Progress in Clinical Psychiatry: Number 1
The flow of medical information is no longer linear. The information does not move from laboratory or clinical research setting to refereed journal to clinician and, on occasion, to mass media. We now receive information that is unpatterned, unscreened, and unrefereed, via both the traditional media and the limitless expanse of cyberspace, which adds information at an overwhelming pace. With this in mind, what are we to make of a book of review articles?
Isn't this format an anachronism? If that were so, why was I enjoying the experience of reading the book? I went back to the preface to review the editors' purpose. Drs. Weller and van Kammen state that this book is "the first of what we hope will be bi-annual reviews of advancing areas of psychiatric research that impinge on clinical practice." They believe that the latter will be "more focused on outpatient care, more consultative, and more in an educative role."
They continue, "We choose our topics because we believe that they are neglected or that recent developments require a closer look." The book is targeted to readers on both sides of the Atlantic. The editors and authors are also from the two continents. Finally, they hope that the readers "will find the same enjoyment" they did in putting the book together.
I think they succeed. Not only is the book enjoyable to read, but it provides scaffoldings for information that is thrown at us from multiple sources. Many of the articles provide the wisdom that helps to organize the information. I doubt that many of us will read outcome studies in the same way after absorbing the contribution of Jim van Os and associates' "Risk Factors for Emergence and Persistence of Psychosis." They carefully evaluate outcome studies and cogently critique the literature so that we may read other articles in a more critical manner.
The authors of the chapters do an excellent job in organizing the reviews, with well-considered subtopics. Basic science is represented in an informative historical review by Janice Stevens on "Neuropathology of Schizophrenia: 1871-1996." Updates on clinical entities include Earl Giller's "Post-Traumatic Stress Disorder" and Simon Wessely's "Chronic Fatigue Syndrome," which is an extensive review with a comprehensive bibliography of almost 250 references drawn from the world literature. I have already had reason to reread these two reviews for assistance with clinical problems on our own service. Anthony Bateman's "Borderline Personality Disorder: History and Current Dilemmas" is particularly good on diagnostic issues, comorbidity, and differing psychodynamic issues and treatments, but research on the biology and psychopharmacology is not extensive.
Eric Johnson-Sabine does a good job of summarizing disparate research areas in "Transcultural Psychiatry." One hopes there will come a time when cultural dimensions will be integrated into all reviews of clinical issues. Finally, the most speculative and eccentric chapter is "Antioxidants in Psychiatric Practice" by Sukdeb Mukherjee and Sahebarao Mahadik, which offers leads and speculation while introducing many of us to this research dimension. Having read this book, which organizes and integrates information, I feel better prepared to face cyberspace.
Dr. Feiner is professor of psychiatry at the University of Texas Southwestern Medical Center in Dallas and clinical and training director of Mental Health Connections.
