Guide to Neuropsychiatric Therapeutics

Aug 01, 2007

Book Review

Philadelphia: Lippincott Williams & Wilkins, 2007
449 pages, $69.95 (softcover)

Author: Edward Coffey, Thomas McAllister, and Jonathan M. Silver (eds)

The fields of behavioral neurology and neuropsychiatry have been developing at a prodigious rate, with an expanding body of literature to show for it. Existing texts provide a magnitude of depth and clarity, ranging from basic introductions to intimidating treatises assuming considerable prior familiarity with the subject. However, sorely lacking from this growing body of work is an easily accessible volume that provides up-to-date information of high clinical applicability, which is both accessible to the novice neuropsychiatrist and satisfying to the more accomplished practitioner of the discipline. The recently published Guide to Neuropsychiatric Therapeutics thoughtfully fills this void.

Coffey, McAllister, and Silver, backed by an impressive lineup largely represented by the fellowship of the American Neuropsychiatric Association, have put together a volume that skillfully covers a broad range of neuropsychiatric conditions encountered in clinical practice. While variation in style is apparent among the authors, each chapter consistently provides a high level of clinically applicable information. The topics covered in the chapters include apathy, delirium, cognitive impairment, dementias, emotion, anxiety, pain, personality, sleep, and aggression.

The text opens with a particularly good chapter on apathy and its related disorders. It familiarizes the reader with this often-missed and misunderstood manifestation of neuropsychiatric illness. Chapter 2 meticulously addresses cognitive impairment, yielding a very useful map for approaching this area of functioning and the numerous domains it encompasses. The neuropsychiatric manifestations of common clinical conditions, as well as conditions with frequent neuropsychiatric presentations, such as dementias, movement disorders, and seizures (epileptic and nonepileptic), are presented in a clear, concise, and clinically applicable format. The final chapter addresses the clinical indications and utility of neuroimaging and electroencephalography, and nicely clarifies the role of studies that evaluate neuropsychiatric disorders.

Each chapter focuses on a given topic with considerable detail. Most begin with background information and a review of relevant neuroanatomy and pathophysiology, which lay the ground- work for subsequent discussions of the appropriate diagnostic evaluation and management of each disorder. An easy-to-follow guide to the workup and treatment of these often-complicated cases is provided. Sections on management use a holistic approach, capturing somatic, psychotherapeutic, behavioral, and various multidisciplinary treatment modalities where appropriate. When evidence-based treatment approaches exist, the authors report on them. When such evidence is lacking, recommendations are thoughtfully synthesized from available data, and findings from related disorders are offered.

The target audience is broad and includes residents as well as experienced neuropsychiatrists who are looking for a review of the latest evidence-based practices. The book is written in an outline format. The size and format make it ideal for busy care providers who need fast answers to clinical questions, and for seasoned veterans who need a handy field manual for on-the-go clinical practice. The overall finished product represents an excellent and much-needed entry in the field of neuropsychiatry. Its tremendous strength lies in its rigorous adherence to evidence-based practice. Sadly, it can only remain current for so long, as the rapid pace of development in the behavioral neurosciences quickly outdates contemporary dictums. The second edition will surely be highly anticipated.

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