This is the ninth edition of Kaplan and Sadock's Comprehensive Textbook of Psychiatry, the first of which was published in 1967, more than 40 years ago. Since then the growth of psychiatry has been marked by an explosion of research and new knowledge in neural sciences and in basic biological and psychological sciences. As a result, this edition bears little resemblance to the first. It is approximately four times the size, in two volumes rather than one, contains almost twice as many sections, and has more than three times the number of contributors (571 compared to 170). Because of the many changes, this edition can be considered an entirely new textbook based on the tradition and built on the foundation of those that came before.
The Comprehensive Textbook is a “university without walls” whose aim is to educate all those who work with the mentally ill—psychiatrists and other physicians, psychologists, psychiatric social workers, psychiatric nurses, and mental health professionals from all fields. Its goal remains unchanged: to foster professional competence and to ensure the highest quality of care. The textbook has earned the reputation of being a thoroughly up-to-date encyclopedic compendium of psychiatric knowledge. As editors, we are extremely gratified by its wide acceptance and use both in this country and abroad. No other major textbook in psychiatry can lay claim to having such a long, consistent, and enriched publication history.
The editors, Benjamin J. Sadock, M.D. and Virginia A. Sadock, M.D., are particularly pleased that Pedro Ruiz, M.D., a close personal and professional associate has joined them as the third editor. He is a distinguished academic psychiatrist, renowned as both an educator and clinician both in this country and around the world. He is a past president of the American Psychiatric Association and president elect of the World Psychiatric Association. The recipient of countless numbers of awards, his participation has immeasurably facilitated and enhanced the preparation of this work. Dr. Ruiz is Professor of Psychiatry and Behavioral Sciences at the University of Texas Medical School at Houston.
Comprehensive Teaching System
The textbook forms one part of a comprehensive system developed by us to facilitate the teaching, of psychiatry and the behavioral sciences. At the head of the system is the Comprehensive Textbook of Psychiatry, which is global in depth and scope, designed for and used by psychiatrists, behavioral scientists, and all workers in the mental health field. Synopsis of Psychiatry is a relatively compact, highly modified, original, and current text useful for medical students, psychiatric residents, practicing psychiatrists, and mental health professionals. Two special texts, derived from Synopsis, are the Concise Textbook of Clinical Psychiatry and the Concise Textbook of Child and Adolescent Psychiatry. The former covers descriptions of all psychiatric disorders, including their diagnosis and treatment and the latter limits itself to disorders of children and adolescents. Both books are useful for clinical clerks and psychiatric residents who need a succinct overview of the management of clinical problems. Another part of the system, Study Guide and Self-Examination Review of Psychiatry, consists of multiple-choice questions and answers; it is designed for students of psychiatry and for clinical psychiatrists who require a review of the behavioral sciences and general psychiatry in preparation for a variety of examinations. The questions are modeled after and consistent with the format used by the American Board of Psychiatry and Neurology (ABPN), the National Board of Medical Examiners (NBME), and the United States Medical Licensing Examination (USMLE). Other parts of the system are the pocket handbooks: Pocket Handbook of Clinical Psychiatry, Pocket Handbook of Psychiatric Drug Treatment, Pocket Handbook of Emergency Psychiatric Medicine, and Pocket Handbook of Primary Care Psychiatry. These books cover the diagnosis and treatment of psychiatric disorders, psychopharmacology, psychiatric emergencies, and primary care psychiatry, respectively, and are designed and written to be carried in the pocket by clinical clerks and practicing physicians, whatever their specialty, to provide a quick reference. Finally, the Comprehensive Glossary of Psychiatry and Psychology provides simply written definitions for psychiatrists and other physicians, psychologists, students, other mental health professionals, and the public. Together, these ten books create a multifaceted approach to the teaching, study, and learning of psychiatry.
Changes in This Edition
Adding new contributors and new sections to each edition is a hallmark of the Comprehensive Textbook, and this edition is no exception. New authors ensure a fresh approach to each topic and keep the textbook vital and current. The editors are deeply grateful to the more than 2,000 psychiatrists and behavioral scientists who contributed to previous editions, all of whom maintained the highest standards of scholarship. Many of those sections remain classics in the field and are accessible to the interested reader. We especially wish to acknowledge the past contributions of John Nemiah, M.D., editor emeritus of the American Journal of Psychiatry who, except for this edition, contributed to every previous edition and whose work we recommend to all students of psychiatry.
