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friend return after many years, having Goodwin & Guze’s assumed the person was gone. Carol S. North and Sean H. Yutzy, both trained Psychiatric Diagnosis at Washington University, teamed up to resurrect the book, now renamed Goodwin & Guze’s psychiatric diag- Samuel Guze, George Winokur, Don- nosis, in part to remind its audience of ald W. Goodwin, Robert Woodruff, those great men. There are several im- Lee Robins, Paula Clayton, Rodrigo portant changes in the new edition, in- Munoz, John Feighner, and many oth- cluding new chapters on the evolution ers. Although considered progressive of diagnosis, evaluation, posttraumat- by many, this “atheoretical” approach ic stress disorder (PTSD), and border- was a direct challenge to predominant line personality disorder. Chapters on views of the time. “anxiety neurosis” and “phobic neuro- I discovered the second edition sis” have been renamed and consoli- when I was a resident and it was love dated as “panic disorder and phobia.” at first sight. The book was clearly writ- The chapter on anorexia nervosa has ten, entertaining, and presented facts been changed to “eating disorders.” All about a disorder without the psychiat- chapters present up-to-date material, By Carol S. North and Sean H. Yutzy. ric jargon I saw in other texts. The book and tend to follow the same format (ie, New York, NY; Oxford University Press; focused on the many syndromes the history, epidemiology, clinical picture, 2010; ISBN 978-0-19514429-1; pp 432; authors considered valid, as explained etc.), followed by references. Recom- $45 (paperback). in their groundbreaking paper on psy- mendations for clinical management chiatric diagnosis, commonly referred reflect the latest information. Few his is the sixth edition of a clas- to as the “Feighner Criteria.”1 Validity psychiatric writers seem to care about sic text. I am fortunate to own was determined based on clinical de- the history of psychiatry, and this book Ta copy of the first edition pub- scription, laboratory studies (as lim- reminds us that little of what we see to- lished in 1974, authored by Robert ited as they were), delimitation from day is new. For example, in the chapter Woodruff, Donald W. Goodwin, and other disorders, follow-up, and fam- on PTSD, the authors point to a wit- Samuel Guze. The book was pioneer- ily studies. These “five phases” are still ness of the Great Fire of London in ing because it presented psychiatry considered the standard for validating 1666 who later wrote: “… I cannot through the lens of the medical model diagnoses. This new approach to diag- sleep at night without great fear of that originated at Washington Univer- nosis, in which specific criteria were being overcome by fire.” sity in St. Louis, MO. This remarkable enumerated, was embraced in DSM- The book retains its original department brought together a diverse III, published in 1980. The book was style—readability combined with a group of people, many trained in the not comprehensive and ignored other no-nonsense approach that is refresh- East, to pursue a new paradigm often topics that residents needed, such as ingly jargon-free. I highly recommend referred to as “biologic psychiatry.” As interviewing methods. Yet, it endured this book. someone trained in this model, the through subsequent editions until term is a misnomer and still is greatly 1996. Its authors passed away, and Donald W. Black, MD University of Iowa misinterpreted by its critics. Simply those who knew of the book assumed Iowa City, IA, USA put, the model espoused evidence- that it had disappeared into history. based psychiatry before the term was Imagine my surprise (and delight) REFERENCE 1. Feighner JP, Robins E, Guze SB, et al. Diagnostic cri- even coined. These men and women when I received a copy of the sixth edi- teria for use in psychiatric research. Arch Gen Psychia- included Edwin Gildea, Eli Robins, tion. This was akin to seeing an old try. 1972;26:57-63.

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aggerated psychological symptoms The Handbook of Forensic and cognitive impairment. The second section deals with Neuropsychology ethical and legal issues. These chap- ters provide crucial information to the practicing forensic neuropsycholo- functions and hemispheric lateral- gist, including solutions when dealing ization serving as good resources to with practice issues. Letter samples those already knowledgeable about and case examples are well utilized neuropsychology. Those not well in this section. I believe the chapter versed in neuropsychology may use dealing with test security should be this book as a resource, however, the required reading by not only neuro- information on specific brain areas psychologists but also psychologists controlling certain cognitive and per- who conduct any testing, whether or sonality functioning may be misinter- not they engage in forensic practice. preted as being absolute. The chapter reviewing civil com- The history of clinical neuropsy- petencies is brief despite listing im- chology in the forensic world and key portant competencies, including those issues, such as fixed vs flexible battery related to medical decision-making,

