Clinical Manual of Neuropsychiatry

Clinical Manual of Neuropsychiatry

edited by Stuart C. Yudofsky, MD, and Robert E. Hales, MD, MBA. American Psychiatric Publishing, Washington, DC, 2012, 427 pages, $70.00 (paper).

Over the last 5 years, American Psychiatric Publishing (APP) has produced the fifth edition of its Textbook of Neuropsychiatry and Behavioral Neurosciences (2007); the second edition of its half-sized but still hefty companion, Essentials of Neuropsychiatry and Behavioral Neurosciences (2010); and a Study Guide to Neuropsychiatry and Behavioral Neurosciences (2008). This year, APP and editors Stuart C. Yudofsky and Robert E. Hales deliver us a Clinical Manual of Neuropsychiatry. Potential readers are justified in asking whether this latest book brings anything distinctive to an interesting but possibly crowded party.

At a glance, the blue and black cover, with its diffusion tensor and 3-D fiber tracking sagittal image of the brain, marks it as a member of the aforementioned series. Continuing to judge this book by its cover, though, one notes that behavioral neurosciences is dropped from the title format—a distinction between neuropsychiatry and neuroscience is implicitly recognized. This change suggests intent to deliver a clinical manual in a field whose scientific pursuits may unnecessarily scare many providers off, depriving patients of what ought to be standard and readily available care.

Still, this is no dumbed down version of the neuropsychiatric knowledge base. Pint-sized but potent, this edited text features many chapters authored by leaders in the field who combine fluid presentations with effective distillations of both foundational and up-to-date literature in their areas of interest. Quality is almost uniformly high, especially in terms of balancing basic principles of neuropsychiatric syndromes with just enough cutting-edge knowledge and theory to make the Clinical Manual useful to both general psychiatrists and neuropsychiatric specialists.

Most chapters are devoted to general neuropsychiatric syndromes. The reader gets especially practical, clearly presented discussions of delirium, traumatic brain injury, seizure disorders, stroke, HIV, and the more common dementias. Rather than the expected year-old-review-article feel that such chapters can often have, these possess the flow of good lectures, conveying the useful and the intriguing elements of the authors’ ongoing life works. Somewhat weaker chapters on brain tumors and dementias with motor dysfunction suffer in the first case from overreliance on impressionistic statements and outdated literature and in the latter case from a list-like structure that glosses over areas that demand more focus and nuance (eg, psychosis in parkinsonian presentations).

Sandwiching the pathology content are 2 opening chapters on neuropsychiatric assessment and 2 closing ones on treatment. The assessment chapters focus on formal neuropsychological testing and neuroimaging, though it seems a Clinical Manual would be better served by a discussion of the physician’s initial interview and examination of a patient suspected of having neuropsychiatric pathology. That said, the chapter on neuroimaging is the best of its type I have encountered in terms of relaying clinically useful information. The treatment chapters globally address pharmacology and rehabilitation/adaptation in the neuropsychiatrically ill, somehow avoiding getting bogged down in their diffuse tasks, and instead dispensing pearls at a manageable pace.

So, does the world really need APP’s Clinical Manual of Neuropsychiatry? Unfortunately, and emphatically, yes. Unfortunately, because even after a "Decade of the Brain," and the publication of myriad texts, neuropsychiatry remains a specialized domain rather than a part of every psychiatrist’s skill set. Emphatically, because Drs Yudofsky and Hales have put together a book that, by virtue of its generally high quality and streamlined quantity, stands a good chance of beginning to change that situation.

Nicholas Kontos, MD

nkontos@partners.org

Author affiliation: Harvard Medical School, Boston, Massachusetts.

Potential conflicts of interest: None reported.

J Clin Psychiatry 2012;73(12):1566 (doi:10.4088/JCP.12bk08183).

© Copyright 2012 Physicians Postgraduate Press, Inc.