Book Review

Comprehensive Adolescent Health Care

N Engl J Med 1993; 328:1580May 27, 1993

Article

Comprehensive Adolescent Health Care
Edited by Stanford B. Friedman, Martin Fisher, and S. Kenneth Schonberg. 1231 pp., illustrated. St. Louis, Quality Medical, 1992. $85. ISBN: 0-942219-14-7

Comprehensive Adolescent Health Care is an encyclopedic textbook dealing with the physical and mental health of teenagers. The authors represent many different disciplines -- there are physicians from many specialties, as well as behavioral and education specialists, among others. The book is divided into five sections covering the principles of adolescent medicine; medical disorders; psychosocial issues; gynecology, urology, and sexual issues; and surgery in adolescents. The editors designed the book to provide comprehensive information on primary health care for adolescents and their families.

I read 80 of the 141 chapters and skimmed the remaining chapters to get an impression of their content. The book is well referenced overall, and it provides a more comprehensive overview of the field than previous books in this area. There are good discussions of high-risk behavior in general, as well as of substance abuse, sexually transmitted diseases, pregnancy, and contraception. I read the section on psychosocial issues and the adolescent from the perspectives of clinician, teacher, and father of two adolescents. There were many good practical points that I could (and will) put to use in all those roles.

In the preface the editors warn of some redundancy in several of the chapters; this is particularly evident in the sections on principles and medical disorders. Several authors, particularly in the medical-aspects section, do not include a developmental perspective when discussing medical issues; they may describe the differences among infants and children, adults, and teenagers, without discussing why prevalence or presentation is different in these age groups. Although there are insightful chapters on the impact of poverty and violence on youth, the majority of this book, like most others, is directed toward middle-class adolescents.

Considering that the cost of Comprehensive Adolescent Health Care is within dollars of that of far less comprehensive books on adolescent health, and given its many strong points, this book deserves a strong recommendation. Another recently released book on adolescent health (E. McAnarney et al., eds. Textbook of Adolescent Medicine. Philadelphia: W.B. Saunders, 1992) is more focused on the developmental and maturational aspects of adolescent health, but it is more expensive than this one. The primary health care provider, particularly one with a limited budget, should find Comprehensive Adolescent Health Care a cost-effective reference for adolescent patients and their families.

Frank M. Biro, M.D.
Children's Hospital Medical Center, Cincinnati, OH 45208