Edited by Arthur MacNeill Horton, Jr and approach, are well enunciated even consenting to treatment, consenting to Lawrence C. Hartlage. for the layperson. The current status of research, and fiduciary and testamen- New York, NY; Springer; 2010; neuroimaging in the legal world, par- tary abilities. The chapter on criminal ISBN: 978-0-8261-1886-8; pp 588; $125 (hardcover). ticularly in the area of aggression and competencies has extensive legal in- the connection to psychopathy and formation. However, neither the sec- personality disorders, is introduced tion on civil competencies nor criminal lthough forensic neuropsy- with appropriate descriptions of how competencies lists neuropsychological chology is a young field, it has results can be applied and interpreted measures that would be useful in con- Agrown by leaps and bounds in and possible limitations. ducting various evaluations. recent years in terms of utilization of An area that I, as a forensic neuro- The chapter on privacy, confiden- neuropsychologists in legal proceed- psychologist, found exceedingly use- tiality, and privilege is comprehensive, ings, new case holdings, and research. ful was information on malingering. and is useful for neuropsychologists Drs. Horton and Hartlage have updat- Certain relevant issues, however, are and general psychologists involved in ed their 2003 book to not only include missing, such as the emerging issue forensic issues with excellent use of more legal and research material but of using the Minnesota Multiphasic clinical examples. The conflict of - in also to address application of neuro- Personality Inventory-2 vs the Min- terest chapter is extensive and reviews psychology to special groups and dis- nesota Multiphasic Personality Inven- practical issues including testifying, cuss future issues in the field. tory-2 Restructured Form, and the fees, and providing depositions. The first section, foundations of use of symptom questionnaires (ie, The third section, practice is- neuropsychology, provides an intro- Structured Inventory of Malingered sues in neuropsychology, segues well duction to brain functioning assessed Symptomatology, Structured Inter- from the previous chapters. Here you by neuropsychologists and brain tax- view of Reported Symptoms, Miller see the integration of issues that are onomy. Given that brain structure is Forensic Assessment of Symptoms unique to neuropsychology, such as not the focus of this book, this is an Test) in conjunction with neuropsy- brain lateralization of functioning and adequate abstract of neuroanatomy, chological tests of malingering, given issues unique to forensic neuropsy- with charts summarizing brain lobe the frequent presentation of both ex- chology, such as third party observ-

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ers, positions by professional organi- extensively, including fitness for but, surprisingly, not in forensic psy- zations, and relevant research. duty, disabled individuals, older chology. The section on measuring clients, children and youth, au- Overall, I found the Handbook of change in functioning is quite tech- tism spectrum disorders, substance forensic neuropsychology to be useful nical, but an important area of neu- abuse, and neurotoxicology. How- in providing survey information for ropsychology to be elucidated be- ever, there is great variability in the many issues associated with the field. cause it provides evidence necessary structure of these chapters. Some The strongest and most useful chap- to determine not only clinically but are short and lack information on ters were those with charts, examples, also statistically meaningful change. specific tests that are appropriate and/or sample materials. However, I In this section, graphs and tables are and useful to conduct evaluations have an issue with the inconsistency of very useful in explaining complex is- and base legal opinions and some the information provided across chap- sues, and the utilization of specific are extensive with specific recom- ters, with some providing information test examples, such as the Wechsler mendations for neuropsychologi- only on forensic psychology or only Memory Scale, is beneficial. cal evaluation and helpful case ex- on general neuropsychology, rather Similarly, information regard- amples. Reviewing these chapters, than all chapters addressing issues of ing the estimation of premorbid IQ I found myself wanting to know if forensic neuropsychology. In the next is easily understood through specific there are any case holdings specific edition of the book, I would like to see test examples, and the concept of tra- to autism because there is no men- more integration as well as integration ditional “hold” tests is included. For tion and to read a summary of how of assessment of psychological symp- regression equations, such as the Bar- drug use pertains to recidivism, for toms (such as psychosis) with assess- ona, I would prefer to see a list of the which there is extensive literature. ment of cognitive functioning. factors that are part of the equations, if The conclusion addresses impor- not the actual equations themselves. tant future issues, such as utilization Galit Askenazi, PhD, ABPP Neuropsychology and Forensic Psychology In the fourth section, special is- of the Internet. There also is mention Specialty Services sues and populations are discussed of certifications in neuropsychology Cleveland, OH, USA

