Psychiatric Primary Care
Linda Denise Oakley, Claudette Potter
Mosby-Year Book, Inc, 11830 Westline Industrial Dr, St Louis, MO 63146 USA
1997/448 pp
Strengths
Assessment and DSM-IV diagnosis
Weakness
Specific pharmacologie treatment
Audience
Family physicians and allied mental health professionals
The authors of this ambitious book state, “We have developed a book for primary care practitioners that presents everything from basic mental concepts and terms to clinical examples of psychiatric primary care.”
The book is divided into five parts that deal with basic concepts of assessment and diagnosis; common mental disorders; psychosocial problems; special populations and problems, such as children; and practice notes covering mental health laws, threatening patients, and clinical vignettes.
Illnesses are conceptualized in the biopsychosocial model, and diagnoses are based on DSM-IV definitions. This book is very strong in assessing mental disorders, presenting epidemiologic data, risk factors, psychiatric terminology, and DSM-IV criteria. It is also strong in addressing the psychosocial context in which mental illnesses occur.
This book is too general in the area of management. For example, in treating depression, information on using specific medications and dosages is not provided. As well, while cognitive-behavioural therapy is mentioned, advice on how to use it in specific disorders is not given. This wide-angle perspective on management, especially pharmacologie treatment, probably arises from the nursing background and praètice of the authors.
It is important to note, given the book’s emphasis on DSM-IV diagnoses, that the DSM itself is continually evolving and that its diagnoses are based strictly on empirical clinical presentation. We would be wise to acknowledge the ambiguities of human nature and not thoughtlessly use formulae to reduce the complexities and richness of human expression into 5-digit codes.
This book excels in teaching attitude and background knowledge of psychiatric primary care. However, specific knowledge and skills are still required for proficient practice. The book describes certain important aspects of continuing education in psychiatric primary care for Canadian physicians.