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Book Review   |    
Stacey Burpee
Psychiatric Services 2009; doi:
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by Lauren B. Marangell, M.D.; Arlington, Virginia, American Psychiatric Publishing, 2009, 410 pages, $44.95

Dr. Burpee is affiliated with the Department of Psychiatry, University of Massachusetts Memorial Medical Center, Worcester.

Throughout medical school and residency training, medical reference handbooks—often conveniently located in one's white coat pocket—have been a reliable source of information when working in the trenches. The Resident's Guide to Clinical Psychiatry is a succinct handbook created for the psychiatry trainee, whether it be the medical student, psychiatry intern or resident, or the medical resident who is training in neurology or a primary care specialty. In this book, Lauren B. Marangell, coauthor of the Concise Guide to Clinical Psychopharmacology, provides trainees with the most current information on diagnosis and treatment of patients with a psychiatric illness.

This book follows a natural progression, beginning with the initial encounter with the patient and then proceeding to evaluation, diagnosis, and treatment. The first chapter reviews the initial evaluation, offering key tips for beginning the interview process, such as how to establish rapport with the patient and ensure safety. Examples of orders for various samples as well as of a patient history and physical examination are given, as is a helpful guide to documenting a suicide risk assessment. For trainees, the most valuable information in this chapter is the set of tables outlining selected elements of physical and neurological examinations, which detail pathologic findings, examination procedures, and signs and symptoms suggestive of a medical cause for psychiatric symptoms.

The main body of the text consists of 12 chapters focusing on common psychiatric disorders and three chapters covering the most common specialties of consultation-liaison psychiatry, emergency psychiatry, and child and adolescent psychiatry. Material is brief and easy to reference. It cites comprehensive, evidence-based information regarding the prevalence, risk, differential diagnosis, DSM-IV criteria, evaluation, and treatment of each disorder. Brief explanations of differential diagnoses can be quickly referenced and are not simply lists of diagnoses but include valuable diagnostic clarifications, such as the differentiation between obsessive-compulsive disorder and obsessive-compulsive personality disorder.

The book concludes with three chapters on pharmacotherapy, psychotherapy, and electroconvulsive device-based treatments. Chapter 14, on pharmacotherapy, is the most comprehensive of the three chapters and is organized by medication class. Characteristics of each medication are listed, including medication effects, mechanism, side effects, and prescribing for special populations. Convenient tables offer simple prescribing guidelines pertaining to starting and maintenance dosages, available oral doses, and mean half-life for each medication. The chapter even provides a comprehensive guide to the informed consent process for prescribing monoamine oxidase inhibitors, including a detailed chart of special diet and medication restrictions, which is not commonly available in pocket reference guides. In looking toward the future of psychiatric treatment, the guide concludes with a chapter on the technologically based treatments, including electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation, and deep brain stimulation.

The Resident's Guide to Clinical Psychiatry is a great pocket reference for any individual in the early stages of psychiatric training. This guide would benefit not just psychiatry residents but also all medical trainees, such as general medical students and residents anticipating a future of serving individuals who have a psychiatric illness.




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