This is a big book—661 pages with a list of contributors that encompasses many of the names in the field of obsessive-compulsive disorder (OCD), including some international flavor and even a touch of the pharmaceutical industry. There are some notable omissions, which could be editorial oversights or just overburdened authors for whom the invitation to write came at the wrong time. Be that as it may, Goodman, Rudorfer, and Maser have produced an obsessive-compulsive tour de force that rivals the magnus opus of Jenike et al. (1) in breadth, depth, and overall readability (and it is 2 years ahead in copyright date—2000 versus 1998).

Since the two books have some authors in common, I thought it would be worth doing some chapter comparisons. My dismay at finding the identical 1891 quotation beginning the chapters on body dysmorphic disorder in both books melted away with the realization that the more recent chapter was not a knockoff but, rather, a fresh and timely view of the disorder by its preeminent investigator. On the other hand, the neurosurgery chapters shared much verbatim verbiage.

So much for comparisons; what about content? The book bypasses the basics, such as a chapter on epidemiology (not even found in the index) and clinical features of OCD, and begins with a discussion of boundary, spectrum, and subtyping issues. The focus then shifts to pathophysiology and etiology (which remains as elusive as ever), and next to overviews on assessment and outcome measures (to set the stage for the main thrust of the book, which is treatment). At least a few words in the assessment chapter on the Children’s Yale-Brown Obsessive Compulsive Scale would have been welcome.

Treatment is the book’s strongest suit, with 73 pages devoted to cognitive behavior therapy, 205 pages to medications and other somatic treatments, and 45 pages to combined treatments. Obviously, the meat of the matter is somatic therapy, and this is where I would go for comprehensive, in-depth reviews of standard as well as more creative interventions. Treatment resistance is dealt with in many of the chapters, and, fortunately, there is much of substance to be found. There is no question that among the anxiety disorders, OCD is the only one for which there is a substantial body of information on managing treatment-resistant or refractory patients. What I consider to be a rather glaring omission is the fact that there is no chapter on the treatment of child and adolescent OCD. This, in turn, may account for an absence of information on immune therapies such as plasmapheresis.

As an aside, both books have hyphenated obsessive-compulsive correctly, in keeping with DSM-IV, which, for reasons unknown, in a maneuver best referred to as the conservation of the hyphens, removed the DSM-III-R hyphen from post-traumatic stress disorder and transferred it to the unhyphenated obsessive compulsive disorder.

All in all, Obsessive-Compulsive Disorder: Contemporary Issues in Treatment is a very substantial contribution to the field and well worth the investment of anyone with more than a passing interest in OCD.