Pub Date : 2018-05-28DOI: 10.1177/0706743718779981
A. Douglass
The purpose of this book is to introduce a new and comprehensive type of cognitive behavioural treatment for insomnia (CBTi), which the authors have called “TranS-C,” for “transdiagnostic sleep and circadian intervention.” It is clearly aimed at psychologists who are already doing CBTi in their practice but who wish to have a broader set of treatments to offer. While the book has little to say about medication treatment for insomnia, it amply fulfills its purpose with a very detailed elaboration of the proposed multipronged attack on sleep disorders—it is not just a book about insomnia. The authors accurately note the modern conception of insomnia and depression as being a “two-way street,” in that sufficient sleep disruption from any cause appears to trigger depression, while depression has insomnia as one of its major symptoms. Over long follow-up, there are also other patients who demonstrate either pure insomnia or pure depression. These authors are extremely well qualified to write on this topic. Dr. Buysse is the lead author of the Pittsburgh Sleep Quality Inventory (PSQI), which is currently the most frequently used questionnaire in the world to assess subjective sleep quality. He is also a career-long author in the area of insomnia and cognitive behavioural treatment. Likewise, Dr. Harvey is an internationally respected authority in the field whose career focusses mainly on CBTi. The main thesis of the book is that existing psychological treatments for sleep disorders have been too narrowly focussed on insomnia and have not operationally included a large amount of recent neurobiological findings. The “transdiagnostic approach” that they propose is quite complex. It consists of unlinking existing treatments from particular disorders and looking at the problem much more broadly. One benefit is that patients with more serious and complex problems can be treated, such as a bipolar patient with severe insomnia and sleep apnea. Also, elements of other existing treatments have been incorporated in the method, such as chronotherapy and motivational interviewing. The major areas of focus for the new treatment are sleep schedule regularity, subjective satisfaction with sleep, alertness during the daylight hours, ability to sleep efficiently (i.e., few awakenings while in bed), timing of the patient’s sleep in the 24 hours, and sleep duration. They further subdivide the treatment into “cross-cutting modules,” “core modules,” and “optional modules.” Numerous tips and techniques for obtaining the sleep history initially are provided, as well as hints for interventions when the therapy sessions do not seem to be going well. This volume amounts to a core textbook for psychologists or other therapists doing CBTi. It is sufficiently detailed that a current practitioner could learn many of the therapy principles directly from the book, although medication treatment and continuous positive airway pressure for sleep apnea are described only briefly. Canadian
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Pub Date : 2018-04-09DOI: 10.1177/0706743718758042
G. Remington
{"title":"Book Review: The Schizophrenia Spectrum","authors":"G. Remington","doi":"10.1177/0706743718758042","DOIUrl":"https://doi.org/10.1177/0706743718758042","url":null,"abstract":"","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127757226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-03-21DOI: 10.1177/0706743718760509
R. Tempier
Lithium is one of the most important medications available to psychiatry, and while it was used extensively in the past, the use of lithium therapy is now decreasing, especially in North America. Why? One of the reasons could be the side effects of the drug, but it could also be that this medication might not be as well known as one would think. This book by Malhi et al. will help psychiatrists as well as other physicians and health professionals update and improve their knowledge of lithium, providing a much better understanding of the mechanisms of action, the reasons for use, and the art of prescribing lithium salts. The general purpose of this book is to give a clear and comprehensive picture of what lithium does in the body and how to use it optimally. This book fulfills its purpose well in 21 chapters and more than 300 pages. To my knowledge, it is one of the most comprehensive and up-to-date reviews on lithium therapy. The book is divided into 2 parts. The first part fully explains the “science” of lithium, which includes the pharmacodynamics and the pharmacokinetics of this ion, its impact on neurotransmission and the cellular mechanism, as well as pharmacogenomics or lithium response variability. The second part focuses on the use of lithium in clinical practice, starting