In selecting the contents of this book, the editors have stressed the neurobiologic basis of psychiatry. In a book devoted explicitly to that body of work, a relative neglect of psychology and other behavioral sciences could be more readily excused. But if "medical psychiatry" refers to a clinical discipline, it would be important to acknowledge the heavy debt owed to findings in the behavioral sciences. In a more enlightened world, such Cartesian distinctions might be unnecessary, but we have still not achieved that level of integration.
This book is not a clinical reference manual, and students and practitioners in search of one should look elsewhere. Residents and fellows seeking an introduction to contemporary biologic psychiatry, as well as psychiatrists and researchers looking for an update, will find this book useful.
Lawrence H. Price, M.D.
Butler Hospital
Providence, RI 02906
lawrence_price_md@brown.edu((Medical Psychiatry. Vol.)
Rather, the title appears to underscore a concept of psychiatry that is firmly grounded in modern biomedical research. The editors' goal was to "summarize . . . the main advances in the understanding of the basic mechanisms and therapeutics of the major psychiatric illnesses that have taken place in recent years." Their organizational approach was to group 60 chapters into nine sections covering research methodology, disorders in children and adolescents, major disorders in adults (including substance abuse and the dementias), and pharmacotherapy. A positive consequence of this breadth is that the reader can find in one book detailed information that might ordinarily be spread out among several. A downside is that the book can seem disjointed and unfocused, especially given the marked stylistic disparities among chapters.
Although this is not a compendium of clinical pearls, it does contain many gems for the reader who seeks a deeper understanding of current themes in psychiatric research. Some of the most productive research in the past decade has been in the areas of genetics and neuroimaging, and there are many outstanding chapters that address these topics. A chapter on neuroimaging findings in schizophrenia, for example, is the best summary I have read to date in an area that is both fast-moving and riddled with contradictions. There are other strong contributions on topics ranging from the basic mechanisms of mood disorders in children to advances in the development of drugs for depression and anxiety.
The book has three principal drawbacks. The first one, which is perhaps inevitable, is the redundancy and unevenness among chapters. The redundancy may be more problematic for a reviewer than for a typical reader, who will probably browse and sample rather than read straight through the entire text. The unevenness, however, particularly as exhibited by authors with more zeal than perspective, can be disconcerting. The second limitation involves the editing and the illustrations. Both are so poor as to be distracting.
Finally, there is the lack of attention to the underpinnings of modern psychiatric practice in the behavioral sciences. This recalls my quibble with the title. In selecting the contents of this book, the editors have stressed the neurobiologic basis of psychiatry. In a book devoted explicitly to that body of work, a relative neglect of psychology and other behavioral sciences could be more readily excused. But if "medical psychiatry" refers to a clinical discipline, it would be important to acknowledge the heavy debt owed to findings in the behavioral sciences. In a more enlightened world, such Cartesian distinctions might be unnecessary, but we have still not achieved that level of integration.
This book is not a clinical reference manual, and students and practitioners in search of one should look elsewhere. Residents and fellows seeking an introduction to contemporary biologic psychiatry, as well as psychiatrists and researchers looking for an update, will find this book useful.
Lawrence H. Price, M.D.
Butler Hospital
Providence, RI 02906
lawrence_price_md@brown.edu((Medical Psychiatry. Vol.)