This volume is described as a deskbook aimed at giving a comprehensive overview of the relevant objectives of child and adolescent psychiatry in clinical practice and to help with quality control for child and adolescent psychiatrists and other specialists concerned with child mental health. The editors state that the authors intention is not to cover exhaustedly all the relevant science but to present in condensed form any research findings that are significant for clinical practice.
The 24 chapters all share a common format, written by 28 experts in their field mainly from the UK, Europe and Scandinavia and with 5 authors from North America. After an introduction, definition and comparison of both ICD-10 and DSM IV classifications and their strengths and weaknesses, epidemiology, the clinical picture, etiology, treatment and outcome are specifically outlined for each disorder. There are many useful treatment algorithms. There are suggested readings and appendices with screening instruments. There are no separate chapters specifically on the child psychiatric interview, early intervention, infant psychiatry other than attachment disorder, or on the use of other investigational methods. There is a chapter on personality disorder. Psychopharmacology is addressed as deemed necessary by each of the authors.
It is succinct to the extreme…30 pages on schizophrenia and schizophrenia like disorders in which the author raises the specter of diagnostic uncertainty but does not directly aid the reader with advice as to how to proceed when confronted with such a dilemma.
I enjoyed the chapter on brain disorders which covered brain injury, infectious disorders, cerebral palsy, epilepsy, brain tumors and minimal brain dysfunction. I found the table of syndromes attributed to minimal brain dysfunction particularly useful but wished the labels could have been more fully ICD and DSM cross referenced.
I did query some of the Table 1.3 listed side effects of medications used to treat brain injured adolescents but put this down to my lack of experience in this population. There was a useful table listing interview questions to elicit neuropsychological deficits and the corresponding psychological tests.
The book serves as commemoration to Richard Harrington who died just before the manuscript was finalized and who wrote the chapter on affective disorders. His advice is practical, firmly addressing the difficulty of differentiation of the normal mood swings of adolescence from the pathological, as well as addressing the comorbidity of affective disorder. The concept of preadolescent bipolar disorder is relegated to three diplomatic sentences. Diagnostic instruments are recommended.
Christopher Gillberg wrote the informative chapters on autism, mental retardation/learning disability and co-authored the chapter of brain disorders. I found the chapter on elimination disorders with the accompanying parental questionnaire very useful. Another excellent, comprehensive chapter is on sleep disorders. The chapter on anxiety disorders with the numerous recommended assessment instruments and a practical relaxation script is useful but perhaps a little short on references to other experts in the field.
If this book genuinely represents the clinical practice of each of the experts writing the chapters in the most skeletal outline, it is a fascinating and sort of northern hemisphere guide to contemporary clinical practice. However, in my opinion, it failed because of its stark format to adequately address issues specific to child and adolescent practice, to stress that comorbidity and subsyndromal presentations, as well as psychosocial and service resourcing variables often compound the best laid evidenced based plans.
Given that the textbook is a work of such erudite clinicians and presented as a deskbook of evidence based practice, it may be too much to ask that a section at the end of each chapter be relegated to emerging questions and current controversies. The European bias certainly widened my knowledge. The uniformity of each chapter makes for easier reading. Its succinctness can be appealing too…being lighter to read in bed. But it relies heavily on the references for adequate coverage of the subject, and I would have appreciated more suggested readings especially for recommended treatment manuals.
I do intend to consider it as a tool for discussion with the multi-disciplinary team with whom I work and look forward the controversies to which it will doubtless lead with the psychologists involved. I think it would be a valuable addition to a departmental library. In my opinion this book is reasonably priced for a hard covered volume of this nature.