with recommendations for international guidelines for lithium therapy; it includes its use mainly in the acute and maintenance treatment of bipolar disorders and its particular value in suicide prevention. There is also a chapter on shortand mid-term side effects of lithium treatment. In the practice section, the book also reviews in detail lithium toxicity and the impact on the kidney, a very important issue for any dedicated clinician. The authors address the administration of lithium during pregnancy as well as its pediatric use, an approach, I think, unfamiliar to most clinicians. There is a chapter on the use of lithium within the elderly population, a consideration that will grow in importance in the years to come. Lithium is the mood stabilizer par excellence and should be revisited. I was particularly interested in the history of lithium in medicine and psychiatry, as well as various other chapters, such as the one on the neuroprotective effect and its effects on the stabilization of circadian rhythms. The book includes an appendix on the lithium battery– clinical in order to probe neurocognitive assessment during lithium treatment. For each chapter of the book, key points are highlighted. Numerous contributors (49), most from France, authored many of the chapters. It is written in good English, and the text is clear and not difficult to read. The book appears to be free of any conflict of interest or any commercial purposes. Its price is relatively reasonable for this kind of specialized book. The Canadian Journal of Psychiatry / La Revue Canadienne de Psychiatrie 2018, Vol. 63(5) 337 a The Author(s) 2018 Reprints and permission: sagepub.com/journalsPermissions
锂是精神病学最重要的药物之一，虽然它在过去被广泛使用，但锂治疗的使用现在正在减少，尤其是在北美。为什么?其中一个原因可能是药物的副作用，但也可能是这种药物可能不像人们想象的那样为人所知。Malhi等人的这本书将帮助精神科医生以及其他医生和卫生专业人员更新和提高他们对锂的认识，更好地理解锂盐的作用机制、使用原因和处方艺术。这本书的一般目的是给一个清晰和全面的图景，什么锂做在身体和如何最佳地使用它。这本书有21章，300多页，很好地实现了它的目的。据我所知，这是关于锂治疗最全面和最新的评论之一。本书分为两部分。第一部分全面阐述了锂离子的“科学”，包括锂离子的药效学和药代动力学，对神经传递和细胞机制的影响，以及药物基因组学或锂反应变异性。第二部分侧重于锂在临床实践中的使用，从锂治疗国际指南的建议开始;它包括其主要用于双相情感障碍的急性和维持治疗及其在自杀预防方面的特殊价值。还有一章是关于锂治疗的短期和中期副作用。在实践部分，本书还详细回顾了锂的毒性和对肾脏的影响，这对任何专职临床医生来说都是一个非常重要的问题。作者讨论了怀孕期间锂的管理以及它的儿科使用，我认为大多数临床医生都不熟悉这种方法。书中有一章是关于在老年人口中使用锂的，这一考虑在未来几年将变得越来越重要。锂是最优秀的情绪稳定剂，应该重新审视。我特别感兴趣的是锂在医学和精神病学中的历史，以及其他章节，比如关于神经保护作用及其对昼夜节律稳定的影响的章节。这本书包括一个附录的锂电池-临床，以探索在锂治疗期间的神经认知评估。书中的每一章都有重点。许多作者(49人)，大多数来自法国，撰写了许多章节。它是用很好的英语写的，文字清晰，不难读。这本书似乎没有任何利益冲突或任何商业目的。它的价格对于这种专业书籍来说是比较合理的。加拿大精神病学杂志/ La Revue Canadienne de Psychiatry 2018, Vol. 63(5) 337 a .作者(s) 2018转载并许可:sagepub.com/journalsPermissions.nav TheCJP。ca / LaRCP。加拿大精神病学协会
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Pub Date : 2018-01-22DOI: 10.1177/0706743717737308
R. Hibbard
{"title":"Book Review: Stepped Care for Borderline Personality Disorder","authors":"R. Hibbard","doi":"10.1177/0706743717737308","DOIUrl":"https://doi.org/10.1177/0706743717737308","url":null,"abstract":"","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114396609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-01DOI: 10.1177/0706743716677724
R. Whitley, Jiawei Wang, M. Fleury, Aihua Liu, J. Caron
Objective: To examine variations between immigrants and nonimmigrants in 1) prevalence of common mental disorders and other mental health variables; 2) health service utilisation for emotional problems, mental disorders, and addictions, and 3) health service satisfaction. Methods: This article is based on a longitudinal cohort study conducted from May 2007 to the present: the Epidemiological Catchment Area Study of Montreal South-West (ZEPSOM). Participants were followed up at 4 time points (T1, n = 2433; T4, n = 1095). Core exposure variables include immigrant status (immigrant vs. nonimmigrant), duration of residence, and region of origin. Key outcome variables included mental health status, health service utilisation, and health service satisfaction. Data were analysed both cross-sectionally and longitudinally. Results: Immigrants had been in Canada for 20 years on average. Immigrants had significantly lower rates of high psychological distress (32.6% vs. 39.1%, P = 0.016), alcohol dependence (1.4% vs. 3.9%, P =0.010), depression (5.2% vs. 9.2%, P = 0.008), and various other mental disorders. They had significantly higher scores of mental well-being (48.9 vs. 47.1 score, P = 0.014) and satisfaction with social (34.0 vs. 33.4 score, P = 0.021) and personal relationships (16.7 vs. 15.6 score, P < 0.001). Immigrants had significantly lower rates of health service utilisation for emotional problems, mental disorders, and addictions and significantly higher rates of health service satisfaction at all time points. Asian and African immigrants had particularly low rates of utilisation and high rates of satisfaction. Conclusions: Immigrants had better overall mental health than nonimmigrants.
