Book review

A Clinician’s Handbook of Child and Adolescent Psychiatry [CHCAP]. Edited by Gillberg C, Harrington R and Steinhausen HC (New York: Cambridge University Press, 2006) [p. 751]. ISBN: 0-521 81936-9. £65. Psychiatric disorders manifesting in childhood and adolescence are common, under-treated and associated with elevated levels of mental health problems and psychosocial disability in adulthood [1,2]. As well illustrated by the field of paediatric rehabilitation, the very factors that make childhood a period when the developing individual is at his or her most sensitive to risk render it a powerful window of opportunity for intervening and promoting beneficial outcomes. Young people with mental health problems are over-represented amongst those seen by paediatricians, paramedical healthcare professionals, social workers and the legal system. CHCAP is aimed at these professionals in addition to child and adolescent psychiatrists. The authors state that a major objective of the text is ‘. to condense the scientific knowledge that is significant for clinical practice’. At 750 pages this text occupies a space between some of the significantly shorter [3] and longer [4] child and adolescent psychiatry textbooks currently available. It is organized according to the main categories applicable to childhood and adolescence in the two dominant diagnostic systems currently used, ICD-10 and DSM-IV. The only exception is a chapter on physical and sexual abuse. Each chapter is clearly laid out. Good use is made of tables, and algorithms outlining good practice in assessment and treatment. Each chapter had an appendix containing a few useful rating scales and/or assessment schedules. The text is not referenced, with a suggested reading list being provided for each chapter instead. The book is well indexed. In general, CHCAP does not dwell on theoretical and conceptual considerations—instead giving more space to making explicit the clinical relevance of varying classification systems and epidemiological findings, as well as covering assessment and treatment in relatively greater detail. There are sections within most chapters that give close attention to real world problems such as co-morbidity, treatment non-response and other common challenges. The pressures to make trade-offs between covering theoretical vs practical issues are particularly strong for a mid-sized text such as this one. Thankfully, it is only in a minority of chapters where this balancing act is negotiated with limited success. At times the lack of conceptual underpinning combines with the absence of references and the inclusion of some insufficiently validated constructs to make one feel slightly uneasy about the treatment a topic is given. Examples of this problem can be found in ‘Brain Disorders’ and ‘Autism Spectrum Disorders’, which give somewhat unqualified and controversial accounts of Minimal Brain Dysfunction and Asperger syndrome, respectively. These chapters, along with ‘Eating Disorders’ are also notable as, in comparison with other chapters, their lists of suggested reading can give slightly less even and/or up-to-date coverage. The vast majority of chapters in this delightfully pragmatic book are, however, excellent, and supply the reader with key information in an accessible and engaging manner. ‘Schizophrenia and schizophrenia-like disorders’ provides hard to come by guidance on how to best apply existing diagnostic categories to the often textbook-defying world of early onset psychosis and gives frameworks for tackling complexities such as mental state examination and making decisions about optimal treatment settings. ‘Hyperkinetic disorders’ elegantly demonstrates that neuro-scientific knowledge can be beneficially incorporated into a clinician’s handbook and does so with such grace as to convince the reader that an integration of perspectives is indeed essential. ‘Conduct disorders’ argues strongly for the importance of delivering evidence-based treatments to a marginalized population in a highquality manner using rigorous monitoring of treatment effectiveness. Other highlights include ‘Sleep Disorders’, ‘Obsessive-compulsive disorders’ and ‘Affective disorders’. I would strongly recommend this book, which is designed for day-to-day use. It very much ‘does what it says on the cover’ and condenses a wealth of information into a clinician’s treasure-trove. The few minor and largely circumscribed limitations outlined above can be readily addressed by the interested reader referring to larger reference texts where needed. This book would rapidly become wellthumbed in the hands of most trainee Child and Adolescent Psychiatrists and those consultant Child and Adolescent Psychiatrists working in less