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FACULTY Differential Diagnosis of Bipolar Disorder Roger S. McIntyre, MD Medical Management of Bipolar Disorder: AD A Pharmacologic Perspective Matthew A. Fuller, PharmD, BCPS, BCPP, FASHP Individualizing Treatment for Patients With Bipolar Disorder: Optimizing Efficacy, Safety, and Tolerability Christoph U. Correll, MD FREE CME/CPE credit* This supplement to Annals of Clinical Psychiatry was submitted by Asante *Visit www.PSYCHClinician.com/CEBDCompendium. Communications, LLC; supported by educational grants from Eli Lilly and Company and Janssen, Division of Ortho-McNeil-Janssen Pharmaceuticals Inc; and This continuing education (CE) activity is jointly sponsored by Albert administered by Ortho-McNeil-Janssen Scientific Affairs. It was peer reviewed by Einstein College of Medicine, Montefiore Medical Center, the College Annals of Clinical Psychiatry. of PsychiatricAACP.com and Neurologic Pharmacists (CPNP), and Asante Communications, LLC. ANNALS OF CLINICAL PSYCHIATRY

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costs for the entire health care system Prime Time. Maximizing the (mine: almost another industry!). Part I of the book, “Ways to make Therapeutic Experience. A the 20-minute hour work for you,” consists of 8 chapters—1. Begin- Primer for Psychiatric Clinicians nings—not a moment to spare; 2. Measuring symptoms; 3. Setting the contract; 4. Decisions, decisions; 5. more (quality work) with less time” Psychoeducation/teaching; 6. Short- (p ix). He adds that “all too often the cuts; 7. Early and later pitfalls; and 50-minute hour gets shrunk to the 8. Terminating treatment. The focus 20-minute hour for follow-up ap- of these chapters is to provide short- pointments” (p ix) and that his “prim- cuts, from using small talk to enhance er” provides a variety of shortcuts and rapport, to measure symptoms and experience-tested ways to maximize changes quickly, to jump start edu- those 20-minute (or so) sessions. cation, or to end a session on time The book is divided into an intro- without much problem. Some of the duction, preface, 2 parts (total of 26 advice is good (ie, list of office supplies brief chapters), and an appendix con- for the initial interview), some advice taining a list of useful references. The points out that shortcuts also mean preface, “The 20-minute hour is new, cutting and focusing on money. The By Frederick G. Guggenheim. New York, NY; where did it come from?” provides a chapter on measuring symptoms ad- Routledge (Taylor & Francis Group); 2009; historical review of the changes in our vocates using a visual analogue scale ISBN 978-0-415-80109-6; pp 227; practice over the past 4 decades—the (not bad advice), and a small scale for $24.95 (paperback). origins of the 50-minute hour (Freud rating depression from 0 to 10 with suggested to “chill out or cool off for sad or smiley faces is included. The he pressure to do more, to see a few minutes between therapeutic chapter on contract includes a solid more patients, and to push hours” [p xi]); non-parity for mental handout concerning practice infor- Tproductivity is increasing in all health; the arrival of managed care mation for the patient. Some advice medical specialties. Unfortunately, with its management of access, re- is questionable and seems driven increased productivity does not nec- quirement rates, and documentation by the idea of just cutting. I person- essarily mean better work. It is fre- requirements; the concept of health ally would not wait 6 weeks to see a quently measured by numbers, akin care as a profit center from the cor- patient who was started on selective to car companies during the “good porate and the clinician’s perspec- serotonin reuptake inhibitor “unless old times,” when focus was on the tive; the impact of managed care on there are unacceptable side effects.” volume of cars produced. Because psychiatry and psychotherapy in par- That is too long and does not foster a our day is naturally limited and can- ticular; the changes in reimbursement therapeutic relationship, even if the not be stretched, ultimately we end rates (psychotherapy is reimbursed patient sees a therapist in the mean- up squeezing in more patients per significantly less per minute than the time. The discussion of psychoeduca- hour or day. This volume provides ad- rest of the psychiatric practice); and tion is good. It correctly points out that vice and guides us on how to increase the positives of managed care. Access interest in teaching psychoeducation the number of patients effectively. to mental health has increased and to residents and students is minimal The focus of this book, as Frederick the costs have decreased (almost no or non-existent. I missed the resources G. Guggenheim postulates, is “to as- inpatient care!) but there has been a (handouts, etc.) for psychoeducation sist the time-pressured clinician to do huge increase in the administrative here, but fortunately they are listed in