目的:探讨移民和非移民在1)常见精神障碍患病率和其他心理健康变量方面的差异;2)对情绪问题、精神障碍和成瘾的卫生服务利用;3)卫生服务满意度。方法:本文基于2007年5月至今进行的纵向队列研究:蒙特利尔西南流域流行病学研究(ZEPSOM)。在4个时间点对参与者进行随访(T1, n = 2433;T4, n = 1095)。核心暴露变量包括移民身份(移民与非移民)、居住时间和原籍地区。主要结果变量包括心理健康状况、卫生服务利用情况和卫生服务满意度。对数据进行横断面和纵向分析。结果:移民在加拿大平均居住时间为20年。移民的高心理困扰(32.6%比39.1%，P = 0.016)、酒精依赖(1.4%比3.9%，P =0.010)、抑郁(5.2%比9.2%，P = 0.008)和其他各种精神障碍的发生率显著低于移民。心理幸福感(48.9分比47.1分，P = 0.014)、社会满意度(34.0分比33.4分，P = 0.021)、人际关系满意度(16.7分比15.6分，P < 0.001)显著高于大学生。在所有时间点，移民因情绪问题、精神障碍和成瘾而利用卫生服务的比率明显较低，而卫生服务满意度明显较高。亚洲和非洲移民的使用率特别低，满意度很高。结论:移民总体心理健康状况优于非移民。
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Pub Date : 2017-07-25DOI: 10.1177/0706743717723527
A. Schaffer, D. González
The authors present a broad overview of issues related to mental health in Canada. They offer evidence from physical sciences, clinical practice, and social sciences, thus examining mental health issues from a wide variety of perspectives. They have developed a good text for students, from the level of senior high school to postgraduate, who want to develop their understanding of mental health and its many issues. This book could also be useful for many professionals to remind them of the broader issues beyond their particular profession. Residents in family medicine or psychiatry could benefit since it is likely to open their eyes beyond any possible narrow professional view to more of a population health focus. To give some idea of the scope of the book, chapters include discussion of what is mental health, biological foundations, insights from social sciences, substance use, diagnostic systems and their problems, stigma, workplace mental health, children and youth, gender and sexuality, culture, mental health crises, treatment of mental disorders, and a description of services in Canada. This very broad spectrum is a major strength of this book. The book is written in an easy to read style, avoiding unnecessary jargon. This is perhaps the essence of good scientific writing, that complex scientific issues are made easily comprehensible to a general readership. This well-written, easy to read style makes this book easily accessible to those with no special knowledge of mental health. The 3 authors are to be congratulated on having managed to achieve a consistent style throughout the book. They have also managed to keep the book very up-to-date. The format of the book is unusual and interesting. Each chapter ends with a conclusion, followed by a helpful glossary of terms, a number of critical thinking questions that really focus on the main content of the chapter, and a short list of recommended readings and recommended websites, followed by a full reference list for that chapter. There are also numerous vignettes throughout the book. This format makes the book ideal for learning purposes, whether for the individual reader, a group or small seminar (perhaps the most useful format for study), or a larger class. This reviewer does not know of any other text that so comprehensively brings such a wide variety of mental health issues into clear focus and that is also very readable and entertaining. My only criticism is of some of the illustrations. There are numerous illustrations throughout the book, none in colour, and the black and white rendering is frequently not very attractive. In addition, in some instances, it is difficult to see the relevance of the illustration to the topic under discussion. This should not detract from the overall quality and relevance of this publication.
