It is customary in reviewing later editions of general textbooks to compare them with earlier volumes by weight or length. Using either measure, the third edition of the Comprehensive Textbook of Geriatric Psychiatry is much bigger and contains much more information. Of course, what the potential reader wants to know is whether the volume is useful and accessible. To assess this, I used the book to help with two recent consultations. The first was a case of chronic delirium, which led me to read the chapter on delirium by Benjamin Liptzin. It is comprehensive, readable, and clinically relevant. It presented information on prolonged delirium that was useful in my consultation and provided balanced information on both clinical management and potential pathobiology. I highly recommend the chapter to any student seeking an introduction to the topic of delirium as well as to any experienced clinician who would like an overview of the most recent information on this prevalent and challenging condition. The index also provided references to discussions of delirium in other chapters.

The second case involved an individual with musical hallucinations. I did not find a mention of this topic in the book, but hallucinations in each sensory modality are discussed in depth in several places. My inability to find the topic does not reflect negatively on the textbook. Rather, it reflects the fact that one of the limitations of textbooks is that they cannot include references to every rare clinical situation because doing so would make a book so encyclopedic as to be unusable.

Although I did not read the book from cover to cover, I did review a number of chapters at random and compared them with the two previous editions. Several generalizations can be made. First, the field of geriatric psychiatry has advanced substantially since the first volume was published in 1991. Discussions of recently hypothesized etiological mechanisms are present throughout this volume, illustrating both how much has been learned in the past decade and how much greater the linkages are between clinical and geriatric psychiatry and basic science knowledge. I also reviewed the treatment recommendations in a number of chapters and found them all to be well balanced, thoughtful, and critical. In an age in which pharmaceutical support is ubiquitous and is claimed to infiltrate every aspect of information provision, my impression is that the authors provide information reflecting the state of the literature and readily acknowledge the limits of empirical knowledge.

Finally, although the five sections of the book are the same as in the first edition, this volume is much more comprehensive than the first two editions. It now includes extended discussions on family issues, psychiatry at the end of life, neuroimaging, and genetics, topics that were not in the first edition and that are up-to-date and clinically relevant. Thus, I highly recommend this volume both to the medical student or resident who would like to learn more about geriatric psychiatry and to the practitioner who would like a well-referenced source of information for challenging clinical situations.