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BOOK REVIEWS the following chapter. The chapter on 24. When your patient (or you) is ity of care we provide. The amount of shortcuts provides some tips on talk- stalked; 25. When tragedy befalls our paperwork should be reduced and ing to patients effectively (but pointing you or your patient; and 26. The cli- the approval procedures by insurance out that one should never interrupt nician’s vulnerability to violence. companies simplified. Some of these and never tell someone who is talking Similar to the first part, some chap- concerns are touched upon lightly in that his/her time is up). This chapter ters present useful information (ie, this volume and some are not. There also points out the importance of doc- the chapter on the “anxious patient” are some factual mistakes and at times umentation and includes a table on includes a table on the amount of caf- the author writes about persons who “how to avoid malpractice problems.” feine in various drinks), while oth- had done something important, yet The last 2 chapters of this part, on early ers present less useful and not very does not provide proper reference (ie, and late pitfalls and termination, are clear information (ie, the chapter on introduction to somatization disor- again a mixture of the author’s empiri- mild schizophrenia includes a non- der patient). Those are probably fix- cal advice, opinions, and occasional useful and non-critical review of the able and at times tolerable flaws. The material supported by the literature. CATIE study). Some chapters are just main issue I have with this book is its The second part, “Quick-grab short blurbs (questionably psychotic unclear message. Do the proposed chapters,” includes 18 chapters dis- patients, adolescent patients) while shortcuts enable us to maintain good cussing specific clinical situations, others cover their topics fairly well quality of care? What is the purpose of encounters, and troubling issues with (the elderly patient, the depressed shortcuts—good care or an easier life chapters on: 9. The depressed patient; pregnant patient). The most readable for treating physicians? I am not exact- 10. The bipolar patient; 11. The anx- chapters are the ones covering topics ly clear, although I recognize the im- ious patient; 12. The traumatized pa- not frequently found in other texts or portance of both. In summary, this is tient; 13. The angry or violent patient; not taught well in residency training a mixed bag of useful information and 14. The somatizing patient; 15. The (ie, working with the divorcing pa- not so useful or not much information patient with mild schizophrenia; 16. tient or with the mildly mentally re- at all about certain topics. Some be- The questionably psychotic patient; tarded patient). ginners may find this book useful and 17. The adolescent patient; 18. The I am not against shortcuts and/ some may find it simplistic, not very elderly patient; 19. The borderline or increasing productivity in a good informative, or will question the way personality patient; 20. The mildly sense. However, the focus should some topics are covered (or better, not mentally retarded patient; 21. The not be on numbers and should not really covered). suicidal patient; 22. The depressed be measured exclusively by negative Richard Balon, MD patient that is or wants to become outcomes. The focus rather should Wayne State University pregnant; 23. The divorcing patient; be on quality of outcome and qual- Detroit, MI, USA

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resources and tools of self-manage- Self-Management of ment, such as individualized assess- ment, collaborative goal-setting, skills Depression: A Manual for enhancement, follow-up and support, access to resources of daily life, and Mental Health and Primary continuity of quality clinical care. The second chapter, “Care man- Care Professionals agement of depression,” focuses on treatment of depression in primary care and the need for a multidisci- According to the authors of this plinary approach. It discusses the role book, “Self-management can be de- of care managers in the management fined as the methods, skills, and strat- of depression in primary care (eg, egies by which individuals effectively facilitating depression screening or direct their own activities toward the providing depression education). The achievement of specific objectives. final part of this chapter reviews bar- It usually includes goal-setting, riers in the implementation of collab- planning, scheduling, task tracking, orative care for depression in primary self-evaluation, self-intervention, and care, such as technical difficulties, self-development” (p 1). They wrote practice orientation of primary care this book to “provide primary care physicians, and reimbursement poli- physicians and nurses, psychiatrists, cies of insurers. One important piece psychologists, social workers, and of information found in this chapter: other professional caregivers with most screening questionnaires, such By Albert Yeung, Greg Feldman, and the knowledge and tools for making as Center for Epidemiological Stud- Maurizio Fava. New York, NY; Cambridge their work with patients with depres- ies Depression Scale (CES-D), Patient University Press; 2009; ISBN 978-0-521- 71008-4; pp 206; $55.00 (paperback). sion more efficient and effective by Health Questionnaire (PHQ-9), and integrating self-management treat- Quick Inventory of Depressive Symp- ment strategies with conventional tomatology-Self-Report (QIDS-SR) hronic diseases, such as professionally delivered treatment are free, but there is a fee for using the diabetes, obesity, some car- modalities” (p 2). Beck Depression Inventory II (BDI-II). Cdiovascular diseases, and The book consists of 8 chapters The third chapter, “Self assess- depression, often are irreversible or that explain the use of self-manage- ment instruments for depression,” relapsing conditions that are either ment in depression in various set- is a detailed review of properties persistent or run a wax-and-wane tings and discuss key elements in its of self-assessment instruments for course (p 4). The goal of chronic dis- use. The first chapter, “The use of self- monitoring the severity of depres- ease treatment is not cure—as we do management for depression,” explains sion (CES-D, PHQ-9, Inventory of not have a cure, in most cases—but what self-management is and how it Depressive Symptomatology Self “to support patients in managing is relevant for depression and other Report, QIDS, and BDI, BDI-IA, and their own disease so they can main- chronic conditions, and then discuss- BDI-II), Internet-based self-instru- tain satisfying, pleasurable, and in- es the principles of self-management, ments for depression, and the applica- dependent lifestyles” (p 4). Thus, the such as empowering patients and tion of all these instruments. The au- modern approach to comprehensive promoting their self-efficacy. The text thors point out (p 47) that, compared management of various chronic ill- then turns to the specifics of self-man- with clinician-rated instruments, nesses includes self-management. agement of depression and the key self-rated instruments are less time

