Abstract
The World Psychiatric Association (WPA) has initiated a series of volumes with the overall title ‘Evidence and Experience in Psychiatry’, to bridge the gap between research evidence and clinical practice for the most prevalent mental disorders. This is the third volume in the series, edited by Maj and Sartorius. Earlier volumes dealt with depressive disorders and schizophrenia. The publication of the volume under review was made possible by a grant from the Lundbeck Foundation – an act of disinterested generosity as Lundbeck do not yet market any anti-dementia drugs!
Like its predecessors, the volume is structured around a series of reviews each of which is followed by multiple brief commentaries by experts in the field. Six areas are reviewed: definition and epidemiology; clinical diagnosis; neuropsychological and instrumental diagnosis; pharmacological treatment; psychological interventions; and costs. Each review is subject to between 7 and 14 one to three page commentaries.
The quality of the reviews is very variable. Henderson and Jorm provide a typically thorough and up-to-date review of epidemiology, but the section on clinical diagnosis is little more than an extended advertisement for Functional Assessment Staging (FAST) and related concepts, including that of retrogogenesis (which seeks to parallel the loss of functions in dementing illness with the acquisition of similar functions in childhood) propounded over many years by Reisberg and colleagues in New York. One of the more entertaining features of the book is the way that a couple of the commentators politely, but firmly, put the boot in to this self-indulgent and inadequate review.
Researchers who are interested in dementing illnesses will want to have access to a copy of this book. Anybody prescribing drug treatments for patients with Alzheimer's Disease would be well advised to read the section on pharmacological treatments by Samuels and Davis, while health planners and bureaucrats will find the section on costs useful and stimulating. I would like to have seen a section on the neuropathology of the dementias and it might have been worthwhile to have a specific section on carers. However, I learned several useful things from reading this book.