Book Review

Women's Mental Health: A Comprehensive Textbook

N Engl J Med 2002; 347:1458October 31, 2002

Article

Women's Mental Health: A Comprehensive Textbook
Edited by Susan G. Kornstein and Anita H. Clayton. 638 pp. New York, Guilford Press, 2002. $65. ISBN: 1-57230-699-8

Less than a decade ago, as the editor-in-chief of American Psychiatric Press, I asked a senior colleague for an opinion about publishing a book on women's mental health. I was told that there were insufficient data to generate a full-length book and that a few papers might cover what was known. This 638-page book edited by Kornstein and Clayton illustrates how far we have come in a very short time.

The editors and authors of this book are to be congratulated for delivering a tour de force. They have produced a comprehensive, authoritative, and well-balanced book on sex and mental health. The editors have chosen their authors well and have accomplished an important task: they have managed to hold each author to a specific focus on his or her assigned topic. There is remarkably little repetition or overlap for a multiauthored book. The excellent cross-referencing enables the reader to find references and topics quickly. Each author has presented currently available data, considered conflicting information and opinions, and provided a synthesis and perspective that will be useful to readers as they navigate this complex, rapidly evolving body of information.

The book is divided into five parts. Part I, “Women's Psychobiology and Reproductive Life Cycle,” consists of seven chapters; it begins with a review of sex differences in biologic systems, which is followed by a review of the relevant psychopharmacology. The other chapters in Part I cover the psychiatric aspects of the reproductive life cycle. Each chapter is thorough, well written, and current. I would have been more comfortable, particularly in the chapter on psychopharmacology, with a disclosure of the author's sources of funding and possible conflicts of interest. Other chapters in the book might have benefited from such disclosures as well.

Part II, “Assessment and Treatment of Psychiatric Disorders in Women,” includes comprehensive reviews of our current understanding of a range of commonly seen psychiatric disorders and sex-related differences in etiology, prevalence, onset, types of presenting symptoms, course, treatment, and outcome. A necessary and useful chapter on complementary and alternative medicine, which appears misplaced in a sea of disorders, concludes the section.

Part III, “Psychiatric Consultation in Women,” covers major medical areas in which there is substantial sex-related information that would be important for primary care clinicians as well as for specialists. The chapters' topics include gynecology, oncology, rheumatologic diseases, endocrine disorders, cardiovascular disease, gastrointestinal disorders, the human immunodeficiency virus and AIDS, neurologic disorders, and cosmetic surgery. Each chapter presents its body of information in a succinct, well-thought-out manner, emphasizing the disorders with which women frequently present to the clinician.

Part IV, “Sociocultural Issues for Women,” covers sex roles and psychological development, marriage and family, career and workplace issues, trauma and violence, and issues particular to lesbian women, women of color, and aging and elderly women. This section incorporates much research from the social and behavioral sciences, which enhances the value of the previous sections in this book by placing their discussions in the context of Western societies. The authors review the relevant research, synthesize the major findings, and consider their implications. The final section of the book, “Research and Health Policy Issues,” includes excellent chapters on research methodology and on the implications for mental health policy of the material discussed in the earlier chapters.

This book puts many myths and much misunderstanding to rest. It presents the current state of the art in this rapidly growing field. It will be of special interest to those in mental health fields, but it will also serve the needs of all health care providers. The range and depth of information it provides are rarely found in one comprehensive reference book. I hope that future editions are already planned. The next edition will be needed very soon, at least in order to clarify recent developments, such as in the use of hormone-replacement therapy. The chapter covering this topic considers preliminary data that raise questions about the risks and benefits of hormone-replacement therapy, but more definitive information is already available. This book is a must for a reference library and for any clinician interested in women's health.

Carol Nadelson, M.D.
Harvard Medical School, Boston, MA 02115
carol_nadelson@hms.harvard.edu