Concise Guide to Geriatric Psychiatry

Concise Guide to Geriatric Psychiatry, 2nd edition

Spar JE, La Rue A

Washington (DC): American Psychiatric Press; 1997. 326 pp with index

ISBN 0-88048-796-8 (paper)

Geriatric psychiatry is becoming an important psychiatric sub-specialty. The authors, James Spar, MD, and Asenath LaRue, PhD, from the University of California, Los Angeles and the University of Mexico, respectively, are experts in this burgeoning field. The first edition of their book, based on the DSM-III-R and published in 1990, provided a delightful, well-written, pocket-book-sized summary of practical information for psychiatrists, psychiatry residents and medical students working in a variety of treatment settings. It included information on mental health issues in old age, on normal aging and on the diagnosis and management of geropsychiatric disorders.

The second edition (based on the DSM-IV) is even better. It is 50% longer than the original and includes necessarily expanded sections on the differential diagnosis and psychopharmacology of mood disorders, an additional section on Alzheimer’s disease, and a thoughtful 30-page appendix of instruments (e.g., Mini Mental State Examination, Geriatric Depression Scale) commonly used for clinical assessment. Particularly useful are the numerous clinical vignettes throughout the text and the many tables and figures that summarize information.

Despite the strengths of this little book, it does have limitations. It is not evidence-based. It does not define the frontiers of knowledge or encourage critical thinking. Some statements or recommendations appear to be just opinions; for example, some readers might not agree that selective serotonin reuptake inhibitors (SSRIs) are first-line drugs for the treatment of depression. Finally, the lists of references and additional readings include articles published almost exclusively in US journals.

Limitations notwithstanding, this pithy paperback is the book of choice for psychiatry residents completing a mandatory rotation in geriatric psychiatry. It may also be of interest to general psychiatrists, geriatricians or family physicians who want a clear summary of the psychiatry of old age.