BOOK REVIEWS

Psychosomatic Medicineand Liaison Psychiatry:Selected PapersBy Z. J. Lipowski. New York. Plenum MedicalBook Company. 1985.453 pp. $39.95.

• Z. J. Lipowski occupies a uniqueposition within the field of consulta­tion-liaison psychiatry. An undisput­ed scholar with meticulously refer­enced papers, he has been the contem­porary historian of consultation­liaison psychiatry, sage editorial com­mentator on developments in psycho­somatic medicine, and conceptualsynthesizer. He has made importantcontributions to our understanding ofdelirium and dementia via a number ofimportant clinical studies. This publi­cation collects his contributions in onevolume.

The book is divided into four sec­tions. The first includes papers devot­ed to theoretical concepts within psy­chosomatic medicine. The secondsection is composed of two unpub­lished papers that review psychosocialreactions to physical illness. The thirdis devoted to physical illness and psy­chopathology, and the fourth to con­sultation-liaison psychiatry.

Included is the three-part review ofconsultation psychiatry and psychoso­matic medicine published in 1967-68,which continues to be an essential se­ries to be reviewed and assimilated byall psychiatrists. Written almost twodecades ago, these papers still chal­lenge the clinical investigator andpractitioner who works at the interfacebetween psychiatry and medicine.Problems of specificity, measurementand definition of body image, and thebest approach to define psychosomat­ic medicine are all addressed in thistriad. Fortunately, Lipowski's morerecent article, "What does the word

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'psychosomatic' really mean? A his­torical and semantic inquiry, " is alsoincluded to help define this complicat­ed tenn. The author's classic paper,"Delirium, clouding of conscious­ness, and confusion," is another es­sential review. The volume also in­cludes a previously unpublished gem,"The concept and psychopathologyof dementia, " which presents an ele­gant historical account as well as theauthor's concise description of de­mentia...Sensory and informationoverload: Behavioral effects" is im­portant in its review ofboth theoreticaland clinical infonnation. In all, theseven previously unpublished papersincluded in this volume provide a richsource of new material for the reader.

The two papers in Part 2 offer a ma­jor review of the broad range of ap­proaches to an individual's reaction tophysical illness. Such reviews areunique in this age of computerizeddata retrieval by their magnificent or­ganization and scholarly bibliogra­phies that demonstrate to the studentthat literature searches should not bedone by computer alone.

The last section can be read and re­read to look at consultation-liaisonpsychiatry's political status at variouspoints in time. Unfortunately, consul­tation-liaison psychiatry has not re­ceived the financial stability it merits.Lipowski does not shirk this problem,but directly examines the conceptsand controversies of the field. In re­viewing the final papers, a series ofcommentaries on the past, present,and future status of consultation-liai­son psychiatry, the reader must takeheart at the variety of clinical optionsthat face us. Despite problems offunding and competition from otherdisciplines, such as liaison nursingand behavioral medicine, consulta-

tion-liaison psychiatry has a largeconstituency to serve. Interestingly,in his closing paper, Lipowski callsfor the integration of liaison psy­chiatry with geropsychiatry.

The book provides a sense ofexcitement and hope. The author's el­egance and scholastic rigor should bea role model to all. This stands as anextraordinary volume by itself and is awonderful follow-up to the author'simportant monograph on delirium. I

Over the years, I have found that myreprints of the articles included in thisbook have been repeatedly 'penna­nently borrowed' by colleagues, stu­dents, and residents. With this inmind, the book should be carefully lo­cated within one's office to prevent itsloss. Its scope, detail, and clarity ofpresentation make it important read­ing for psychiatrists, and it should beon the shelves of all medical libraries .

TlwfTUJS N. Wise, M.D.Georgetown University

REFERENCE1. Lipowski ZJ: Delirium. Springfield, III, Charles

CThomas, 1980.

Handbook of GeriatricPsychopharmacologyBy Michael A. Jenike, Littleton. Mass, PSGPublishing, 1985, 167 pp, $20.

• Dr. Jenike, who is co-directorof theGeriatric Psychiatry Memory Disor­ders Clinic at Massachusetts GeneralHospital and editor of the monthlynewsletter Massachusetts GeneralHospital Topics in Geriatrics haswritten an excellent handbook review­ing a variety of topics including al­tered drug metabolism; psychosis,rage, and violence; affective illness;anxiety; Alzheimer's disease andother dementias; insomnia; and diag-

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PSYCHOSOMATICS