{"title":"Book Review: Still Down: What to Do When Antidepressants Fail","authors":"A. Schaffer, D. González","doi":"10.1177/0706743717723527","DOIUrl":"https://doi.org/10.1177/0706743717723527","url":null,"abstract":"The authors present a broad overview of issues related to mental health in Canada. They offer evidence from physical sciences, clinical practice, and social sciences, thus examining mental health issues from a wide variety of perspectives. They have developed a good text for students, from the level of senior high school to postgraduate, who want to develop their understanding of mental health and its many issues. This book could also be useful for many professionals to remind them of the broader issues beyond their particular profession. Residents in family medicine or psychiatry could benefit since it is likely to open their eyes beyond any possible narrow professional view to more of a population health focus. To give some idea of the scope of the book, chapters include discussion of what is mental health, biological foundations, insights from social sciences, substance use, diagnostic systems and their problems, stigma, workplace mental health, children and youth, gender and sexuality, culture, mental health crises, treatment of mental disorders, and a description of services in Canada. This very broad spectrum is a major strength of this book. The book is written in an easy to read style, avoiding unnecessary jargon. This is perhaps the essence of good scientific writing, that complex scientific issues are made easily comprehensible to a general readership. This well-written, easy to read style makes this book easily accessible to those with no special knowledge of mental health. The 3 authors are to be congratulated on having managed to achieve a consistent style throughout the book. They have also managed to keep the book very up-to-date. The format of the book is unusual and interesting. Each chapter ends with a conclusion, followed by a helpful glossary of terms, a number of critical thinking questions that really focus on the main content of the chapter, and a short list of recommended readings and recommended websites, followed by a full reference list for that chapter. There are also numerous vignettes throughout the book. This format makes the book ideal for learning purposes, whether for the individual reader, a group or small seminar (perhaps the most useful format for study), or a larger class. This reviewer does not know of any other text that so comprehensively brings such a wide variety of mental health issues into clear focus and that is also very readable and entertaining. My only criticism is of some of the illustrations. There are numerous illustrations throughout the book, none in colour, and the black and white rendering is frequently not very attractive. In addition, in some instances, it is difficult to see the relevance of the illustration to the topic under discussion. This should not detract from the overall quality and relevance of this publication.","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115696973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-23DOI: 10.1177/0706743717718174
J. Paris
{"title":"Book Review: How Can I Help? A Week in My Life as a Psychiatrist","authors":"J. Paris","doi":"10.1177/0706743717718174","DOIUrl":"https://doi.org/10.1177/0706743717718174","url":null,"abstract":"","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121733219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-21DOI: 10.1177/0706743717717254
R. Bland
The authors present a broad overview of issues related to mental health in Canada. They offer evidence from physical sciences, clinical practice, and social sciences, thus examining mental health issues from a wide variety of perspectives. They have developed a good text for students, from the level of senior high school to postgraduate, who want to develop their understanding of mental health and its many issues. This book could also be useful for many professionals to remind them of the broader issues beyond their particular profession. Residents in family medicine or psychiatry could benefit since it is likely to open their eyes beyond any possible narrow professional view to more of a population health focus. To give some idea of the scope of the book, chapters include discussion of what is mental health, biological foundations, insights from social sciences, substance use, diagnostic systems and their problems, stigma, workplace mental health, children and youth, gender and sexuality, culture, mental health crises, treatment of mental disorders, and a description of services in Canada. This very broad spectrum is a major strength of this book. The book is written in an easy to read style, avoiding unnecessary jargon. This is perhaps the essence of good scientific writing, that complex scientific issues are made easily comprehensible to a general readership. This well-written, easy to read style makes this book easily accessible to those with no special knowledge of mental health. The 3 authors are to be congratulated on having managed to achieve a consistent style throughout the book. They have also managed to keep the book very up-to-date. The format of the book is unusual and interesting. Each chapter ends with a conclusion, followed by a helpful glossary of terms, a number of critical thinking questions that really focus on the main content of the chapter, and a short list of recommended readings and recommended websites, followed by a full reference list for that chapter. There are also numerous vignettes throughout the book. This format makes the book ideal for learning purposes, whether for the individual reader, a group or small seminar (perhaps the most useful format for study), or a larger class. This reviewer does not know of any other text that so comprehensively brings such a wide variety of mental health issues into clear focus and that is also very readable and entertaining. My only criticism is of some of the illustrations. There are numerous illustrations throughout the book, none in colour, and the black and white rendering is frequently not very attractive. In addition, in some instances, it is difficult to see the relevance of the illustration to the topic under discussion. This should not detract from the overall quality and relevance of this publication.
