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Encyclopaedic guide to depression

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Mood disorders. Recognition and treatment. Peter R Joyce, Philip B Mitchell (editors). Sydney: UNSW Press, 2004 (xvi + 508 pp). ISBN 0 86840 447 0.

This is a big book about a big topic. Anyone concerned with observing — or improving — the human condition must be informed about mood disorders. The book covers both depression, which is the most common disorder, and the various levels of mania, where depression usually presents intermittently. Medical practitioners, in particular, need to be up-to-date in their knowledge of mood disorders in order to improve and save lives.

The editors begin wisely. Instead of starting their book with its subjects stretched out anatomised on dissecting room tables, they begin with descriptions of being depressed or being manic written by people who have experienced these conditions. Any reader who has escaped these painful and destructive disorders should read the descriptions carefully and reflect upon them. This book, of more than 500 pages, containing 40 essays by clinicians, covers everything from brain imaging and electroconvulsive therapy to psychotherapy. It is an encyclopaedia, worthy of its subject, and I used it like an encyclopaedia. I put it on my shelves and took it down when I wanted to expand my knowledge in a particular area, or to examine whether or not I was up-to-date on a topic. Professor Mulder’s contribution on the duration and natural course of depression is particularly important (it is often subdued but only occasionally totally vanquished). The book was both illuminating and helpful. Importantly, it is also very thoroughly referenced so that one can pursue a topic further if one wishes.

I would like to make one personal observation. To my mind depression is, in some respects, like pain. All pains have a lot in common, but there are many different causes of pain and many different kinds of pain. In most cases the cause determines the management (eg, the pain of acute appendicitis is better dealt with by appendicectomy than by referral to a pain unit). So it is with depression, but some contributors (eg, in “Psychological therapies for depression”) could lead one to believe that there are some invariant aspects of depression which require psychotherapy of some complexity. Sometimes this is true and sometimes not. Many patients make a full recovery with appropriate medication, some commonsense support, and information and advice of the kind that we would give to patients with diabetes mellitus.

Who should buy this book? Certainly all psychiatrists, but there are many other practitioners who have to deal with this common and lethal spectrum of disorders. For many it will not be their primary text, but it will be a very good resource when difficulties arise.

John H T Ellard
Psychiatrist, Sydney, NSW

 


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