by Robert M. Post, M.D., and Gabriele Leverich, M.S.W., L.C.S.W., B.C.D.; New York, W. W. Norton and Company, 2008, 576 pages, $65
Dr. Marsh is assistant professor of psychiatry at UMass Memorial Medical Center, Worcester, Massachusetts.
Written by Robert Post and Gabriele Leverich, Treatment of Bipolar Illness illustrates the course of bipolar disorder and treatment approaches through longitudinal case examples. Dr. Post, with 37 illustrious years at the National Institute of Mental Health (NIMH), where the cases originated, is a leader in research on bipolar disorder and creator of the Mental Health Life Charting Method (NIMH-LCM) with which the cases are depicted over time. The book takes on the challenge of focusing on treatment providers, be they physicians or clinicians, and patients and their families.
The first chapters lay the background. They begin with the historical and phenomenological aspects of bipolar illness and then present the principles of treatment. They close by discussing the basic psychopharmacology of mood stabilization. These chapters are sound and provide a balanced perspective and sufficient depth to be a concise review for psychiatrists treating mood disorders. However, they are likely to be too complex for most patients.
The heart of the book resides in case studies exemplifying clinical scenarios related to different psychopharmacological treatments. Chapter topics cover a representative breadth of bipolar treatment considerations, including antidepressants, mood stabilizers, complex combination treatment, as well as the hot topic of childhood bipolar disorder.
The clinical scenario chapters begin with a brief case history and a visual mood chart of the NIMH-LCM; next, the treatments and rationale for using them are reviewed. The chapters close with bullet points of concepts weighted by strength of clinical evidence. This format creates a surprisingly easy and rapid read. The case presentations are short and concise, and the mood charts display significant information that can be quickly grasped. The discussions are of reasonable length, and the concluding bullet points digest the content for the scanning reader.
This ingenious approach to the chapter format draws in both physician and patient. The patient will identify with the case patient's story but will have to work a little harder to assimilate the denser treatment discussion. The clinician is likely to glide through the case studies to focus on the treatment scenarios, considering them in the context of his or her own practice approach.
The final chapter on guidelines for patients and families highlights key points, such as use of social supports, education, and of course, the necessity of medication, but it tends to wax into phenomenology. It would have stayed truer to its guideline title, as well as the book format, if it had ended with take-home bullet points for patients, as it does on medication management for doctors.
Overall, Dr. Post and Ms. Leverich did a commendable job in creating a casebook for clinicians and patients on the treatment of bipolar disorder. Although at times too complicated for the average patient and skimmable for the psychiatrist, the book as a whole covers a healthy breadth of topics on a level that will engage both audiences. Treatment of Bipolar Illness brings both doctor and patient onto the same page—a rare yet critical accomplishment.
The reviewer reports no competing interests.