The editors also wish to thank Robert Michels, M.D., one of this country's most distinguished psychiatrists for writing the Foreword to this textbook in which he comments on important issues facing the field, both now and in the future.
More than 50 new sections were written for this edition, and almost every section has been completely rewritten or revised to represent the most current and most important advances in the field. The new additions to the textbook and other highlights are listed below.
Neural Sciences
The neural sciences represent one of the fastest growing areas in psychiatry and every section has been updated and revised. This chapter has four new sections representing the latest advances. These include Novel Neurotransmitters, which describes the cutting edge of research in this field; Pain Systems, a new and important area of research and clinical application; Neural Science of Social Interaction, which approaches social systems in an entirely new way; and Basic Science of Self, which deals with consciousness and identity from a neuropsychological point of view.
For his crucial help in this section as contributing editor, Jack Grebb, M.D. deserves special mention. He passed away during the preparation of this work and is deeply missed by us and by all who knew him. He was not only responsible for the Neural Science section in this edition but also for three previous editions. He worked closely with us for over 20 years and was co-author of the seventh edition of the Synopsis of Psychiatry. He was a distinguished researcher, clinician, and educator who had an encyclopedic knowledge of the behavioral sciences and psychiatry. In appreciation for all he has done, not only for us but also for the field of psychiatry, we wish to dedicate the Neural Science section of the book to his memory. In addition to organizing the section, Jack wrote the section, Introduction and Considerations for a Brain-Based Diagnostic System in Psychiatry in collaboration with his friend and colleague, the Nobel laureate, Arvid Carlsson, M.D.
Schizophrenia
The chapter on schizophrenia was extensively reorganized to provide the reader with information about the latest advances in the field. There are now three sections, instead of one, that cover the rapidly growing field of neuroimaging in Schizophrenia. Structural Brain Imaging; Functional Brain Imaging; and Molecular Brain Imaging. A new section, Postpartum Tissue Findings in Schizophrenia, appears for the first time in a major textbook of psychiatry. Three new sections, Phenotypes of Schizophrenia, Phenomenology of Schizophrenia, and Psychosis as a Defining Dimension, describe schizophrenia in a unique way and provide a humanistic understanding of what it means to suffer from psychosis. The new section, Medical Health in Schizophrenia, acknowledges the medical care required to thoroughly manage this disorder. A new and different approach toward prognosis is described in the section entitled The Concept of Recovery in Schizophrenia. The reader will find the most extensive survey and overview of schizophrenia to be found in any modern textbook of psychiatry. We thank Carol Tamminga, M.D., contributing editor, for her scientific and creative abilities in organizing this section.
Mood Disorders
The chapter on bipolar disorders has two new additions: Psychoeducation for Bipolar Disorder and Brain Circuits in Major Depressive and Bipolar Disorders. The first increases our therapeutic understanding and the second increases our scientific understanding of these complex disorders. We wish to thank Hagop Akiskal, M.D. for his work as contributing editor for mood disorders in this and previous editions of the textbook.
Anxiety Disorders
This section has been thoroughly updated and revised. New contributors wrote Neurophysiological Aspects; Neurochemical Aspects; and Neuroanatomical Aspects. These additions cover the major scientific advances in the field of anxiety. All sections were updated and revised and we wish to thank Daniel Pine, M.D., section editor, for his excellent help in organizing this section.
Psychosomatic Medicine
The chapter on Psychosomatic Medicine was expanded with the addition of three new sections, Diabetes, Transplantation, and Burns, all of which represent areas in which psychiatry has made significant contributions. A discussion of bariatric surgery was added to the section on Obesity in view of its role in dealing with this disorder. The Psychosomatic section is one of the most comprehensive to be found in any textbook. Constantine Lykestos, M.D. was contributing editor for this section, and we extend our sincere thanks to him.
