Abstract
When this book arrived in my pigeon-hole, my first greedy glance at the contents page as I ambled back to my office evoked a little surprise. There were the chapters I expected on Parkinson's disease, on MS, on stroke, Huntington's and AIDS, but I was a little puzzled to see very substantial chapters on Wilson's disease and on dystonia and an entire chapter devoted to Fahr's Syndrome. Certainly these are important and interesting disorders, but not particularly common. What was going on?
Some days later, when finally I got around to tackling the book, all was made clear. The editor's professed aim was to focus on psychiatric management, and his strategy was to select key, representative neurological disorders to illustrate a range of clinical principles in neuropsychiatric treatment. Thus, among the selected disorders, some are focal in nature, some multifocal, some diffuse; some affect principally basal ganglia, others involve white matter tracts of basal gangliacortical circuits. Systemic illnesses are represented and immunological disorders too.
In other words, this does not aim to be a comprehensive text book of neuropsychiatry, but as the title truthfully conveys, a text on psychiatric management in neurological disease.
Preceding the eight disorder-based chapters is an introductory section on psychiatric management principles, including a compact account of behavioural neuroanatomy. Following the eight chapters is a concluding chapter on family management issues. The coverage is reasonably detailed and thorough, briskly written and with well chosen tables, diagrams and neuroimaging figures. The content is as up-to-date as a book can be. The depth of treatment, level of detail and general style is very reminiscent of Psychiatric Clinics of North America. There is no chapter on epilepsy, but an entire book in this series has already been devoted to this topic [1].
Each of the disorder chapters follows a similar plan, starting with the epidemiology, clinical presentation, pathology, neuroimaging and other neurological features of the disorder; then systematic accounts of the psychiatric manifestations; followed by summaries of the main modalities of neurological management; concluding with psychiatric management of the various syndromes associated with each disorder. The overviews of neurological treatment are very helpful, but variably so. Thus it is excessively detailed for Wilson's disease and much too brief for MS (one longish paragraph). It is good to see the presence of a chapter on family management issues in a book such as this, but unfortunately the chapter is brief and superficial.
All in all this is a very useful book which succeeds within the terms set for it by the editor and which fills a gap in the market. Most psychiatrists working in neuropsychiatry, or providing consultation–liaison psychiatry to neurology patients, will find it useful. So too will many general psychiatrists wanting a concise, up-to-date refresher in aspects of neuropsychiatry. Most general psychiatrists, I imagine, would be reluctant to buy one of the larger, more detailed neuropsychiatric texts [2–5], some of which are considerably more expensive [5], some are increasingly dated and most are without the detailed coverage of management issues to be found here.