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Am Fam Physician. 1998 Sep 15;58(4):1015-1016.

Primary Care Psychiatry

Edited by David J. Knesper, Michelle B. Riba and Thomas L. Schwenk. Pp. 352. Price, $39.00. Saunders, Curtis Center, Independence Square West, Philadelphia, PA 19106, 1997.

Massachusetts General Hospital Handbook of General Hospital Psychiatry

Edited by Ned H. Cassem, Theodore A. Stern, Jerrold F. Rosenbaum and Michael S. Jellinek. Pp. 688. Price, $44.95. 4th ed. Mosby, 11830 Westline Industrial Dr., St. Louis, MO 63146, 1997.

Primary Care Psychiatry is an excellent review of psychiatric problems seen in the outpatient care setting. This book is geared to “match the realities” encountered by the busy family physician. Part I of the book is titled “Principles of Practice, Diagnosis and Treatment.” The authors describe an innovative “road-map” approach to the diagnosis and treatment of mental health problems, making it a useful alternative to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) approach. The book also provides an overview of psychopharmacology and counseling for behavioral change. Part II covers specific neuropsychiatric disorders such as minor depression, major mood disorder, anxiety, and common problems among children and adolescents. Part III covers neurobehavioral disorders such as chronic fatigue, addiction problems, obesity and domestic violence. In general, each problem is covered in an appropriate depth for a busy clinician, with clear treatment and referral guidelines.

Some very useful and unique features throughout the book are specific scripts on what to tell patients and families about treatment, referral and the diagnosis itself, as well as specific ways to speak to difficult patients. Because of the practical nature of this book, one will not find in-depth discussion on etiologies of psychopathologic states or psychodynamic issues of patients. However, the authors present extensive lists of resources for mental health issues including organizations, self-help books and a chapter on the World Wide Web. They also provide medication fact sheets for patients and screening tests for mental illnesses. The section on children and adolescents is remarkable for its clarity on the challenging presentations of mental illness in children.A section guiding parents on behavioral management of children without mental disorders would have been helpful. Primary Care Psychiatry is written by authors with a medical and behavioral background who collaborated extensively to provide a truly useful book for the practicing family physician.

The Massachusetts General Hospital Handbook of General Hospital Psychiatry is directed at the care of hospitalized medical patients who develop psychiatric difficulties. In the preface, the editors note that “physicians, not just psychiatrists” should be able to recognize and treat common problems. The book covers an array of pertinent topics, such as delirious and demented patients, depressed patients, alcohol and drug addiction, psychopharmacology in medical patients, legal aspects of psychiatric consultations and consultations with children. They also sensitively address psychosocial issues related to hospitalized patients such as coping with illness, the dying patient and special patient populations (e.g., obstetrics-gynecology patients, burn victims, and patients with spinal cord injuries, human immunodeficiency virus, acquired immunodeficiency syndrome, etc.). Although the authors also target non-psychiatrist physicians, this book is clearly written to meet the practical day-to-day needs of consultation psychiatrists, which it does very well. For the family physician, it can function as a useful reference book and provide a pointed, yet appropriately detailed review of specific psychiatric issues that arise in hospitalized patients.

Outpatient Medicine

Edited by Stephan D. Fihn and Dawn E. DeWitt. Pp. 774. Price, $39.95. 2d ed. Saunders, Curtis Center, Independence Square West, Philadelphia, PA 19106, 1997.

As care shifts to the outpatient setting, primary care clinicians need assistance to efficiently and effectively evaluate and manage patient problems. Out-patient Medicine, 2nd edition, goes far in this direction, providing a strong source of easily accessible information. The foreword for this edition states that the book is written for internists, but it has strong utility for any practitioner involved in adult care. Multiple authors have prepared chapters that are formatted to allow easy access to useful information. The chapters are grouped in 21 sections that provide a flow to the volume. Each of the sections begin with chapters on screening, followed by chapters on common diagnoses, specific problems and symptoms, and, finally, procedures.

Each chapter is very readable and sprinkled with charts and algorithms, forcing the reader to learn every time this book is opened. The evaluation and management recommendations are easily accessible, comply with the latest guidelines and are in accord with appropriately documented evidence. The use of expert opinion and evidence-based recommendations is nicely integrated and gives the book the maximal authority possible in this format. The references, which contain brief annotations at the end of each chapter, appear helpful, as are the multiple cross-references to other chapters for related information.