Public and Global Psychiatry
As described by the authors of Public and Community Psychiatry, public psychiatry includes medical and psychiatric services directed “for the public good,” which are comprehensively described. The reader will also find an extensive overview of psychosocial needs and services around the world, in the section World Aspects of Psychiatry. Other new sections in this area include The Hospitalist in Psychiatry, A Socio-Cultural Framework for Mental Health and Substance Abuse Disparities, and Criminalization of the Mentally Ill. One of the editors, Pedro Ruiz, M.D., played a crucial role in organizing this section of the textbook.
Other New Sections
In view of the increased importance of metabolic issues as they relate to mental disorders, a new section on Neuropsychiatric Aspects of Neuroendocrine and Neurometabolic Disorders was added. Another new section entitled Transcultural Psychiatry describes the similarities and differences in mental illness around the world. Two new sections relate to diagnosis in psychiatry: Psychiatric Guidelines, which describes and discusses all the treatment guidelines as set forth by the American Psychiatric Association, and Clinical Applications of the Quantitative Electroencephalogram. We note with sadness the death of E. Roy John, M.D., co-author of the latter section. Telemedicine was expanded to include the section on Electronic Media in Psychiatry, a thorough discussion on the electronic record and information technology, which is playing an increasingly important role in modern-day medicine and psychiatry. A new section Nonconventional Approaches in Mental Health Care was added as well.
The chapter on Sociocultural Aspects of Psychiatry deals with areas that have political overtones about which we feel mental health professionals should be aware. The last edition covered the consumer movement and this edition covers posttraumatic stress disorder (PTSD). In addition, PTSD in adults is discussed from a clinical viewpoint in great detail in a separate section. Two new sections Gambling and Violence and Aggression were added to this edition in view of their being major public health issues to which psychiatry has much to contribute. The section on History of Psychiatry was updated to the present. We note with sadness that Ralph Colp, M.D., who wrote this section over many editions, passed away shortly before publication. The importance of physician health and functioning is covered in a new section called Physician and Medical Student Mental Health.
Psychotherapies
Despite the dramatic rise in pharmacologic treatment of mental disorders, psychotherapy continues to play a major role in the care of the mentally ill. Every type of psychotherapy is covered in the textbook and two new areas are represented: Narrative Psychiatry and Psychotherapy and Positive Psychology. The latter is better known to psychologists than to psychiatrists, but it is a movement of major importance in both education and therapy and deserves more attention than received previously in textbooks of psychiatry. The editors also included Psychodrama, a section that describes a widely used therapeutic modality for certain mental disorders.
Biological Therapies
In this textbook, wherever possible, drugs used to treat mental disorders are classified according to their mechanisms of action rather than using such broad categories as antidepressants, antipsychotics, anxiolytics, and mood stabilizers, which are overinclusive and do not scientifically reflect the clinical use of psychopharmacological agents. For example, many antidepressant drugs are used to treat anxiety disorders; some anxiolytics are used to treat depression and bipolar disorder; and drugs from all categories are used to treat other clinical problems such as eating disorders, panic disorders, and impulse control disorders.
Furthermore, there are many other drugs used in the treatment of mental disorders that do not fall neatly into any broad classification. Information about all pharmacological agents is comprehensive and includes data about pharmacokinetics, dosages, adverse effects, and drug–drug interactions.
Data about each drug were thoroughly updated and all drugs approved since the publication of the last edition are included. The section Brain Stimulation Methods was expanded significantly to reflect the new methods in use for the treatment of a variety of mental disorders.
Finally, the reader will find colored plates showing commonly prescribed psychotropic agents in their proprietary form with their most common dosages listed. Many of these drugs are manufactured in a generic form; however, practitioners have found the illustrations of proprietary drugs to be of use in both prescribing and identifying medications. We thank Norman Sussman, M.D. for his outstanding help in organizing this section in his role as contributing editor.
Child Psychiatry
Five new sections were added to child psychiatry, each representing an important new advance in diagnosis and treatment. Neuroimaging in Child and Adolescent Psychiatry describes in detail how imaging techniques are advancing the field of child psychiatry. A section Assessment of Preschoolers describes the special approaches to diagnosis for this unique developmental period. New advances in genetics are covered in the section Genetics in Child Psychiatry. A thorough discussion of sleep problems in children is covered in the new section Pediatric Sleep Disorders. Finally, a new section Impact on Parents of Raising a Psychiatrically Disabled Child deals with the difficult problems involved in managing this special patient population.
