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Book Forum: Children and Adolescents   |    
Child and Adolescent Psychiatry: A Comprehensive Textbook, 3rd ed.
Am J Psychiatry 2004;161:180-a-181. doi:10.1176/appi.ajp.161.1.180-a
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Vancouver, Wash.

Edited by Melvin Lewis, M.B., B.S., F.R.C.Psych., D.C.H. Philadelphia, Lippincott Williams & Wilkins, 2002, 1,495 pp., $179.00.

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From the early days of medicine, physicians have seen the experience of childhood as unique. Recently there has been a dramatic increase in scholarly research illuminating how truly unique this period is in one’s lifespan. Improvements in our understanding of development, neurophysiology, and psychopathology are occurring at a rapid pace. Advances in neuroimaging have led to a greater understanding of brain structure, morphology, and function. The historic nature versus nurture debate has fallen by the wayside, allowing for a more robust look at the interplay between the two. Making sense of this growing body of information is a daunting task. Melvin Lewis’s Child and Adolescent Psychiatry attempts just this task by reviewing not only the putative neurodevelopmental and neurochemical mechanisms but also the modulative psychological influences of childhood disorders. Assisting in the production of this work are 200 authors responsible for contributions in their respective areas of expertise.

This expanded text consists of 10 sections with a total of 133 chapters. It begins with a comprehensive review of developmental pathways and phases. The development and assessment of symptoms are then quickly dissected, leading the reader to child and adolescent syndromes. Each section reviews history, epidemiology, etiology and pathogenesis, differential diagnosis, and treatment. Historical perspectives provide a link to the rich history of psychiatry. Each chapter is augmented with case presentations highlighting the complex presentations seen in clinical practice. Chapter 52, on attention deficit hyperactivity disorder, is an outstanding example. The clinical description of the disorder is rich in detail. The discussion of treatments is inclusive, well rounded, and thought provoking.

The following sections are devoted to pharmacological and psychological treatments as well as the role of child psychiatrists and allied professionals. Salient topics ranging from pediatric transplantations to Munchausen’s syndrome by proxy are dealt with in a straightforward and easy-to-read manner. The chapter dealing with psychiatric issues in pediatric bone marrow, stem cell, and solid organ transplantation presents the reader with survival data, stages of evaluation, treatments, developmental considerations, and specific organ transplant prognoses. Cases are reviewed from the patient’s perspective as well as that of parents and providers.

The intended audience for Child and Adolescent Psychiatry includes not only psychiatrists but also pediatricians, psychologists, and neurologists as well. It also may serve as a valuable reference for schools, social service agencies, lawyers, and lawmakers. Each would be well served by this text. The chapters are easy to read and are remarkably inclusive. Biological, psychological, and social theories are given fair weight. Indicators of risk are identified. Treatments and their relative efficacies and drawbacks are critically discussed. Practitioners will find this text useful, often negating the need for time-consuming literature searches. Child and adolescent fellows will find this text valuable as a study guide for boards. This is not to say that there is not room for improvement. Psychopharmacology should be reviewed more extensively, given the great number of chemical treatment modalities available and the increasingly complex cases seen in practice.




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