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BOOK REVIEWS consuming, less expensive to admin- The fifth chapter, “Physical - ex pression, encouraging treatment, etc.); ister, and don’t require trained person- ercise as a form of self-management and D. Six interpersonal habits that can nel for administration. This chapter for depression,” is a solid review of the make depression worse. also covers the limitations of depres- evidence of the value of exercise in de- The last chapter, “Putting it all to- sion screening using self-assessment pression management, challenges in gether,” is the usual summary of the instruments and the clinician’s role in implementing exercise as a treatment previous chapters—in this case, advis- the use of these instruments. for depression, and practical recom- ing how to apply self-management for The following chapter, “Self-help,” mendations for incorporating exer- depression in your practice. addresses the role of bibliotherapy cise into depression management. Although this book addresses and computerized psychotherapy This chapter includes 4 appendices: an important area of management in self-management of depression. A. Weekly exercise log; B. Tips for de- of depression and parts of the book Bibliotherapy is defined as the use of ciding on type, schedule, and intensity are interesting, I had mixed feelings written texts as a means of personal of exercise; C. Frequently asked ques- about it. It is wordy and repetitive at development or alleviating distress, tions about exercise and depression times. I think it provides too much in- whereas computerized psychother- treatment; and D. The pros and cons formation about issues busy clinicians apy is a standardized, automated in- of beginning an exercise program. would not care much for—or have tervention delivered by a computer The sixth chapter, “Self-manage- much time for—such as a detailed dis- program to a user who accesses the ment of depression using meditation,” cussion of the various versions of the program through software on a per- is a thorough review of meditation use BDI. The first half of the book is not sonal computer or from a distance via in depression (including mindfulness very practical, and the authors only the Internet or telephone (p 69). The training), its challenges and limita- slowly get into practical, clinically ori- authors discuss several books they tions, and finally, some practical con- ented advice later. consider very useful books (eg, Feel- siderations (which patients would be I would appreciate much more ing good, Control your depression, and appropriate candidates for meditation, concise and direct advice-oriented Mind over mood), and they list self- how should it be introduced, etc.). This summaries of each chapter, perhaps help resources for patients. They also chapter includes an appendix on re- in the form of bullets. One would also summarize computerized cognitive- sources for learning about meditation. appreciate an appendix with all the behavioral therapy programs. The seventh chapter, “Cultivating screening assessment tools (at least The chapter concludes with social support,” focuses on the role of the free ones) printed and ready to be practical challenges to implement- peer support in self-management. The copied. I also cannot envision many ing bibliotherapy and computerized peer who provides the support usually practitioners having enough time to psychotherapy (eg, cost, resistance is an individual who has previously had implement most of the advice, which from psychotherapists) and practical first-hand experience with the patient’s is not a criticism of the book but rather recommendations for incorporating condition (p 163). This chapter again a complaint about the current state of these modalities into a treatment plan. discusses challenges and limitations of affairs in the practice of psychiatry. There are 4 possible models for inte- peer support and provides some prac- In summary, this is a book about grating self-help into practice: 1) Self- tical advice in this area. The chapter self-management of depression, not help is offered to the patient before or is accompanied by 4 appendices: really for introducing self-manage- instead of therapy, or, in some cases, A. Tips for finding a peer support group; ment of depression to one’s practice; medication; 2) Self-help is presented B. Tips for selecting a peer support so although it contains a lot of useful as a “therapist extender;” 3) Self-help group; C. How can family and friends information, it is not very practical for is presented as a complement to stan- help when a loved one is depressed? that purpose. dard psychotherapy; and 4) Self-help (very useful, eg, recognizing and un- Richard Balon, MD is integrated into a comprehensive e- derstanding the symptoms of depres- Wayne State University health system. sion, approaching the person with de- Detroit, MI, USA

