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Book Review

Practical Child and Adolescent Psychiatry for Pediatrics and Primary Care

Pieter Joost van Wattum, MD, MA

Published: July 15, 2010

Practical Child and Adolescent Psychiatry for Pediatrics and Primary Care

by Harsh K. Trivedi, MD, and Jeryl D. Kershner, MD. Hogrefe, Cambridge, Massachusetts, 2009, 220 pages, $49.00 (spiral-bound).

Pediatricians and primary care doctors frequently do not know how to handle the case or where to turn for help when a patient presents in their office with a mental health problem. They need not worry any longer. From the same publishers of the very successful Clinical Handbook of Psychotropic Drugs for adults and the Clinical Handbook of Psychotropic Drugs for Children and Adolescents comes a new guide aimed at providing a helping hand to pediatricians and primary care practitioners facing patients with mental health problems. The book comes with high expectations considering the success of the aforementioned series.

Edited by an experienced child psychiatrist and a behavioral pediatrician, this practical guide is divided into 5 well-written sections. Section I, Getting Ready, consists of practical advice, including a chapter entitled, "Setting Up Your Office," which addresses the concerns practitioners and their office staff may have before taking on the task of mental health assessment and treatment. Section II, Approach to Common Chief Complaints, starts with snapshots of commonly encountered complaints, for example, "My child has been irritable lately," followed by "key points" directing the practitioner in what to consider with regard to severity of symptoms, context, and possible underlying medical disorders and comorbidities. This is followed by a list of psychiatric differential diagnoses and an assessment algorithm for the chief complaint, in which references are made to Section III, which consists of chapters addressing further evaluation of the possible disorder.

Each chapter includes a full list of criteria according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and provides a treatment algorithm divided into emergent, urgent, and routine care. This algorithm refers to Section IV, Toolbox of Interventions, which consists of 2 parts: Pharmacologic Interventions and Psychotherapeutic and Psychosocial Interventions. The first part describes drug classes, dosage forms, how to initiate and discontinue dosing, and most commonly seen side effects and drug interactions. It is enhanced with handy clinical pearls. The second part describes how to refer for psychotherapy and even how to best match a therapist with a particular patient, addressing issues such as gender, culture, ethnicity, practice style, and theoretical framework.

The fifth and final part consists of a well-rounded section of appendices, including an example of a comprehensive psychiatric evaluation, suicide risk assessment, a concise overview of pertinent DSM-IV-TR diagnostic codes needed for billing, and a listing of suggested rating scales and how and where to obtain them.

This book has everything pediatricians and primary care providers need to comfortably assess, treat, and/or refer children and adolescents whose chief complaint of mental health may be out of their comfort zone. It deserves a place among every pediatrician’s reference books.

Pieter Joost van Wattum, MD, MA

Author affiliation: Yale School of Medicine, New Haven, Connecticut.

Potential conflicts of interest: None reported.

Volume: 71

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