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Psychiatric Management in Neurological Disease Edited By Edward C. Lauterbach. Washington, DC: American Psychiatric Press. 2000. 346 pp. £31.50 (hb). ISBN 0 88048786 0

Published online by Cambridge University Press:  02 January 2018

Jonathan Michael Bird*
Affiliation:
The Burden Centre for Neuropsychiatry, Neuropsychology and Epileptology, Frenchay Hospital, Bristol BS16 1JB, UK
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Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2001 

The presence of a psychiatrist on a neurological ward is, of course, no longer novel, but it remains an occurrence that is too infrequent for the full and proper management of many patients with neurological disorders. It is to be hoped that this book will encourage psychiatrists to become more aware of their potential for improving the management of patients with a variety of neurological diseases.

This volume is a useful reference of not only the psychiatric management, but also the clinical state and psychiatric complications of selected neurological conditions. The emphasis on the treatment of individual psychiatric problems is welcome and the book forms a worthy introduction to this field. This is a multi-author text, but it is clear that fairly strict editorial control has been exercised, which makes it easy to use in everyday liaison neuropsychiatric practice. There is a helpful initial introduction to the neuropsychiatric presentations of neurological disorder and their possible management, followed by eight chapters on individual syndromes. Each chapter includes an introduction, a brief epidemiological overview, an outline of the neurological presentation, pathology and investigation of the disorder, a review of the psychiatric manifestations, and finally details of management of the neurological and psychiatric problems that might arise from the condition. The only exception to this is the chapter on stroke, in which only the neuropsychiatric aspects are covered. There are several very helpful lists, for instance of drug/drug interactions and of disease/drug interactions. A number of illustrations, including magnetic resonance imaging brain scans and a startling picture of a Kayser—Fleischer ring, augment the text.

The main weaknesses of the book are that the selection of neurological disorders is incomplete and that the coverage of some that are included is variable. There are, for example, 42 pages on Fahr disease but only 22 on multiple sclerosis. Movement disorders are well covered, particularly Parkinson's disease, Huntington's disease, Wilson's disease and dystonia. There is a useful chapter on the management of the psychiatric manifestations and complications of HIV. All of the chapters tend more towards the pharmacological than the psychological or psychotherapeutic management of psychiatric problems in people with these neurological diseases, but the book does end with a short paper about family management issues. Perhaps the emphasis on pharmacological matters indicates a relative paucity of worthwhile research into other areas of psychiatric management, but it is a shame that no attention is paid to the variety of cognitive—behavioural and allied treatments that can be used in this area.

The book does not purport to cover the apparently neurological presentations of psychiatric disorder and makes almost no mention of somatoform disorders. At the outset the editor remarks that books on the psychiatry of Alzheimer's disease and epilepsy exist, and therefore he makes no further mention of them. However, serious omissions appear to be the psychiatric management of migraine, motor neuron disease, infections of the central nervous system other than HIV, normal-pressure hydrocephalus and, possibly, some mention of the sequelae of head injury. Consequently, this cannot by any means be regarded as a comprehensive reference book for those interested in liaison psychiatry on neurological wards, but it can be strongly recommended as a practical handbook for the trainee or general psychiatrist who is consulted by a neurological colleague about a patient with one of the eight conditions featured.

References

EDITED BY SIDNEY CROWN and ALAN LEE

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