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However, while the efficacy of psy- Bipolar Disorder in Young chological interventions in BD has been studied and well documented, People: A Psychological many studies tend to exclude people under the age 18 (p x). This slender Intervention Manual volume summarizes and manualizes the available information in this area in combination with the authors’ syndrome and diabetes mellitus. Last experience “of working with a natu- but not least, part of this debate is the ralistic, ‘real world’ population of proposal of a new DSM-V diagnostic young people who are experiencing category of “temper dysregulation dis- their first episode of mania and who order with dysphoria.” This category previously had little, if any, contact should supposedly help to alleviate with a mental health service.” After the overdiagnosing of BD in children summarizing key information about and adolescents, which, according to BD in young people in the first chap- some, is much less frequent than gen- ter, this manual describes 8 modules erally thought. addressing key areas commonly ex- Somehow lost in this entire de- perienced when working with this bate remains the new developments population (p vii)—assessment and in the management of BD in young engagement; psychoeducation and individuals—the host of psycho- adaptation; medication adherence; By Craig A. Macneil, Melissa K. Hasty, logical interventions that have been targeted cognitive-behavioral in- Philippe Conus, et al. New York, NY; found effective in BD, either alone terventions; social rhythm regula- Cambridge University Press; 2009; or in combination with medica- tion; family work; comorbid issues ISBN 978-0-521-71936-0; pp 186; $55 (paperback). tions. The use of these interventions (substance abuse, alcohol and other in young individuals is the focus of disorders); and relapse prevention, a new volume by Australian and Eu- including identification of early ipolar disorder (BD) in children ropean authors, Bipolar disorder in warning signs. and adolescents has received, young people: A psychological inter- The first chapter has clinically Bfor various reasons, a lot of at- vention manual. important and relevant points, such tention in the scientific and lay press The book contains a preface, as the fact that BD has one of the lately. Many have rightfully ques- introduction, 9 chapters, and 13 ap- highest lifetime risks for suicide as- tioned the increase in the number of pendices. As the authors point out, sociated with any psychiatric disor- children and adolescents diagnosed this is the first book summarizing a der, and it has been demonstrated with this disorder. The potential role manualized psychological interven- that receiving treatment is associ- of new medications approved for this tion for people in adolescence and ated with lower suicide and mortal- disorder and the marketing push by early adulthood who are experi- ity rates (pp 2-3). This chapter also their makers has been widely debated. encing BD (p vii). The introduction succinctly summarizes some char- The widespread use of the new anti- notes that most BD patients relapse acteristics of young people with BD psychotics in BD especially in young after 5 years of treatment despite and opportunities for early psycho- individuals brought another serious good medication adherence (p ix). logical intervention following the element into this debate—the pos- Psychological interventions clearly first episode (ie, early intervention sible long-term adverse effects of seem to help in preventing relapse may prevent suicide and may pre- these medications such as metabolic and aid in adherence to medications. vent secondary morbidity; it may

