Philadelphia: Lippincott Williams & Wilkins, 2007
283 pages, $39.95 (softcover)
Reviewed by Niranjan Karnik, MD, PhD, and Hans Steiner, FAPA, FACAAP, FAPM
One of the major challenges in child psychiatry is teaching the essentials of the field to the general physician or medical school student who needs some understanding of developmental issues and psychopathology. Dorothy Stubbe's contribution to this challenge is a small and well-written handbook published as part of the series, Practical Guides in Psychiatry. Dr Stubbe, a faculty member at the renowned Yale Child Study Center who also serves as training director for its fellowship program in child and adolescent psychiatry, is well placed to author such a guide, and her experience in teaching and clinical practice is evident. This handbook can be used by students during their core psychiatry rotations and provides an excellent outline of the discipline.
Section I concisely describes and defines the concept of child development. A brief chapter on the psychiatric evaluation of children and adolescents is included.
Section II reviews major conditions that usually begin during childhood, such as developmental disorders, disruptive behaviors, tic and elimination disorders, and disorders of feeding.
Section III examines the multiplicity of psychiatric disorders that can begin in childhood and extend into adulthood, such as mood, anxiety, psychotic, eating, substance use, trauma, and adjustment disorders. Throughout this section, the author weaves in the relevance of taking a developmental view and makes clear the unique issues that arise in childhood disorders.
The challenges of assessing children in psychiatric emergencies and the special needs of children who are abused or neglected are the focus of Section IV. In this section, Dr Stubbe's clinical experience becomes clear as she guides readers through this of- ten emotional and painful terrain. She is cautious in offering advice, and instead highlights potential pitfalls for the front-line practitioner and provides a broad outline of how to approach risk assessment and emergen- cy interventions.
Section V concludes the book by examining issues in treatment planning, psychopharmacology, psycho- social and educational interventions, and consultation to other systems of care. These are weighty topics, and as with much of the book, each could form the basis of its own text. Nevertheless, the reader is given enough information to understand these interventions, and further references in the appendices supply additional information if needed.
Throughout this book, clinical vignettes, well-formatted tables, and useful clinical pearls are provided. They not only make the book more accessible but also serve to help highlight major points that emerge in the text. The author's clinical vignettes, which display her clinical acumen and give the reader a rare glimpse into the challenges and opportunities child psychiatrists face, are generally the most interesting. Students and trainees will undoubtedly be able to use this book, thereby gaining from Dr Stubbe's experience.
Drs Karnik and Steiner are in the division of child and adolescent psychiatry at Stanford University School of Medicine in Palo Alto, Calif.