The sections on gastrointestinal disorders and preoperative assessment are particularly diversified and useful. The alcohol screening chapter is very useful and contains valuable tools. The chapter on electrolyte imbalance is also a wealth of clinical pearls. The section on preventive services is useful, although depression screening is located in the section on psychiatric and psychosomatic disorders. Plus, the discussion of high-risk screening appears limited to medical entities and omits important areas like screening for suicide.

Other omissions, which do not really negate the value of this book, include descriptions for some common office procedures, such as nasal packing or direct laryngoscopy in the section on disorders of the ears, nose, throat, and mouth. Some newer therapies are omitted, including bupropion for smoking cessation and valacyclovir and famciclovir for herpes zoster treatment. The inclusion of illustrations and diagrams may have been useful both for the clinician and for patient education. It is always strange to read about dermatologic disorders without seeing a picture.

The omissions and faults are few when the scope of this book is considered. This volume covers the bulk of adult medicine in an accessible and practical manner. The varied chapters including ethics, travel medicine and end-of-life care provide a wealth of knowledge that is useful to all clinicians. The editors have succeeded in their stated effort to compile a book that should be in the hands of medical students, residents and generalist physicians.

Also Received

The Physician's Guide to Disease Management

By James B. Couch. Pp. 308. Price, $49.00. Aspen Publishers, 200 Orchard Ridge Dr., Ste. 200, Gaithersburg, MD 20878, 1997.

A Portrait of Breast Cancer: Expressions in Words and Art

By Project Woman. Price, $12.95. American Cancer Society, 4323 Northwest 63rd St., Ste. 110, Oklahoma City, OK 73116, 1996.

The Primary Care Performance Management System

By Margot S. Kravette, Barbara J. Mauer, Dale A. Jarvis and Richard W. Mockler. Pp. 181. Price, $49.95. Centralink Publications, 1110 Mar West St., Ste. E, Tiburon, CA 94123, 1997.

Probability Without Equations: Concepts for Clinicians

By Bart K. Holland. Pp. 113. Price, $16.95. Johns Hopkins University Press, 2715 N. Charles St., Baltimore, MD 21218-4319, 1997.

Quick Consult Manual of Evidence-Based Medicine

Edited by Burton W. Lee, Stephen I. Hsu and David S. Stasior. Pp. 744. Price, $35.95. Lippincott-Raven, 227 E. Washington Sq., Philadelphia, PA 19106-3780, 1997.

The Repetitive Strain Injury Recovery Book

By Deborah Quilter. Pp. 240. Price, $14.95. Walker & Company, 435 Hudson St., New York, NY 10014, 1998.

Successful Aging

By John W. Rowe and Robert L. Kahn. Pp. 265. Price, $24.95. Pantheon Books, 201 E. 50th St., New York, NY 10022, 1998.

The Tennis Partner: A Doctor's Story of Friendship and Loss

By Abraham Verghese. Pp. 347. Price, $25.00. Harper Collins, 10 E. 53rd St., New York, NY 10022-5299, 1998.

University of Iowa: The Family Practice Handbook

Edited by Mark A. Graber, Peter P. Toth and Robert L. Herting, Jr. Pp. 810. Price, $36.95. 3d ed. Mosby, 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, 1997.

What You Really Need to Know About Cancer: A Comprehensive Guide for Patients and Their Families

Edited by Robert Buckman. Pp. 363. Price, $19.95. Johns Hopkins University Press, 2715 N. Charles St., Baltimore, MD 21218-4319, 1997.

When Autism Strikes: Families Cope with Childhood Disintegrative Disorder

Edited by Robert A. Catalano. Pp. 250. Price, $19.95. Plenum Publishing, 233 Spring St., New York, NY 10013, 1998.

Women and Heart Disease

Edited by Desmond G. Julian and Nanette K. Wenger. Pp. 454. Price, $120.00. Mosby, 11830 Westline Industrial Dr., St. Louis, MO 63146, 1997.

Women's Mental Health

By Vivian K. Burt and Victoria C. Hendrick. Pp. 168. Price, $21.00. American Psychiatric Press, 1400 K St., NW, Washington, DC 20005, 1997.

The Yale Guide to Children's Nutrition

Edited by William V. Tamborlane, Janet Z. Weiswasser, Teresa Fung, Nancy A. Held and Tara Prather Liskov. Pp. 415. Price, $18.00. Yale University Press, P.O. Box 209040, New Haven, CT 06520-9040, 1997.



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