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Book Review   |    
Mark R. Munetz
Psychiatric Services 2008; doi:
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edited by Kim T. Mueser and Dilip V. Jeste; New York, Guilford Press, 2008, 650 pages, $75

Dr. Munetz is professor and the Margaret Clark Morgan chair of psychiatry, Department of Psychiatry, Northeastern Ohio Universities College of Medicine, Rootstown, Ohio. He is also chief clinical officer, Summit County Alcohol, Drug Addiction and Mental Health Services Board, Akron, Ohio.

Do we need another large book about schizophrenia? In the case of the Clinical Handbook of Schizophrenia, edited by Kim Mueser and Dilip Jeste, the answer is a resounding yes. The editors, a psychologist and psychiatrist who are preeminent schizophrenia treatment experts, set out to create "an interesting and useful resource for clinicians." Overall, the editors have succeeded. As described in the book's preface, each chapter "has been written by a world authority on the topic, in plain language with minimal (or no) references in the text, and a resource list of references and recommended readings at the end." Chapters on treatment provide "guidelines for clinicians about implementing specific treatment approaches or working with particular populations."

The book is divided into eight sections: core science and background information; assessment and diagnosis; somatic treatment; psychosocial treatment; systems of care; special populations and problems; policy, legal, and social issues; and special topics. I counted a total of 109 contributors who are, in fact, from all over the world.

This is not a book most readers will want to read from cover to cover. Since each chapter ends with a short summary of key points, one useful strategy might be to read the key points first to decide which chapters to read thoroughly. Given the book's 61 chapters, the key points alone comprise about 30 pages of very useful text.

Some high points of the book include a very clear summary of the impact of psychosocial factors on schizophrenia in a short seven pages. The slow dissemination of family interventions is explained in part by the need to change clinical practice in a whole service system rather than simply training individual clinicians. Also there is fascinating use of a case example to describe cognitive behavioral therapy for psychosis. Many readers may be surprised at contributor Anthony Morrison's contention that, "It is likely that psychotic experiences are essentially normal phenomena that occur on a continuum in the general population, and it appears that catastrophic or negative appraisals of such psychotic experiences results in the associated distress." Chapters on remission and recovery are also of particular interest. The chapter on clinical case management, while excellent, left me mostly frustrated that the responsibilities and associated skills needed to perform this essential function are increasingly rarely found in our public mental health systems. The clinical case example made the chapter on strengths-based case management compelling.

In summary, this is a useful reference book for those interested in clinical and systems issues in the treatment of schizophrenia. Its strengths are in its worldwide perspective, its mostly successful effort to be brief and practical, its chapter-ending key point summaries, and its up-to-date list of references and recommended readings. It is a book I am likely to refer to often as we look to develop effective new programs in our service system.




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