Hong Kong J Psychiatry 2001;11(4):25-27
Book Reviews
Kaplan & Sadock’s Pocket Handbook of
Clinical Psychiatry, 3rd Edition
Authors: Sadock BJ, Sadock VA.
Lippincott Williams & Wilkins, Philadelphia, USA, 2001.
US$49.95; pp: 479; ISBN: 0-7817-2532-1.
As the authors emphasise, the Pocket Handbook of Clinical There are also overviews of management, including
Psychiatry is not meant to be a substitute for a major textbook psychotherapy, psychopharmacology, laboratory tests, and
of psychiatry. Rather, it aims to serve as an easily accessible brain imaging. The chapter on psychopharmacology is
guide for medical students, psychiatric residents, and especially worth mentioning, as it includes updated
psychiatrists to consult in their clinical work. Thus, one information on new antidepressants, new antipsychotics/
would expect features to suit this purpose, being brief, serotonin-dopamine antagonists, and the cholinesterase
concise, clinically oriented, and convenient to use. Is it so? inhibitors. Not only are the pharmacological actions, side
The book is written in note form with clear headings effects, drug interactions, and clinical guidelines provided
and points. Useful information and clinical tips are tabulated but one can also ‘see’ the drugs as there is a 5-page guide
for easy reference. There are 28 chapters. The first 3 chapters containing colour reproductions of commonly prescribed
are general introductions covering history taking, mental psychotherapeutic drugs. There is a separate chapter on
state examination, psychopathology, and classification of medication-induced movement disorders, which covers
mental disorders. Mental phenomena that relate to signs and neuroleptic-induced parkinsonism, acute dystonia, acute
symptoms are listed in alphabetical order followed by their akathisia, tardive dyskinesia, neuroleptic malignant
def initions. The list is by no means complete but is syndrome, and postural tremor. Each disorder is described
comprehensive enough for a quick reference, which will in detail and the Abnormal Involuntary Movement Scale
inevitably be most welcomed by medical students who like examination procedure is also included, which may help to
to recite definitions without necessarily understanding what remind medical students and trainees who often overlook
they really mean. The part on clinical assessment does these common side effects.
highlight important features and summarises them in tables, There are also several chapters covering different
which are abundantly utilised in other parts of the handbook subspecialties such as child and adolescent psychiatry,
as well. Of particular interest is a table summarising special geriatric psychiatry, psychosomatic medicine, and forensic
interview situations, such as ‘seductive patients’, ‘patients aspects of psychiatry. This arrangement, however, causes
who lie’, and ‘patients from different cultures and considerable overlap within the chapters and may be the
backgrounds’, which may alert novices and offer them advice biggest drawback to the book. For instance, there is a chapter
on how to deal with the situation. on delirium, dementia, and other cognitive disorders,
The other chapters are mainly arranged according to classified in the diagnostic category, but information on
diagnostic categories in the Diagnostic and Statistical dementia is also given in the chapter on geriatric psychiatry.
Manual of Mental Disorders, 4th edition. Concise summaries Another example is that there is a chapter on psychosomatic
covering essential aspects of aetiology, epidemiology, medicine/consultation liaison psychiatry but relevant aspects
clinical features, and treatment for a range of psychiatric are only highlighted in the chapter. The details are scattered
disorders are given. They include delirium, dementia, mental throughout the other parts of the book. If one looks at the
disorders due to a general medical condition, alcohol-related table summarising the common consultation-liaison
and substance-related disorders, schizophrenia and other problems, one will f ind ‘suicide attempt or threat’,
psychotic disorders, mood disorders, anxiety disorders, ‘disorientation’, and ‘non-compliance or refusal to consent
somatoform and factitious disorders, dissociative disorders, to procedure’, but the details of how to deal with these
sexual dysfunction and paraphilias, eating disorders, sleep problems are found in different chapters. The assessment
disorders, impulse-control disorders, and personality and management of suicidal patients are found in the chapter
disorders. Information is given in the following format: on suicide, and violent and other psychiatric emergencies.
