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Book Review   |    
Concise Guide to Consultation Psychiatry, third edition ? Psychiatric Management in Neurological Disease
Brad Bobrin, M.D.
Psychiatric Services 2001; doi: 10.1176/appi.ps.52.4.544
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by James R. Rundell, M.D., and Michael G. Wise, M.D.; Washington, D.C., American Psychiatric Press, 2000, 366 pages, $22.95 softcover • edited by Edward C. Lauterbach M.D.; Washington, D.C., American Psychiatric Press, 2000, 354 pages, $39

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In consultation-liaison psychiatry, one has to know about many topics in psychiatry at once, including psychopharmacology, psychotherapy, psychopathology, medicine—at least the neuropsychiatric sequelae of medical diseases—neurology, law, family dynamics, and many others. Given the sweep of these topics, a concise reference text, something you can carry in your pocket, would be useful. Both of these books aim to serve that purpose; they are concise, portable references that can be used to obtain information quickly.

The Concise Guide to Consultation Psychiatry covers in brief detail all of the topics that are important to the consultation-liaison psychiatrist. It is good to see chapters on topics such as violence and aggression, personality, response to illness and medical psychotherapy, medicolegal issues, and geriatric psychiatry along with those on basic psychopathology, medication management, and diagnosis. These are all areas that a trainee in consultation-liaison should know. The chapter on special settings and situations is a welcome one too, covering such topics as burns, cancer, death and dying, transplantation psychiatry, and HIV-AIDS.

As a concise guide, this book is not meant to cover everything in detail, but it does serve its purpose. The book's biggest weakness is that a significant amount of the data it contains come from the 1996 Rundell and Wise textbook (1) of consultation-liaison psychiatry and thus are over five years old. For example, not many data were available at that time on some antidepressants, such as mirtazapine. Otherwise, the book does a good job of serving as a concise reference for consultation-liaison psychiatry. I recommend it for students and residents interested in the field to carry in their pockets.

The second book, Psychiatric Management in Neurological Disease, appealed to me as a consultation-liaison text because neuropsychiatric effects are often seen in medical illness. Although good concise books on the pathophysiology and treatment of neuropsychiatric disorders are available, they seem rare. One strength of this book is that it gives a thorough background on the pathophysiology of these disorders, with plenty of references, and then goes into the treatment of the disorders, again with plenty of references.

The first chapter, on psychiatric management principles in neurological disease, provides a good, brief overview of the important things to consider when evaluating neuropsychological disease. It was a pleasure also to see chapters on Parkinson's disease, dystonia, sequelae of stroke, multiple sclerosis, and neuropsychiatric sequelae of HIV-AIDS. The final chapter, on family management issues, is a particularly important inclusion, since this is a difficult task that all psychiatrists face when treating patients with serious neurological diseases.

Overall, the choice of topics in the book is perplexing. As I was reading the book, I would think a topical theme was taking shape, but then the next chapter would change direction. The book sometimes appeared be an ode to diseases of the basal ganglia. Whatever the overall message the editor wanted to convey by his choice of diseases to include in the book, all readers will likely learn something from the book. One last lament is that seizures would have been a good topic to include.

Psychiatric Management in Neurological Disease is a good book for students and residents as well as for general psychiatrists looking for something more, but not too heavy, on neuropsychiatry.

Dr. Bobrin is affiliated with the department of psychiatry of Cambridge Hospital in Cambridge, Massachusetts.

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