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Book Review: 10 Essentials of Highly Healthy People

evolution of psychiatric diagnosis and treatment, and each chapter provides a brief summation of such. The DSM-IV-TR diagnostic criteria for each chapter topic are included in a light blue, highlighted text box and ICD -10 diagnostic criteria in a gray text box. An actual case representative of the diagnosis is also included in a light blue text box to illustrate the clinical presentation and manifestations of the hallmark symptoms. References are noted at the end of each chapter and include primary and tertiary sources, although practice guidelines and pivotal studies are not consistently included. The treatment section of each chapter includes both psychotherapeutic and pharmacotherapeutic approaches, as well as possible alternative treatments such as electroconvulsive therapy. The pharmacotherapy is addressed briefly and is categorized by major medication class. A synopsis of the relative differences among the agents within the class is noted, with specific dosing approaches only cursorily addressed. A more detailed review of each therapeutic medication is included in a separate 175-page chapter entitled “Biological Therapies,” but this material may have been more appropriately placed within each diagnostic chapter. The Biological Therapies chapter begins with an overview of the pharmacokinetic principles of absorption, distribution, metabolism, and elimination. The chapter addresses special treatment considerations required when using psychotropics to treat children, the elderly, and pregnant and lactating women. The most common adverse effects of psychotropic medications are also reviewed, as are their more common treatment approaches. A 5-page table reviewing the common toxicities encountered with overdose is included, as are the required interventions. Following this comprehensive overview of the principles of pharmacotherapy, the chapter contains 36 subsections devoted to each medication class used in psychopharmacology, including less widely considered agents such as adrenergic receptor agonists/antagonists, thyroid hormones, and dopamine receptor agonists. Each subsection reviews the pharmacology of the agents in the class, therapeutic indications, and dosing guidelines. What most especially distinguishes this section from other reviews of psychopharmacotherapeutic agents is the inclusion of laboratory interferences. This information can be difficult to obtain from common reference and textbooks. Child and adolescent disorders are afforded their own chapters, and the area of psychotherapy in this population is addressed separately. The book also contains chapters on forensic psychiatry, ethics in psychiatry, and end-of-life and palliative medicine. In keeping with the notable effort to reflect the current movements within psychiatry, the use of the term “psychotropic” is stressed, reflecting the rapidly expanding role of these agents beyond their previous classifications (e.g., antidepressants, antipsychotics, anxiolytics). Of significance is the omission of several more recent treatment options, likely a result of the publication delay inherent to textbooks. In particular, escitalopram, approved by the Food and Drug Administration (FDA) in August 2002, is not included in the review of selective serotonin-reuptake inhibitors. The agents listed to treat memory disorders do not list the more recently available rivastigmine and galantamine, which were approved by the FDA in April 2000 and February 2001, respectively. This text makes a remarkable effort at being up to date, as evidenced by the inclusion of the September 11, 2001, attacks on the World Trade Center and the Pentagon in the Posttraumatic Stress Disorder chapter, as well as a review of mad cow disease in the chapter on Mental Disorders Due to a General Medical Condition. The book contains helpful and interesting illustrations throughout, including tables, sample writing from a schizophrenic patient, photos illustrating various syndromes associated with mental retardation, chemical structures, flowcharts, and photos of prominent psychologists. Colorplates of psychotropics in various dosage forms are included in the front of the book. This text would serve as a valuable addition to a medical or public library, as well as a thorough reference text for medical students and residents in both psychiatry and medicine. Priced at $75, it is a bargain for such a prominent work in the field of mental health.