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Book Forum: MOOD DISORDERS   |    
Handbook of Depression, 2002 ed.
Am J Psychiatry 2003;160:1367-a-1367. doi:10.1176/appi.ajp.160.7.1367-a
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Edited by Ian H. Gotlib and Constance L. Hammen. New York, Guilford Publications, 2002, 628 pp., $65.00.

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With the importance of depression self-evident and the large literature of basic research and clinical studies so accessible, an edited text on the subject should have a clear purpose. Although not stated by the editors, this book would seem to be best suited for a graduate-level course on depression taught by a talented individual. In the usual sense of the word, a "handbook" is a readily accessible, easily carried guide. This is not what we have here. Instead, think of a well-organized set of 25 review articles with thousands of references. The editors’ introduction tells us what we will read, and their summary chapter tells us what we have just read, but there is very little to stitch the chapters together. Herein lies the need for a talented teacher if this book is to be used for a course. Big-picture chapters that would have helped integrate information are lacking. The editors should have filled that gap. Occasionally, chapter authors reach for integration, but most stick to their own subject.

The contributors are mostly academic psychologists with a few academic psychiatrists for appropriate topics. The authors are highly knowledgeable, active researchers who have considerable command over the topics about which they write. The book is reasonably priced, which enhances its accessibility. There is an admirable uniformity of style from chapter to chapter, with generally fluent writing. However, the review article style dominates, and there are often 20 references per page. The reference notation style cites author and year of publication in the text with the full reference at the end of the chapter rather than citing by number. Although the standard form for social science publications, it makes for bleary-eyed reading and a constrained writing style. The references are as current as can be expected in a textbook, but one wonders if they could not have been more critically chosen.

Organized into four sections—Descriptive Aspects of Depression; Vulnerability, Risk, and Models of Depression; Prevention and Treatment of Depression; and Depression in Specific Populations (which includes cultural issues, gender differences, different age groups, and suicide)—the book covers quite a large amount of material. The section on descriptive aspects is probably the strongest, not suffering from the parochialism that results when chapters deal with the specifics of one aspect of depression as if little else existed. This section has chapters on genetics, epidemiology, course and outcome, assessment, methodological issues, personality, and bipolar depression.

There is no chapter on evolutionary perspectives, which would have encouraged looking at depression in a broader context than simply as a disorder. Even with all that we have learned about depression in recent years, we should be cautious about our assumptions. Treatment has yet to benefit in any big way from basic research. We may still be far from understanding the true nature of the different depressions we see. For example, if there are susceptibility genes for depression and close to 20% of people experience a clinically significant depression at some time, surely far more than that percent of people must have such genes. Possession of susceptibility genes may be more common than the lack of them. Wouldn’t this drastically change our view of depression? The focus reflected in this book is on depression as the expression of a disordered process rather than on a failure of reparative mechanisms. Considering the complexities of the human organism and its exposure to adversity of all types, we have strong, built-in mechanisms of repair as part of our general biological heritage. A great deal of depression may be what results when repair is overwhelmed by injury.

This will be a useful book for someone who teaches about depression and who wants to review the breadth of the field. Although a book of many small pieces, it may work well as a text for a semester-long course aimed at reviewing research areas in depression, not the usual fare in a residency program. It will not offer a lot to the well-read psychiatrist seeing patients. Its discussions of treatment are synopses, which is appropriate in a volume of this kind but not what the experienced clinician looks for.




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