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Book Review   |    
The Principles and Practice of Addictions in Psychiatry
Patricia Isbell Ordorica,, M.D.
Psychiatric Services 1998; doi:
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edited by Norman S. Miller, M.D.; Philadelphia, W. B. Saunders Company, 1997, 589 pages, $70

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This textbook offers an essential focus on the diagnosis and treatment of addictive disorders as complex biopsychosocial disorders. Dr. Miller brings years of experience in the field as both a clinician and an educator to editing a textbook that addresses the complex interactions between addictive and other psychiatric disorders. The book's six major sections are on Etiology, Neurobiology, Diagnosis, Treatment Approach, Treatment Process, and Pharmacological Treatments. Many of the chapters are written by known experts in the field.

In the etiology section, Jeffrey Goldsmith's chapter on an integrated psychology for addiction psychiatry provides a comprehensive overview of theories on the psychology of addictions, particularly relevant for trainees of all mental health disciplines. The neurobiology section, although relatively brief, is well written and offers a good foundation for understanding mechanisms involved in the addiction process. In the diagnosis section, Robert Anthenelli provides an excellent chapter on guidelines for assessing and diagnosing patients with substance use and other concurrent psychiatric disorders. This chapter is also especially well suited for trainees and for primary care clinicians.

Clinicians in the field will find the section on treatment approach useful, with its topics ranging from managed care to special issues in the treatment of women and adolescents to Drake and Noordsy's case management strategies for patients with severe mental disorders and substance use disorders. The section on treatment process offers several excellent chapters that both trainees and experienced clinicians may find illuminating. The chapters in the final section, on pharmacologic treatments, are of evenly high quality. A weakness of this section is the absence of a discussion of the pharmacological treatment of nicotine dependence.

Dr. Miller should be congratulated for attempting to offer an integrative approach to the diagnosis and treatment of these biopsychosocial disorders. Overall, he succeeds.

Dr. Ordorica is chief of the psychiatry service at the James A. Haley Veterans Affairs Medical Center in Tampa, Florida.




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