Clinical Neuropsychiatry

With the explosion of information in the neurosciences in recent years, consolidating information from the fields of neurology, neuropsychiatry, neuropsychology, and neuroscience research in one volume is an exceedingly difficult task, daunting for any editorial group. Fortunately, the editors of this somewhat uneven effort make note of this difficulty in the very beginning. They have succeeded in creating an introductory volume covering some of the major areas of interest in neuropsychiatry, suitable for residents and colleagues practicing outside the field of neuropsychiatry. The extensive and up-to-date references for the topics covered serve as a helpful resource for anyone seeking more in-depth information, whether novice or expert.

Reviews of current clinical and neuroscience research into the areas of Alzheimer's disease, central nervous system involvement of HIV infection, and schizophrenia are especially well done. The section on HIV disease has some thoughtful and helpful advice on clinical management of agitation and aggression for this challenging patient group. Readers interested in serving severely mentally disabled patients will find the chapter on schizophrenia a valuable resource, with its coverage of symptoms, diagnostic issues, and treatments, as well as erudite explanations of etiological theories including neural networks.

Neuroleptic malignant syndrome also receives a concise and well-referenced review. Chapters on traumatic brain injuries, Tourette's syndrome, and Parkinson's disease are well done. For those interested in biochemical aspects of affective disorders, the contributors provide an exhaustive review of the literature. Attempts to cover areas important to neuropsychiatry that have not been extensively researched—that is, dissociative disorders and, separately, anxiety disorders, under the rubric of "stress"—are thought provoking and will, one hopes, stimulate more inquiry into these areas.

Some uneven sections include the initial chapters on the mental status examination, the neurologic examination, neuropsychological evaluation, and brain imaging. These topics are covered in standard fashion with inconsistent explanations and lack of information about the importance of specific findings from a neuropsychiatric perspective. Sections on epilepsy and neuropsychopharmacology are in some places inaccurate (the data on pseudoseizures) or not timely (no mention of venlafaxine, nefazodone, or zolpidem). Some medications such as dopaminergic agents, beta blockers, and clonidine are not mentioned. Theoretical explanations of the hierarchy and the neuroanatomical and neurochemical as well as the behavioral correlates of aggressive behavior, a common concern in treating such behaviors, are not addressed

In summary, this volume would serve as a useful companion to other recent comprehensive references in the field of neuropsychiatry (1,2,3,4,5,6,7,8) and as an introduction to those new to this specialty. One hopes it will stimulate further reading and enhance understanding of the interface between psychiatry and neurology, with all of its challenges.

Dr. Brady is a neuropsychiatrist and staff psychiatrist at Behavioral Connections of Wood County in Bowling Green, Ohio, and a private neuropsychiatric consultant.