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BOOK REVIEWS help prevent breakdowns in rela- lion. Factors that may assist medica- bipolar disorder (definition, symp- tionships; and it may help prevent tion adherence include understand- toms, treatment etc.); 2. What can relapse). The second chapter reviews ing the reasons for nonadherence, I do to help a person with bipolar issues such as diagnostic difficulties recognizing that adherence is not disorder?—A handout for family in BD (40% of persons with BD are a polarizing concept, identification members and friends; 3. The bucket initially misdiagnosed with unipolar of the right medication and dose, metaphor; 4. The repertory grids; 5. depression), elements of psycho- good psychoeducation, good thera- Views of bipolar disorder question- logical assessment of patients with peutic relationship, work with the naire; 6. Medication attitudes matrix; this disorder, and characteristics of family, motivational interviewing, 7. Blank CBT formulation; 8. Weekly a positive therapeutic relationship and establishing routines and cues. activity schedule; 9. Mood monitor- (therapist and patient factors). The Medication adherence also should ing chart; 10. Responsibility pie; 11. third chapter discusses several im- be strongly encouraged when the pa- Attitude to relapse questionnaire; portant issues such as insight and tient is asymptomatic. The fifth chap- 12. Relapse prevention plan; and 13. the ways in which young persons ter is a solid introduction to cogni- Checklist of interventions completed. may adapt to the diagnosis of BD. I tive-behavioral interventions in BD This volume is a great addition found the discussion of challenges with focus on a phase-specific inter- to the BD literature. It is useful, prac- to insight in the early phase of BD vention. The sixth chapter focuses on tical, clinically oriented, and well or- quite useful—examples include a relatively new element of psycho- ganized. It presents refreshing views the experience of mania and hypo- logical interventions in BD—social (mostly Australian) and an optimis- mania can seem counter-intuitive rhythm regulation and stabilization, tic outlook of psychological inter- to the concept of disorder or that including interventions such as life vention for BD in young individuals. posttraumatic stress resulting from event charting, sleep hygiene, sports, I believe that every clinician treat- involuntary hospitalization may be and diet. The seventh chapter deals ing young patients suffering from distressing and threatening to the with relationships and family work. BD will find this book useful. As the sense of invulnerability. This chap- The eighth chapter discusses the authors point out, “bipolar disorder ter also reviews psychoeducation, high degree of comorbidity in BD, can have a significant effect on ado- functional recovery, and working to namely anxiety disorders, abuse, lescent development and has tradi- enhance psychological adaptation posttraumatic stress disorder (PTSD), tionally been associated with poor and reduce stigma, guilt, and shame, and alcohol and illicit substance use. outcomes, both symptomatically and including the concept of posttrau- The last chapter informs the read- in terms of psychosocial functioning” matic growth. er about the identification of early (p vii). The message of this volume is The following chapter is an warning signs, prevention of relapse that this could be, at least partially, excellent overview of medication and termination of therapy. It in- changed, and the negative impact of adherence. The reasons for poor cludes a good example of a compre- BD on development and future func- medication adherence in BD are hensive “goodbye letter.” All chap- tioning could be alleviated. This is a numerous and challenging, ie, stig- ters include good clinical examples positive message and the manual is ma of long-term medication use, and conclusions summarizing each definitely a good buy. comorbid disorders, the fact that chapter in a bullet form. Richard Balon, MD mania is pleasurable, side effects of One should not forget the 13 ap- Wayne State University medication, impulsivity, and rebel- pendices: 1. Guide for people with Detroit, MI, USA

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cognitive-behavioral therapist would Psychodynamic Therapy: view and clinically approach differ- ent aspects of a patient’s presentation A Guide to Evidence-Based and treatment. It was refreshing to read a description of psychotherapy Practice not presented within a vacuum but in the context of other treatments. In the following chapters, the au- dle phase, combining treatments, thors move on to the opening phase and ending. This provides a unique in treatment, during which skills the chronological structure that begin- therapist needs for a good thera- ning psychotherapists can use to peutic alliance, the patient’s and the organize their understanding of therapist’s role, formulation, and psychodynamic therapy. Clinical treatment goals are discussed. Most examples are woven into the writ- valuable were the specific, practical ing beginning in the first chapter. tips for a beginning psychotherapist, These examples engage the reader, such as how to introduce and explain are useful illustrations of psychody- psychodynamic therapy to a patient namic therapy in clinical practice, and how to appropriately phrase and and provide a deeper understand- time interpretations. ing of its techniques, challenges, In the chapters on core psycho- and goals. The authors emphasize dynamic problems, the authors write By Richard F. Summers and Jacques P. active psychotherapist participation about 6 problems—depression, ob- Barber. New York: NY; Guilford Press; 2010; ISBN 978-1-60623-443-3; pp 355; as opposed to the outdated “blank sessionality, fear of abandonment, $40 (hardcover). screen.” From the beginning, Drs. low self-esteem, panic anxiety, and Summers and Barber describe psy- trauma—which they believe are chodynamic therapy in the context of the majority of problems that are sychodynamic therapy has other treatment options. The authors appropriate to treat with psycho- been criticized as being out- also describe relevant research on dynamic therapy. They discuss in Pof-date, difficult to integrate psychodynamic therapy succinctly detail patient presentation, psycho- within today’s practice, and lacking in each chapter and acknowledge the dynamic conceptualization, therapy evidence-based research. For oth- lack of and difficulties in performing techniques, transference, and coun- ers, it remains an integral way to un- research. However, I think it would tertransference. Unfortunately, the derstand patients on a deeper level, have been informative to discuss amount of evidence for effective help them improve their symptoms, these studies in greater detail. treatment of some problems, espe- and lead healthier lives. Drs. Sum- The chapters on context con- cially obsessionality and low self- mers and Barber address these dif- cisely define psychodynamic ther- esteem, is limited. It would be ben- fering opinions in Psychodynamic apy and explain different perspec- eficial to spend more time describing therapy and set out to “describe a tives within the field. Interestingly, the available research or reasons why contemporary psychodynamic ther- their discussion is not limited to ap- the problems were included if little apy model that we believe is practi- proaches within psychodynamic research was available. Without this, cal, effective, and easily integrated therapy. For example, Drs. Summers it remains unclear why the authors with other treatment modalities.” and Barber coherently weave a clini- thought these particular problems, The book is organized into 5 cal example into the writing and de- and not others, would be appropriate parts: context, opening phase, mid- scribe how a psychodynamic and for psychodynamic therapy.

