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Book Review   |    
Greg Seward
Psychiatric Services 2008; doi:
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by John B. Saunders, Mark A. Schuckit, Paul J. Sirovatka, and Darrel A. Regier; Arlington, Virginia, American Psychiatric Publishing, 2007, 324 pages, $70.00 softcover

Mr. Seward is director of the tobacco-free initiative and the coordinator of tobacco research at the Unviersity of Massachusetts Medical School, Worcester.

The book Diagnostic Issues in Substance Abuse Disorders is part of the current series, Advancing the Research Agenda for DSM-V. This contribution contains 19 chapters summarizing a research planning project to assess the scientific knowledge relevant to our current psychiatric classification system of substance abuse. The text then recommends steps to advance knowledge as we move toward DSM-V.

Although DSM-V is not due for release until 2012, planning for it began five years after the release of DSM-IV in 1994. In the foreword, Regier opens the reader to the process and some key historical points of DSM development. In the introduction, Saunders and Schuckitt discuss the development of the agenda for the research. The authors provide the framework for each chapter: overarching issues relevant to the development of international diagnostic systems, research questions more specific to the substance use disorders section of DSM, and discussions of whether substance use disorders should be included in the broader term "addictive disorders"—a term that includes other compulsive behaviors.

DSM has changed throughout the years since it was first released. Anyone who works in-depth in addictions or in mental and co-occurring substance use disorders knows this particularly well and hopes that the shortcomings of DSM-IV will be remediated by DSM-V. Readers will appreciate the debate and directions for research raised when substance use disorders are considered as categorical or dimensional or both. Each chapter is well conceived but can be tough reading at times for any newly initiated addictions clinicians.

It is encouraging to see the efforts being put forth to look at all addictions in a unified way. Especially refreshing is the focus on the neurobiology of addiction, cultural influences on diagnosis, and nicotine addiction. Patients have long suffered from our not giving all addictive substances and their respective craving behaviors the attention they merit.

Clinicians, educators, and researchers in this field should read this work and then encourage colleagues nationally and internationally to become familiar with it. Insurance company executives would do well to read this fine book and to use it as an invaluable resource to further educate themselves about the morbidity and mortality that result from all addictive substances.

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