definition, epidemiology, aetiology, diagnosis, signs and Delirium is described in detail in the chapter on delirium,
symptoms, laboratory tests, differential diagnosis, course dementia, and cognitive disorders. Issues on consent are
and prognosis, and treatment. Everything is mentioned discussed in the chapter on legal and ethical issues. As a
briefly but concisely. It is assumed that the readers have pocket reference, this layout may cause considerable
already understood the concepts and the terms are simply confusion. The commonest way of using a handbook is to
reminders. Otherwise, referral should be made to the parent look for a subject in the index, but this handbook is not
text Comprehensive Textbook of Psychiatry edited by the particularly user-friendly as some of the relevant pages are
same authors. not shown under a particular subject in the index. For
25
Book Reviews
instance, when looking for ‘vascular dementia’ only the page textbook, it has to be read thoroughly as a textbook before
numbers on vascular dementia in the elderly are shown and one can use it as a day-to-day clinical guide. Indeed, the
the general information for vascular dementia in the other authors never forget to remind the readers to look up the
chapters is not indexed. This means that unless one is familiar more detailed discussion in the full textbook by giving the
with the layout of the handbook as a whole, one is unlikely cross-reference page numbers. For medical students or junior
to get all the information that is provided for a particular trainees, this handbook may be useful for revision for
topic. examinations and is not too overwhelming.
To answer the initial question of whether this handbook
serves its purpose, we can thus conclude that it satisfies 3 Dr Irene Kam
of the 4 features – concise, brief, and clinically oriented. Department of Psychiatry
However, as a pocket reference, it lacks the convenience Prince of Wales Hospital
and seems to be more of an abridged version of the Shatin
Comprehensive Textbook of Psychiatry edited by the same Hong Kong
authors. Despite the authors’ emphasis that this is not a China
Critical Appraisal of Medical Literature
Editor: Marchevsky D.
Kluver Academic/Plenum Publishers, New York, USA, 2000.
US$55.00; pp288; ISBN 0-306-46474-8.
There has been an enormous number of publications on main text if little time is available for reading. This is
medical statistics and critical appraisal in recent years. This particularly important for examination candidates who look
is in keeping with the recent trend in the application of for materials to help with multiple choice examinations and
evidence-based medicine (EBM) in clinical practice and short questions.
clinical audit, as well as professional examination. Part II of this book is the most relevant section to the
We are often confused by the number of EBM textbooks critical review paper of the Member of the Royal College of
that are written by people from different professional Psychiatry (MRCPsych) Part II Examination. The section
backgrounds. To most psychiatrists, books geared towards starts with a few chapters giving the general framework of
polishing critical appraisal skills that are sufficient for critical appraisal technique, which is then consistently
examination and continuous self education purposes, applied to the appraisal of different research designs in the
perhaps written by psychiatrists, would be most relevant and subsequent chapters.
appealing. Existing books on EBM usually adopt various This section encompasses papers on treatment, diagnosis,
approaches. Some of them start from research questions, aetiology, literature review and meta-analysis, audit, clinical
research methodology, and hypothesis testing while some guidelines, and qualitative research. Checklists of items to
adopt the ‘top-down’ approach by appraising the study results consider in appraising different research methodologies are
yielded by different research methodologies. This book, compiled in a summary chapter at the end of Part II providing
however, is written by a psychiatrist who adopts both a quick tool of reference.
approaches. Part III endeavours to cover the various statistical
The book is divided into 3 parts. Part I is devoted to the techniques, including the z-test, t-test, analysis of variance,
discussion of the basic concepts of EBM, in terms of non-parametric tests, correlation, regression and prediction,
probability, variable and measurement, distribution, and multivariate analysis. The coverage is adequate for most
hypothesis testing, research methodology, bias, and errors clinicians and potential MRCPsych examination candidates.
as well as epidemiology. Part II focuses on the approaches On the other hand, in-depth illustrations of the mathematical
to critical appraisal of a wide range of research papers. Part steps and tabulation processes of statistical analysis are
III deals with the more sophisticated statistical concepts of lacking, which makes it difficult for beginners to follow.