294 November 2010 | Vol. 22 No. 4 | Annals of Clinical Psychiatry ANNALS OF CLINICAL PSYCHIATRY

BOOK REVIEWS

In the discussion of the middle The last section, entitled “End- less to a reference text, but may be phase, I found that the chapter on ing,” consists of 1 chapter about ter- applicable to a beginning psychother- change included a thoughtful dis- mination. The description of ways apist who already has some under- cussion of this process within ther- to distinguish premature from ap- standing of and interest in psychody- apy. The section on difficult deci- propriate termination and how ter- namic therapy. Such a reader would sions, which the authors describe mination affects the therapist were appreciate a guide that explains psy- as “particular moments when there particularly informative. Drs. Sum- chodynamic therapy and provides is a sense that the patient is at a fork mers and Barber even address the practical advice. Although the flowing in the road, with an important deci- often encountered forced termina- style is interesting and easy to read, it sion to make,” could be expanded to tion when trainees complete their may be less applicable to experienced include specific examples, possibly training. The authors only briefly clinicians. Those particularly inter- brief process notes from sessions, touch upon the topic of supervision. ested in a thorough discussion of the and further discussion on how to It would be interesting to include available research may be disappoint- approach these important issues. psychodynamic meanings of su- ed with the brief descriptions of most The section on combining treat- pervision and its affect on the ther- of the included studies. However, the ments includes a chapter on combin- apist-patient relationship because authors have formulated an excellent ing psychopharmacology with psy- supervised psychotherapy is a key guide to starting psychodynamic ther- chotherapy. Particularly useful are the component of training curricula. apy. The text engagingly and concisely practical ways to treat patients with Overall, the book provides a offers useful information about how medications and psychotherapy, the structure in which a psychotherapist to understand and apply psychody- complex role a psychiatrist must take, can organize a patient’s presenting namic theory to clinical practice. and how to understand patient reac- symptoms, diagnosis, psychodynam- Eva Waineo, MD tions to medications using psychody- ic presentation, and treatment ap- Wayne State University namic thinking. proach. The organization lends itself Detroit, MI, USA

BOOKS RECEIVED

The following books have been received or otherwise obtained and will be reviewed by selected individuals, the courtesy of the sender is acknowledged by this listing.

Medical management of eating disorders. Psychiatry. Second edition. By Janis L. Secondary schizophrenia. Edited by Second edition. By C. Laird Birmingham Cutler and Eric R. Marcus. New York, NY; Perminder S. Sachdev and Matcheri S. and Janet Treasure. New York, NY; Oxford University Press; 2010; pp 636; Keshavan. New York, NY; Cambridge Cambridge University Press; 2010; pp 264; $47.95 (paperback). University Press; 2010; pp 436; $120 $69 (paperback). (hardcover). Get the diagnosis right. Assessment and Kaplan and Sadock’s pocket handbook treatment selection of mental disorders. Personal recovery and mental illness. A of clinical psychiatry. By Benjamin J. By Jerome S. Blackman. New York, NY; guide for mental health professionals. Sadock and Virginia A. Sadock. Philadelphia, Routledge (Taylor & Francis Group); 2010; By Mike Slade. New York, NY; Cambridge PA; Wolters Kluwer/Lippincott Williams & pp 326; $44.96 (paperback). University Press; 2009; pp 275; $63 Wilkins; 2010; pp 566; $59.95 (paperback). (paperback).

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