Psychiatric Diagnosis. 4th Edition

In their preface to the fourth edition of Psychiatric Diagnosis, authors Goodwin and Guze are clear on the limitations of their work: there is little "theory" or "speculation" nor any unproved claims in this review of a dozen psychiatric diagnoses. While this approach leaves a straightforward and complete compendium of current knowledge, it also handicaps the work. Like other texts, it provides the most current diagnostic definitions and clinical approaches. Unlike more speculative works on psychiatric diagnosis, it offers nothing interesting or exciting. What is left is a complete, but not comprehensive, up-to-date, but dull text. A final chapter presents topics addressed in a psychiatric examination, but is neither complete nor systematic; while this chapter may be of some use to a medical student who has never conducted a psychiatric interview, it would be of little use to a clinician. The chapters themselves provide complete definitions of each diagnosis, with an emphasis on DSM-III-R criteria (which are included verbatim). The historical accounts of the developing nosologies are perhaps the most interesting parts of the chapters. The epidemiological sections provide some substantive data but reflect the often conflicting accounts of prevalence. Several chapters augment this epidemiological data with descriptions of family studies. The sections on clinical data, etiology, and treatment are well written and complete and include transcripted examples. Additional sections on differential diagnosis are included but, in general, are very brief and offer little discussion on either psychometric measures or clinical data which would be of use in distinguishing one diagnosis from another. References at the end of each chapter are extensive and complement the evidence presented throughout the chapters. In particular , the chapters on hysterical disorders and sociopathy are excellent presentations. Although Psychiatric Diagnosis presents solid accounts of eleven disorders, it offers nothing more-in fact, much less-than many other texts. In intentionally omitting their own opinions, the authors have also left out any clinical wisdom which may be critical in making a diagnosis. The text is certainly well written and well researched, but one gets the sense throughout that too much is missing, and that there is nothing unique about it. The book attempts to tackle such relevant topics as alcoholism and anorexia nervosa while eliminating much of the speculative and theoretical research which, although not "absolute proof" for etiology, clinical course, or treatment, has sparked so much of the creative thinking on these disorders. Much of psychiatry …