{"title":"Book Review: A Concise Introduction to Mental Health in Canada","authors":"R. Bland","doi":"10.1177/0706743717717254","DOIUrl":"https://doi.org/10.1177/0706743717717254","url":null,"abstract":"The authors present a broad overview of issues related to mental health in Canada. They offer evidence from physical sciences, clinical practice, and social sciences, thus examining mental health issues from a wide variety of perspectives. They have developed a good text for students, from the level of senior high school to postgraduate, who want to develop their understanding of mental health and its many issues. This book could also be useful for many professionals to remind them of the broader issues beyond their particular profession. Residents in family medicine or psychiatry could benefit since it is likely to open their eyes beyond any possible narrow professional view to more of a population health focus. To give some idea of the scope of the book, chapters include discussion of what is mental health, biological foundations, insights from social sciences, substance use, diagnostic systems and their problems, stigma, workplace mental health, children and youth, gender and sexuality, culture, mental health crises, treatment of mental disorders, and a description of services in Canada. This very broad spectrum is a major strength of this book. The book is written in an easy to read style, avoiding unnecessary jargon. This is perhaps the essence of good scientific writing, that complex scientific issues are made easily comprehensible to a general readership. This well-written, easy to read style makes this book easily accessible to those with no special knowledge of mental health. The 3 authors are to be congratulated on having managed to achieve a consistent style throughout the book. They have also managed to keep the book very up-to-date. The format of the book is unusual and interesting. Each chapter ends with a conclusion, followed by a helpful glossary of terms, a number of critical thinking questions that really focus on the main content of the chapter, and a short list of recommended readings and recommended websites, followed by a full reference list for that chapter. There are also numerous vignettes throughout the book. This format makes the book ideal for learning purposes, whether for the individual reader, a group or small seminar (perhaps the most useful format for study), or a larger class. This reviewer does not know of any other text that so comprehensively brings such a wide variety of mental health issues into clear focus and that is also very readable and entertaining. My only criticism is of some of the illustrations. There are numerous illustrations throughout the book, none in colour, and the black and white rendering is frequently not very attractive. In addition, in some instances, it is difficult to see the relevance of the illustration to the topic under discussion. This should not detract from the overall quality and relevance of this publication.","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131615035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-12DOI: 10.1177/0706743717704826
P. Grof
Undoubtedly, psychiatric diagnoses are central to psychiatric research and clinical practice. The initial impetus for this book came from a symposium on psychiatric taxonomy in San Diego. Later additional contributors were invited to join the authors. The book borrows the title “extraordinary science” from Thomas Kuhn, who coined this term for scientific research that is taking place during the paradigm change. The authors contributing to the volume explore the nature and sources of the present problems and possible ways out. While the book is a must-read for psychiatric researchers, it also has much to offer to clinicians interested in the diagnostic process. The authors feel that the recent hot debates surrounding the DSM-5 indicate in particular that in psychiatry, there are now major tensions between clinical and research aims, as well as controversies over diagnoses and treatments. Many critics have found the DSM unusable for research and feel it is linked to the notable paucity of progress; some consider it also flawed for clinical practice. The overriding concern is that the mental disorder constructs found in the DSM are not appropriate for scientific research. The DSM categories are seen as too general and too symptom based, leading to heterogeneity. They overlap and the boundaries are loose. There are problems with the validity and reliability of psychiatric diagnoses, heterogeneity of the resulting groupings, confusing comorbidities, inclusiveness of criteria, and overlap with normality. The main goal of the book is to help reconcile the competing directions and to explore the ways that may lead out of this