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Book Forum: Neuropsychiatry   |    
Neuropsychiatry and Mental Health Services, ? The American Psychiatric Press Textbook of Neuropsychiatry, 3rd ed.
PETER V. RABINS, M.D.
Am J Psychiatry 2000;157:474-474. doi:10.1176/appi.ajp.157.3.474
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Baltimore, Md.

edited by Fred Ovsiew, M.D. Washington, D.C., American Psychiatric Press, 1999, 406 pp., $59.95. • edited by Stuart C. Yudofsky, M.D., and Robert E. Hales, M.D. Washington, D.C., American Psychiatric Press, 1997, 1,114 pp., $159.95.

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The term "neuropsychiatry" was widely used at the beginning of the twentieth century but fell out of favor in the 1950s as psychiatry turned its interest away from the brain. A renewed search for the biological bases of psychiatric symptoms has been paralleled by the reemergence of a subdiscipline of neuropsychiatry, defined in Neuropsychiatry and Mental Health Services as "encompass[ing] both the care of the patient with overt brain disease…and an approach to the care of patients with the major psychiatric disorders traditionally considered nonorganic or ‘functional.’ " Although this definition seems so broad as to cover all of traditional psychiatry, these two volumes illustrate the discipline’s focus on disorders with identifiable structural brain disease and concomitant "psychiatric" manifestations as well as disorders in which there is substantial indirect evidence that functional central nervous system dysfunction is present.

The two volumes reviewed here take very different approaches. TheAmerican Psychiatric Press Textbook of Neuropsychiatry seeks to be encyclopedic and offers in-depth reviews of basic neuroscience, clinical evaluation, structural and functional diseases of the brain, and general principles of treatment. Although there are useful chapters on schizophrenia by Carol Tamminga and mood disorders by Mayberg, Mahurin, and Brannan, the bulk of the chapters focus either on the evaluation of individuals with presumed neuropsychiatric disorder or on conditions such as headache, seizure disorder, sleep disorder, brain tumors, HIV infection, and Alzheimer’s disease. Neuropsychiatry and Mental Health Services, on the other hand, offers focused reviews of fewer topics. It, too, seeks to link current understanding of brain function and dysfunction to the treatment of conditions such as substance abuse, HIV infection, and developmental disabilities, but the chapters are much more clinical in nature and place less emphasis on presumed or plausible mechanisms of pathogenesis.

Each book meets its stated goals. Neuropsychiatry and Mental Health Services provides an excellent introduction to students and clinicians working in settings in which neuropsychiatric disorders are often seen. However, although it focuses on some of the more common conditions considered neuropsychiatric, there are many prevalent syndromes, such as stroke, epilepsy, and dementia, which are dealt with only in passing. Its discussions of treatment are practical, but supporting references are few. A strength is its emphasis on the need for treatment settings to be structured in a fashion that meets the needs of patients with neuropsychiatric disorders.

The American Psychiatric Press Textbook of Neuropsychiatry, on the other hand, best serves students and clinicians as a reference. It is much larger, covers many more topics, and has more extensive reviews of biology and evaluation. For example, while reviewing the book I saw a patient with presumed Fahr’s syndrome or cerebral calcinosis. I was able to find three discussions in the book that provided useful information and references to more in-depth articles.

Both of these books can be recommended, The American Psychiatric Press Textbook of Neuropsychiatry as a reference resource and an excellent source of information on clinical and laboratory evaluation, and Neuropsychiatry and Mental Health Services to clinicians and health system designers interested in learning about the care needs of individuals suffering the most common neuropsychiatric conditions.

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