Cutting-Edge Medicine: What Psychiatrists Need to Know
This compact and nearly pocket-sized volume, which includes a well-laid-out table of contents and index, covers a lot of ground and is fairly comprehensive in achieving its objectives. Part of American Psychiatric Publishing's "Review of Psychiatry" series, Cutting-Edge Medicine: What Psychiatrists Need to Know focuses on four major areas of the interface of psychiatry with aspects of internal medicine, surgery, and women's health: cardiac, gastroenterology, solid organ transplantation, and the menstrual cycle. The depth and coverage are fairly uniform, and the editor—Nada L. Stotland—is to be commended for trimming redundancies but retaining text that makes sense and contributes to contextual understanding. Despite the inherent difficulty in assembling a small review book such as this, Stotland has largely succeeded in bringing today's psychiatrist up to speed on a good deal of the swirling world of new technology and surgical advances that intimidate, must be doted over, and are not infallible but that can also be awesome in their life-sustaining and prolonging qualities.
There are, however, some disappointments. For example, the curious chapter on psychiatric disorders and the menstrual cycle discusses premenstrual syndrome only, and the vast numbers of now middle-aged women who are menopausal aren't even mentioned in passing. As is the case for the other conditions covered in this volume, menopausal women often find themselves hospitalized for concurrent problems. There is ample evidence that psychiatrists can play a significant role in alleviating the difficult symptoms that may accompany menopause, including depression.
Similarly, the rather dense chapter on gastroenterology, which attempts to cover a broad range of gut disorders, makes no mention of the much-discussed epidemic of morbid obesity that afflicts all strata of our society. A particular current practice that is overlooked in this book is bariatric surgery (gastric bypass), which treats obesity by refashioning the structure—and, hopefully, the style—of eating. Surgical teams routinely demand psychiatric evaluation before and after this surgery because of the need for strict adherence and compliance akin to that required for success in solid organ transplantation.
The overview of current cardiac assist technology and issues in solid organ transplantation are particularly practical. For some disorders, the background of psychiatric aspects are reviewed and the reader is brought up to current thinking. But for others, the psychodynamic and social aspects of these disorders are given short shrift when there is an obvious relationship—for example, the psychodynamics of food, eating, family, and gender—that plays a big part in eating disorders of any kind.
Overall, the topics that are included are covered well, and many important, interesting, and helpful items are embedded in each chapter. The references are up to date and accessible. The invaluable role that well-informed and medically comfortable psychiatrists can play on the multidisciplinary care team is noteworthy. Other mental health professionals—psychologists, supportive therapists, and counselors—who interact with patients who have serious illness with major psychiatric aspects would likely also get a lot out of this book.
Dr. Kennedy is associate professor of psychiatry and preventive medicine and community health at New Jersey Medical School, University of Medicine and Dentistry of New Jersey, and director of consultation-liaison psychiatry at University Hospital in Newark.
