Book Review

The Principles and Practice of Addictions in Psychiatry

N Engl J Med 1997; 337:59July 3, 1997

Article

The Principles and Practice of Addictions in Psychiatry
By Norman S. Miller. 567 pp. Philadelphia, W.B. Saunders, 1996. $70. ISBN: 0-7216-5211-5

This book only partially fulfills the promise of its title, which suggests that all relevant principles will be discussed and that an equal emphasis will be placed on clinical practice. The title A Resource Book for Psychiatrists Interested in Addictions would be more accurate, because this collection of 56 chapters addresses different aspects of addictions relevant to psychiatric practice but not all of the psychological, social, and biologic principles or practice approaches relevant to addictions.

The book has six sections, headed “Etiology,” “Neurobiology,” “Diagnosis,” “Treatment Approach,” “Treatment Process,” and “Pharmacological Treatments.” There are excellent chapters on genetic factors, neurocognitive syndromes and neuroimaging in addictions, substance-induced psychiatric disorders, the course of alcoholism, consultation–liaison psychiatry, the effects of benzodiazepine, psychotherapy and addictive disorders, and experimental pharmacological treatments.

This book may be particularly valuable in training psychiatrists to treat addictions. It serves as an entry into the vast empirical and clinical literatures. It may also acquaint physicians and other health care professionals with the psychiatric approach to the study and treatment of addictions. It is important to realize, however, that this book provides only part of the story. Important principles of psychology such as peer pressures, social learning, and rebelliousness are not discussed, nor are major mechanisms of psychobiology and addictive drugs.

Neil E. Grunberg, Ph.D.
Peter M. Scheufele
Uniformed Services University of the Health Sciences, Bethesda, MD 20814