Essentials of Clinical Psychiatry
Essentials of Clinical Psychiatry
Robert E. Hales, Stuart C. Yudofsky, editors
Washington (DC): American Psychiatric Press; 1999. 1070 pp. with index
ISBN 0-88048-848-1 (paper)
A recent publishing phenomenon in psychiatry, particularly in the United States, is the creation of textbooks that are comprehensive, authoritative and expensive. These textbooks are usually multi-authored, and the contributing authors are selected for their well-established expertise in a particular area. In recognition of the needs of medical students and junior residents, more affordable synopses are then created out of these large textbooks. A well-known example of such a synopsis is the one edited by H. Kaplan and B. Sadock entitled Synopsis of Psychiatry that is based on the comprehensive textbook of psychiatry. That synopsis has gone through many editions and remains a popular reference for residents and medical students.
A recent addition to this trend is Essentials of Clinical Psychiatry, based on the 3rd edition of The American Psychiatric Press Textbook of Psychiatry. It is intended for medical students to use during their 3rd year of clerkship or in 4th-year psychiatry electives and for junior psychiatry residents who want a comprehensive overview.
The editors reviewed the 50 chapters in the parent textbook and selected the 25 chapters they felt were “most important and relevant for clinical practice in a variety of settings.” The authors of these chapters were asked to prune their text by 50%, selecting the most important material for their target audience. The resulting text contains 2 sections, “Theoretical foundations and assessment” and “Psychiatric disorders,” and 2 appendices, “Diagnostic criteria from DSM-IV” and “Excerpts from the American psychiatric glossary.”
Compared with its competitors, the major advantage this synopsis has is its discussion of current controversies in the field. An example is the rediscovery of trauma: “The most exciting development for theory of the mind and psychopathology in the 1980s and 1990s has been the rediscovery of the role trauma plays in shaping personality and creating symptoms.” This ambitious claim is well developed in the section on theories of the mind and psychopathology, which includes a discussion on repressed memory.
How should a medical student decide on the appropriate textbook? The following criteria should be used.
• Comprehensiveness. This book can make a strong claim for comprehensiveness. However, there are notable omissions, such as separate sections on Geriatric Psychiatry and Emergency Room Psychiatry.
• Relevance. The book is relevant to the theory and practice of psychiatry and will remain so for the next few years. However, another consideration for relevance is its value as a quick reference text, specifically in emergency situations. Apart from a few sentences in the section on interviewing skills, this book does not provide quick references.
• Examinations. In my experience, the great value of Kaplan and Sadock’s Synopsis of Psychiatry is that it lends itself more easily than this book to the setting of examination questions (and as a result is of greater benefit to residents when studying for these examinations).
• Integration. Because of the rapid developments in psychiatry, particularly in neurobiology, there is an increasing need to integrate the information in a meaningful way for medical students and residents. Essentials of Clinical Psychiatry is weak in this area, and, particularly in the theories of the mind and psychopathology, a student may be left with the sense that these theories hang loosely, separate from each other.
• Authoritativeness. This book reads as an authoritative text that incorporates the latest information. However, medical students may still need to read other texts for some areas. I recommend the chapter on the alcohol-dependent and drug-dependent person, by George E. Vaillant, in New Harvard Guide to Psychiatry. Also, this book does not contain a chapter on the history of psychiatry. Students should be well informed on this subject, therefore I refer them to Synopsis of Psychiatry. The book contains a number of superb chapters: “Neuroscientific foundations of psychiatry,” “Theories of the mind and psychopathology and the psychiatric interviews” and “Psychiatric history and mental status examination.” “Laboratory and other diagnostic tests in psychiatry” also provides important information, and the section on psychiatric disorders is extremely well done, providing comprehensive information on most of the major diagnostic groups. “Anxiety disorders” stands out as an excellent rendering of this important diagnostic area. • Cost. Choice of a text may depend entirely on cost. Now that the 3rd edition of The American Psychiatric Press Textbook of Psychiatry is available in synoptic form as Essentials of Clinical Psychiatry, it should be an important option for libraries, medical students and psychiatric residents.