Modern Perspectives in the Psychiatry of the Affective Disorders

Modern Perspectives in the Psychiatry of the Affective Disorders

John G. Howells

New York, NY: Brunner/Mazel Publishers, 440 pp., 1989

This multi-authored book is the thirteenth in the modern perspectives series. The purpose of this series is to bring up-to-date information to the clinician and psychiatry resident about developments in particular areas, in this case affective disorders. The book comprises 23 chapters on various aspects of the epidemiology, clinical presentation and treatment of affective illness. Its aim is not to be comprehensive but rather to highlight particularly important aspects of the field.

This book is very uneven in its presentation and in fulfilling its purpose. Most authors have been given the impossible task of trying to summarize a vast literature and a huge amount of information in just a few pages. The result is that many of the general chapters on biology, phenomenology and treatment are cursory in nature and offer little more information than can be obtained in a standard textbook. Furthermore, in some chapters, the information presented is so basic and the concepts so simple that the book appears to be more directed to medical students rather than psychiatrists and residents.

There are some delightful exceptions to the above mentioned criticisms. Dr. Calloway presents some fascinating data on abnormalities of thyroid function tests in depressed patients. Dr. Golden and coauthors have written a lively discussion on the concept of involutional melancholia, and Drs. Williams and McGlashan have written a succinct and critical review of the concept of schizoaffective disorder. There is also an excellent chapter on drug therapy and depression in children and an interesting discussion on the relationship between tardive dyskinesia and affective illness.

Other than the few interesting and well-written chapters mentioned above, this book adds little to the vast number of multi-authored texts written on the affective disorders. In most cases, the discussion is limited and lacks both critical appraisal or comprehensive assessment of the literature. It certainly would not be useful to psychiatrists who are primarily interested in clinical or research aspects of affective illness. I think that it would, with the exceptions noted above, have limited value either for general psychiatrists or residents in training. It may be of some use to medical students and housestaff, although it is likely that it would not be preferred to standard general textbooks of psychiatry.