Book Review

Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression

N Engl J Med 2007; 357:2414-2415December 6, 2007

Article

Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression
Second edition. By Frederick K. Goodwin and Kay Redfield Jamison. 1262 pp., illustrated. New York, Oxford University Press, 2007. $99. ISBN: 978-0-19-513579-4

The first edition of Goodwin and Jamison's book on manic depressive illness, published in 1990, became a classic, and clinicians, researchers, and patients alike frequently referred to it as the bible of bipolar disorders. Producing the much-anticipated second edition of this masterpiece must have been a daunting task, but the editors recruited 15 experts in the field to help collate findings of research since the publication of the first edition, to develop an updated and improved version of their book. It is a tour de force that I expect will receive the universal acclaim given to its predecessor and will be the key resource and reference book in the field for the coming decade. The combination of compassion and science marks this book as psychiatry at its best. There is no equivalent book on manic depression or any other mental disorder, and indeed there are few biomedical science books that match it in either the quality of the writing or the broad-based appeal it will have to the clinical and research communities. It also was up to date at the time of publication and includes references to papers that were published in late 2006.

Some key aspects of the first edition are retained in the second edition. The structure is similar, with clear transitions from the review of clinical descriptions and diagnosis, to clinical studies, to psychology and neuropsychology research, to pathophysiology, and on to the range of pharmacologic and psychological treatments that can be used in acute continuation and maintenance treatment. The authors' ability to draw together an immense and diverse knowledge base into a logical and comprehensive overview is impressive, and while the review of the current evidence base is authoritative, the human face of manic depression and the experience of this disorder among artists, writers, and composers are illuminating.

The second edition does, however, have some differences from the first edition. The most important, as highlighted by the book's title, is the inclusion of data on recurrent depression. This places Goodwin and Jamison's thinking on manic depression in line with Emil Kraepelin's view; they argue that recurrent depression and manic depression have more in common than recurrent depression has with other unipolar disorders. Given this book's contribution to the debate on the classification of mental disorders and its role in the identification of future trends in research, the importance of this perspective should not be underestimated. First, it promotes the idea that cyclicity (i.e., the tendency to recurrence) is more important than polarity. Many current systems of classification divide mood disorders into bipolar disorders and unipolar disorders; this way of thinking is clearly challenged by the evidence presented in this book. Second, this approach to classification has implications for basic science research, since the authors note that we cannot identify underlying genetic risk until we know what we are looking for. It will be interesting to see how these ideas shape forthcoming reviews of classification.

Other changes to the book are less controversial and relate mainly to the style of presentation. The book is heavier than its predecessor, weighing in at more than 6 lb, and it has 200 more pages. This allows for a more detailed discussion of recent research and also for the incorporation of fundamental background information on some key issues. For example, in addition to reviewing key randomized, controlled treatment trials, the authors provide an overview of specific aspects of the design and methods of randomized trials in general. The only other change between the previous and current editions is the one I liked the least — the references are presented at the end of the book, separately for each chapter, instead of as a single reference section in alphabetical order. I am not sure if this new approach has any added value — references to key papers are duplicated many times in the reference lists of the chapters on treatment, and it seems more complicated for a reader who simply wants to check on whether certain references have made it into the new edition. On a more positive note, given the fear that textbooks are at risk of being out of date by the time they are sent to press, it is impressive that the book discusses publications that are less than a year old.

Given the quality and importance of this book, it is a must for any medical library, and many readers will acquire their own personal copy. The only question that remains is whether future editions of this book will be in an electronic format to which updates could be added as needed. Indeed, this contribution to our thinking on mood disorders is of sufficient importance that we already need to be planning for the next edition.

Jan Scott, M.D., Ph.D.
University of Newcastle upon Tyne, Newcastle upon Tyne NE2 3LN, United Kingdom