multivariate analysis and non-parametric tests. The author has, however, made it quite clear that it was not
All topics are organised into short, concise chapters that his aim to teach the computational technique in-depth, hence
can be read in less than 15 minutes. The theories are this part of the book cannot replace standard statistical
illustrated both conceptually and mathematically and textbooks and manuals.
narrated in lucid English. The author has included summaries In general, this book serves to reach the general audience
in note form at the end of each chapter that are with little or no background in research methodology and
comprehensive yet concise enough to allow one to skip the EBM. It is of great relevance to MRCPsych examination
26
Book Reviews
candidates for a quick grasp of the essential approaches to Dr Sandra SM Chan
critical appraisal. However, exercises for taking the Assistant Professor
Membership examination are lacking. Therefore, Department of Psychiatry
examination-oriented readers might need to refer to other The Chinese University of Hong Kong
exercise books on critical appraisal. Hong Kong, China
Kaplan & Sadock’s Synopsis of Psychiatry,
8th Edition, and Study Guide and
Self-Examination Review, CD-ROM,
6th Edition
Editors: Kaplan HJ, Sadock BJ.
Lippincott Williams & Wilkins, Philadelphia, USA, 2000.
US$125.00; ISBN: 0-7817-2142-5.
E-books have become more popular recently. Their compact Review. It will be welcomed by trainees who have to sit for
size, the ease with which you can carry them anywhere, and membership examination abroad — a notebook computer
their environmentally friendly nature are unbeatable features. and a CD-ROM will be invaluable tools.
Most importantly, you can search for a term or subject much The Study Guide is the most interesting part of the entire
more quickly than in traditional books. CD-ROM versions CD-ROM. It contains 1615 questions formatted according
of major textbooks may be considered precursors of today’s to the United States Medical Licensing Examination.
e-books. If you are accustomed to work or study in front of Questions cover 6 sections, including the foundations of
a computer, they are more convenient than references on psychiatry, clinical disorders, psychiatric treatment, child
the shelf. and adolescent psychiatry, special issues, and a continuing
The Synopsis is an abridged version of a typical medical education test.
American psychiatric textbook, and its content and format These questions are best used as a review tool rather
are similar to many others, with too much emphasis on the than for primary study prior to the examination for Member
Diagnostic and Statistical Manual of Mental Disorders, 4th of the Royal College of Psychiatry as they are relatively
edition, classification as the backbone of the text and a easy. Explanations of both right and wrong answers are
weakness in its coverage of psychopathology. Sections on provided for each question, with the cross-referenced
foundation sciences in psychiatry such as psychosocial chapters of the Synopsis just a mouse click away. The
sciences and neurosciences are readable and concise. The programme also features a scoring record to track your
text also contains a number of comprehensive tables that study. Although the questions are easy, they are distilled from
are helpful for quick revision. the text to highlight the practical aspects of clinical
The CD-ROM is not designed solely as a reference piece. psychiatry.
Chapters can be manipulated to suit individual readers, as In summary, the CD-ROM versions of the Synopsis and
the programme has functions that allow readers to highlight Review may be more useful than the hard copy of these books
text in multiple colours, add book marks, and type notes if you plan to utilise the special features. However, if you
anywhere in the text. Readers can also copy and paste are not a trainee with an examination ahead, you might
selected content to create revision notes in Word format. consider buying a CD-ROM version of the Comprehensive
For teaching purposes, it is easy to copy the figures, tables, Textbook of Psychiatry instead. Finally, there are some bugs
and images to your PowerPoint presentations, and this is in the programme if you are using the Chinese version of
permitted within the framework stated in the license the Windows 98 platform to run this CD-ROM.
agreement.
On first receiving this CD-ROM, however, I questioned Dr WS Chung
the need for another digital book in this well-known Consultant Psychiatrist
psychiatric series, since the Comprehensive Textbook of Department of Psychiatry
Psychiatry has already been published in CD-ROM version. Shatin Hospital
This CD-ROM, however, includes another important Hong Kong
resource, namely the Study Guide and Self-examination China
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