This handbook on primary care psychiatry is one of several similar books, all with similar names. In the spirit of full disclosure, I should note that I am the coeditor and coauthor of one of these books, but I am also pleased to note that I am excited about Massachusetts General Hospital's contribution to this genre of primary care textbooks.
The first edition of this outline-based but hefty compendium was published in 1998, and the second edition has been expanded in a targeted and helpful fashion, with several new chapters and appropriate updating of most chapters. While a substantial majority of the authors of the first edition continue into the second edition, many new authors are listed, suggesting fresh ideas and constructive turnover. The editors imply that there is substantial collaboration and coauthorship between psychiatrists and primary care physicians, but a majority of the chapters appear to be written exclusively by psychiatrists, although presumably with some primary care oversight. Of the 97 authors, 76 are listed as having psychiatric appointments or affiliations.
The first edition was organized according to the patient's presenting symptom or psychiatric complaint, followed by a lengthy list of chapters on therapeutic strategies, counseling strategies, and pharmacologic approaches. The second edition reorganizes these chapters and adds several helpful sections on therapeutic complications, quality-of-life–enhancing strategies, and physician-assistance strategies, including particularly helpful new chapters on natural medications in psychiatry and treatment decisions at the end of life. Many, although sadly not all, chapters have helpful figures and tables that summarize the most critical information. Other chapters would have benefited from substantial revisions, such as “Screening Tests for the Detection of Psychiatric Disorders,” in which several common instruments are described but not provided, thus lessening the practical value of the information.
This deficiency is emblematic of a larger issue, which is that the specific target audience and use for the book are not entirely clear. The book is too big to carry around, too detailed to be used by medical students, too limited to be employed as a comprehensive textbook, and too textual to function as a point-of-care decision support tool. However, it is an authoritative and substantive assemblage of clinically useful information, especially for primary care residents, teachers, and clinicians with a special interest in primary care psychiatry.