dilemma. Contributors include mental health researchers and philosophers of science. They discuss the origins of the current controversies, explore the weight of evidence in psychiatric research, and criticise the National Institute of Mental Health (NIMH) proposal to replace DSM diagnoses by their own research categories (RDoC). For clinicians, of particular interest will be the chapters by Richard Bentall on schizophrenia and Harold Kincaid’s chapter on bipolar disorder. Bentall provides a brief history of the schizophrenia concept and demonstrates that the prevailing, widespread assumptions about the nature of schizophrenia do not incorporate all the available evidence. He offers an explanation that researchers may be blind to data that do not fit the expectations and end up protecting the existing paradigm. Kincaid centers his analysis on major depressive disorder and bipolar disorder as they have grounded substantial research findings. After reviewing the evidence, he finds in particular insufficient evidence for using bipolar classification in young children. Several contributors point out that the probing of dominant thinking and the emergence of alternative initiatives suggest an epoch that Thomas Kuhn characterised as “extraordinary science.” It includes both intense attempts to defend the prevailing paradigm (as expressed
{"title":"Book Review: Extraordinary Science and Psychiatry: Responses to the Crisis in Mental Health Research","authors":"P. Grof","doi":"10.1177/0706743717704826","DOIUrl":"https://doi.org/10.1177/0706743717704826","url":null,"abstract":"Undoubtedly, psychiatric diagnoses are central to psychiatric research and clinical practice. The initial impetus for this book came from a symposium on psychiatric taxonomy in San Diego. Later additional contributors were invited to join the authors. The book borrows the title “extraordinary science” from Thomas Kuhn, who coined this term for scientific research that is taking place during the paradigm change. The authors contributing to the volume explore the nature and sources of the present problems and possible ways out. While the book is a must-read for psychiatric researchers, it also has much to offer to clinicians interested in the diagnostic process. The authors feel that the recent hot debates surrounding the DSM-5 indicate in particular that in psychiatry, there are now major tensions between clinical and research aims, as well as controversies over diagnoses and treatments. Many critics have found the DSM unusable for research and feel it is linked to the notable paucity of progress; some consider it also flawed for clinical practice. The overriding concern is that the mental disorder constructs found in the DSM are not appropriate for scientific research. The DSM categories are seen as too general and too symptom based, leading to heterogeneity. They overlap and the boundaries are loose. There are problems with the validity and reliability of psychiatric diagnoses, heterogeneity of the resulting groupings, confusing comorbidities, inclusiveness of criteria, and overlap with normality. The main goal of the book is to help reconcile the competing directions and to explore the ways that may lead out of this dilemma. Contributors include mental health researchers and philosophers of science. They discuss the origins of the current controversies, explore the weight of evidence in psychiatric research, and criticise the National Institute of Mental Health (NIMH) proposal to replace DSM diagnoses by their own research categories (RDoC). For clinicians, of particular interest will be the chapters by Richard Bentall on schizophrenia and Harold Kincaid’s chapter on bipolar disorder. Bentall provides a brief history of the schizophrenia concept and demonstrates that the prevailing, widespread assumptions about the nature of schizophrenia do not incorporate all the available evidence. He offers an explanation that researchers may be blind to data that do not fit the expectations and end up protecting the existing paradigm. Kincaid centers his analysis on major depressive disorder and bipolar disorder as they have grounded substantial research findings. After reviewing the evidence, he finds in particular insufficient evidence for using bipolar classification in young children. Several contributors point out that the probing of dominant thinking and the emergence of alternative initiatives suggest an epoch that Thomas Kuhn characterised as “extraordinary science.” It includes both intense attempts to defend the prevailing paradigm (as expressed ","PeriodicalId":309115,"journal":{"name":"The Canadian Journal of Psychiatry","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131815389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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