Bipolar Disorder: Clinical and Neurobiological Foundations
Drs Yatham and Maj have edited a comprehensive textbook that covers the state of the art of what we know about bipolar disorder, entitled Bipolar Disorder: Clinical and Neurobiological Foundations. The textbook is ambitious in that it encompasses a broad area of subject matter ranging from epidemiology to clinical care to neurobiology. The textbook opens with 8 chapters, each relatively brief, describing the history of bipolar nomenclature and the general clinical presentation and epidemiology of the condition. Moreover, chapter 5 presents an overview of considerations toward changes that might occur in the diagnoses of bipolar disorders in DSM-5, which is certainly timely (although may be outdated by the time DSM-5 is actually published), and helps guide the reader to consider these changes during the rest of the text. Although none of the introductory chapters are particularly detailed, they provide a nice clinical framework for the rest of the textbook.
After this introductory material, the textbook shifts its focus to various research specialty areas in bipolar disorder. This section starts with a discussion of neurocognitive abnormalities in bipolar disorder; although this chapter is out of place (it would have been better immediately preceding the neuroimaging sections), it provides a brief, but relevant, review of the considerations surrounding this research area. Neurocognitive research has been actively looking for bipolar "endophenotypes" within cognitive assessments, and the neurocognitive abnormalities in bipolar disorder are often underappreciated. The textbook is then somewhat tangentially directed, with 2 unrelated, brief chapters—one on bipolar temperament ("The Genius-Insanity Debate") and one on economics—before a return to discussions of bipolar neurobiology. One wonders if these two rather short chapters could have been subsumed adequately in other areas of the book, leaving the neurobiology section better intact.
Beginning with chapter 11, however, the textbook goes into "high gear" by providing 10 chapters that discuss the neurobiology of bipolar disorder, with a particular emphasis on neuroimaging. Many of these chapters provide only a high-level, brief review. Taken together, though, they enable the reader to identify some of the potential models and the limitations to those models facing investigators who are developing hypotheses for the underlying neurophysiologic basis of bipolar illness. A notable exception to the generally brief overview is offered by Drs Lyoo and Renshaw (chapter 14), who provide a nicely comprehensive discussion of functional imaging techniques as applied to bipolar disorder that is a particularly useful review of the current state of investigation. Chapter 16, by Drs Nakic, Krystal, and Bhagwagar, is also a particularly well-written discussion of neurotransmitter systems in bipolar disorder that transcends the overly simplified monoamine hypotheses that have been all too common in considerations of the neurophysiology of bipolar disorder. These 10 chapters provide a relatively comprehensive overview of the field of bipolar neurophysiology.
The remainder of the textbook is dedicated to discussing the treatment of bipolar illness. Again, this section of the book is composed of relatively high-level brief overviews of various clinical studies and approaches toward managing bipolar disorder. Although each chapter is relatively brief, taken together, they provide a reasonably comprehensive overview of modern treatment considerations for bipolar disorder. Chapters on psychoeducation, cognitive-behavioral therapy, interpersonal and social rhythm therapy, family therapy, and collaborative care remind the reader of the importance of a programmatic approach to bipolar disorder treatment that is often overlooked in neurobiologically based textbooks.
This textbook provides a reasonable overview of our current understanding of clinical and neurobiological aspects of bipolar disorder. Although it lacks some of the depth present in more comprehensive texts (namely, Manic-Depressive Illness, edited by Goodwin and Jamison), this volume is recommended to clinicians who manage individuals with bipolar disorder and to investigators who wish to gain an initial overview of broad areas of interest in bipolar illness before pursuing these areas in more detail. The textbook is also an ideal starting point for trainees and young investigators just beginning to explore these subjects. Bipolar Disorder: Clinical and Neurobiological Foundations, then, is a useful addition to the library of most clinicians and academic psychiatrists.
Author affiliation: University of Cincinnati College of Medicine, Cincinnati, Ohio. Potential conflicts of interest: During 2011, Dr Strakowski has received research support (grants to the University of Cincinnati Department of Psychiatry) as a principal investigator from National Institute of Mental Health and Janssen and as a coinvestigator from Eli Lilly, Janssen/Johnson & Johnson, AstraZeneca, Sumitomo, Pfizer, National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, National Institute of Mental Health, and NARSAD; has been a consultant for University of Utah; has been a speaker for Johns Hopkins University; and has directed discussion on WebMD. During 2010, he received research support (grants to the University of Cincinnati Academic Health Center) from Eli Lilly, Janssen, AstraZeneca, Martek, Nutrition 21, Repligen, National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, National Institute of Mental Health, and NARSAD; was a speaker for American Association of Child and Adolescent Psychiatry and CME Outfitters; chaired a symposium for Consensus Medical Communications (CME through University of Minnesota; unrestricted grant from Ortho McNeil/Janssen); mentored at a young investigator meeting of the American Psychiatric Association; and directed discussion on WebMD.
doi:10.4088/JCP.11bk07194
© Copyright 2011 Physicians Postgraduate Press, Inc.
