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Book Review

Psychiatry, vols 1 & 2, 3rd ed

Nyapati R. Rao, MD, MS and Damir Huremovic, MD

Published: December 15, 2009

Psychiatry, vols 1 & 2, 3rd ed

edited by Allan Tasman, MD; Jerald Kay, MD; Jeffrey A. Lieberman, MD; Michael B. First, MD; and Mario Maj, MD. Wiley-Blackwell, Hoboken, NJ, 2008; 2,880 pages, $340.00.

When a book reaches its third edition over a short span of 11 years, such an accomplishment reflects the book’s wide acceptance by its readers and reflects its editors’ commitment to keeping the book current. Such is the case with Psychiatry, a highly regarded textbook edited by Tasman, Kay, Lieberman, First, and Maj, and published by Wiley-Blackwell. This newest edition has been extensively revised, with an addition of 2 new sections that resulted from expanding and separating the psychosocial from the biologic in the sections on psychiatric foundations and treatments, which were featured jointly in the previous editions.

Psychiatry continues to emphasize an integrative approach to understanding psychopathology and providing treatment in the context of therapeutic alliance. Furthermore, this edition welcomes Mario Maj, from Italy, and Michael B. First to the team of editors. Such a move, while emphasizing the interconnectedness of American psychiatry with that of the rest of the world, also reflects the editors’ wish to stay abreast of the current developments concerning DSM-V.

Section I, titled "Approaches to the Patient," is focused on the psychiatric interview and the doctor-patient relationship and features its key elements, including cultural context and legal aspects. Section II, titled "A Developmental Perspective on Normal Domains of Mental and Behavioral Functions," addresses developmental issues in depth, whereas section III reviews "Neuroscientific Foundations of Psychiatry." Section III is very impressive in both its depth and breadth of the material covered. A special gift is chapter 18, "The Scientific Basis of Psychotherapy," which reviews the growing presence of neuroscience in psychotherapy and effectively argues for psychotherapy as a biologic intervention. In contrast to section III on neurobiology, section IV, titled "Psychological and Social Scientific Foundations of Psychiatry," while capturing all the key points, has been shortened in comparison to the previous editions.

After providing these foundations, in section V, titled "Manifestations and Assessments of Psychiatric Illness," the book thoroughly addresses psychiatric phenomenology and various aspects of psychiatric assessment. Section VI, titled "Disorders," provides an exhaustive review of psychiatric diagnoses in both DSM and ICD classification systems, in keeping with the editors’ intent to provide an internationally relevant reference. Most of the chapters on psychiatric disorders are clear and well-written, with valuable evidence-based guidelines regarding treatment. The chapters on substance abuse are, especially, a real treasure trove of references and data and are a formidable overview of the current state of knowledge regarding substance abuse approach and treatment.

Section VII, titled "Psychotherapeutic and Psychosocial Treatments," in addition to being a solid overview of psychotherapeutic modalities, features excellent chapters on psychiatric rehabilitation, as well as on advocacy and consumer-operated services, reflecting the refreshing focus on rehabilitation in modern psychiatry.

Section VIII, "Pharmacological and Brain Stimulation Treatments," is very well organized and comprehensive. The editors opted for a pragmatic, user-friendly approach, one that aims to be of immediate practical relevance for the reader by discussing helpful "how to" topics and decision-making processes, such as selecting a medication, educating the patient, and deciding on starting doses. The title of the section is somewhat misleading in light of the yet-to-be-proven efficacy of brain stimulation in psychiatry (with the exception of electroconvulsive therapy). The chapter titled "Psychopharmacology: Ethnic and Cultural Perspectives" is very useful and serves to demonstrate the major strength of this book—integration of advancing knowledge into multimodal approach to diagnosis and treatment.

Section IX, "Special Populations and Settings," handles a number of heterogeneous but important and often overlooked topics, such as death and bereavement, restraints and seclusions, psychiatric disasters, and homelessness, ending with a consideration of research methodology and statistics. Even though aspects of public psychiatry are addressed throughout various sections, the editors may want to consider a comprehensive public psychiatry chapter in future editions. Similarly, emergency psychiatry, military psychiatry, and refugee mental health deserve more attention. Another missing piece, given such a comprehensive text like this, is a chapter or section on evidence-based treatment and on methods for evaluating the evidence base, which is a must-have skill for a modern-day independent mental health clinician.

In summary, Psychiatry is an excellent textbook and a remarkable achievement in collaborative authorship, on par with, if not superior to, other references in this field. In the current climate, in which books purporting to be textbooks on every conceivable topic in psychiatry are reaching the bookstore every day, to have one single textbook that addresses a vast array of topics with the thoroughness and comprehensiveness that this publication does is a magnificent accomplishment and a true gift to the reader. The contributors are all leaders in their respective areas, and the writing is always clear and articulate, regardless of the complexity of covered subjects.

This book does not call itself a "textbook of psychiatry." Instead, it carries the somewhat pompous, all-encompassing title Psychiatry. Our initial skepticism regarding its ambitious name was dispelled by the breadth and depth of material that we encountered in the book. Psychiatry satisfies the needs of a researcher as well as a clinician, of a trainee and a seasoned practitioner alike, and its value can be further enhanced by making it available as an online reference and keeping it current through regular updates (similar to Harrison’s Online). Meanwhile, we wholeheartedly recommend this heavy tome of knowledge as well worth its weight.

Nyapati R. Rao, MD, MS

Damir Huremovic, MD

Author affiliations: State University of New York (SUNY) Downstate College of Medicine, Brooklyn, and Nassau University Medical Center, East Meadow, New York. Potential conflicts of interest: None reported.

Volume: 70

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