Book Review

Child and Adolescent Psychiatry

N Engl J Med 1996; 335:1469November 7, 1996

Article

Child and Adolescent Psychiatry
(Mosby's Neurology Psychiatry Access Series.) Edited by Dean X. Parmelee. 360 pp. St. Louis, Mosby, 1996. $59.95. ISBN: 0-8151-6809-8

Child and Adolescent Psychiatry is intended for the general pediatrician and the family practitioner, but it is so succinct and well written that any professional in a health-related field who works with children and adolescents could use it. It would be especially useful as a primary textbook for health professionals in fields other than psychiatry and as a general textbook for beginners in a fellowship in child and adolescent psychiatry or psychology training.

The book's three sections were edited by outstanding leaders in the field, and the chapters have been written by specialists. The first section covers the initial assessment and evaluation. Its three chapters deal with the psychiatric examination and diagnosis in children and adolescents, diagnostic instruments, and brain imaging in psychiatry with children and adolescents. Each of these chapters contains excellent practical information and explanations. One may think at first that the information in chapter 1 is too well known, but it is not. The practical information in chapter 2 includes the rating scales in common use to evaluate specific psychiatric diagnoses. The chapter on imaging is a good, basic introduction to the use of imaging methods in psychiatric disorders of children.

The second section, on diagnostic categories, has chapters on pervasive developmental disorders, attention-deficit–hyperactivity disorder, conduct disorder and oppositional defiant disorder, anxiety disorders, mood disorders, eating disorders, schizophrenia, and learning disorders. Each of these contains excellent tables that summarize the diagnostic criteria and the discriminating, consistent, and variable features of these disorders, along with boxed information pointing out pearls and perils. Each chapter also has a section entitled, “Consider consultation when. . . .” Many of these illnesses, in our opinion, are so complicated and difficult to diagnose and treat that they more than likely require early specialty intervention, when there is even the slightest suspicion of a problem. Early and correct intervention helps to keep the children on their developmental trajectory.

The third section targets specific clinical conditions and groups of patients that are difficult to manage, such as aggressive behavior and the suicidal child and adolescent. A section on the at-risk infant has excellent tables outlining the infant-development screening tests, the age at which tests should be given, and the time they take to administer. In this chapter there is also a copy of the Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale scoring sheet, a “clinically expedient, reliable, and valid test that screens cognitive and language development as well as neurologic function,” and the commonly used Achenbach's Child Behavior Checklist. This section includes important charts, including decision trees for assessing suicide risk, substance abuse, enuresis, and encopresis. The psychopharmacologic treatment of these disorders is reviewed but is not the main emphasis of this book.

Child and Adolescent Psychiatry, a book that has long been awaited by nonpsychiatrists, is welcome not only as a textbook for the student but also as an important reference for the general practitioner.

Kathleen A. Moreno, M.D.
Dennis P. Cantwell, M.D.
University of California, Los Angeles, Los Angeles, CA 90024