The section on Child Psychiatry is so thorough and so comprehensive, that it stands as a “text within a text.” We wish to thank Caroly Pataki, M.D. for her outstanding efforts as section editor. She has served in this capacity for several editions, and we owe her a debt of gratitude for her prodigious efforts.
Geriatric Psychiatry
Many new sections have been added to the geriatric section: Complementary and Alternative Medicine in Geriatric Psychiatry covers the explosive growth in the use of alternative agents and methods by the elderly; Assessment of Functioning covers new findings in the field, and Hearing and Sensory Loss is included for the first time to cover this often overlooked area of geriatric psychiatry. Another new section, Successful Aging, describes the psychological and physiological determinants that account for coping successfully as one ages. Sexuality and Aging reflects the continuing role that sex plays in the lives of the elderly. Finally, the important differences between men and women as they age are reflected in another new section, Gender Differences.
As with child psychiatry, the section on geriatric psychiatry continues to expand with each edition and can stand alone as a separate textbook in its comprehensive coverage of the psychiatric disorders of old age. Each section was written by an outstanding geropsychiatrist and the editors wish to thank Dilip V. Jeste, M.D. for his role as contributing editor to geriatric psychiatry, which he carried out with outstanding ability and judgment.
Cognitive Disorders
This section of the textbook which also covers Delirium and Dementia was completely updated and revised. All Sections were rewritten by new contributors to provide a fresh approach to these brain disorders. We thank Richard Sweet, M.D. for his help in organizing this section.
Case Histories
Throughout time, the teaching of psychiatry depended on the discussion and analysis of case histories, which still play an important part in psychiatric education. Case descriptions are used extensively in the text to add clarity and bring life to the clinical disorders described. They are derived from the DSM and ICD casebooks and from the clinical and research experiences of the contributors. We wish to thank the American Psychiatric Association (APA) and the World Health Organization (WHO) for permission to use some of their material. Cases appear in shaded boxes to help the reader find them easily. We also direct the reader to section 28.7 Famous Named Cases in Psychiatry, which chronicles important psychiatric case histories from the 16th through the 21st century, the knowledge of which should not be forgotten.
Citations
The style of this textbook is similar to other great textbooks of medicine: No internal citations are used. This requires contributors to evaluate the extensive and sometimes conflicting literature to create evidence-based conclusions for the benefit of the reader. That is often a difficult task, but as experts in their respective fields, they do it well. Contributors were also asked to limit references to 30 to 40 major books, monographs, and review articles and to include current references; thus, some citation lists are not as long as some of the authors would have wished. Contributors were also asked to note the five most important references with asterisks. References are as up-to-date as possible. The editors are also mindful that modern-day readers consult internet databases to stay abreast of the most current literature and they encourage that trend. Cross-references at the end of each section are used to direct the reader to related parts of the textbook to enhance the learning experience.
Cover Art and Illustrations
The Comprehensive Textbook of Psychiatry has always used photographs and artwork to enrich the learning experience and to prevent the reader from being lost in a sea of type. The text is illustrated profusely in both color and black and white. An innovation in Kaplan and Sadock texts is the use of cover art to portray some aspect of psychiatry. In Synopsis of Psychiatry, we placed Edvard Munch's painting Melancholy on the cover to convey the despair of this most common of all psychiatric disorders. For this text, we chose a painting by Alexi von Jawlensky (1864–1941) called Looking Within: Rosy Light. Jawlensky converts the human face into a symbol of expression that invites the viewer to meditate on the image, in this case, a feeling of happiness, to which all persons, including the mentally ill, have a right.
Classification of Disorders
DSM-IV-TR
A revision of the fourth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), called DSM-IV-TR (TR stands for text revision), was published in 2000. It contains the official nomenclature used by psychiatrists and other mental health professionals in the United States; the psychiatric disorders discussed in the textbook are consistent with and follow that nosology. Every section dealing with clinical disorders has been updated thoroughly and completely to include the revisions contained in DSM-IV-TR. The reader also will find every DSM-IV-TR diagnostic table reprinted in this textbook as it has been in each of our editions.
A new version of the Manual, DSM-V, is scheduled to be published in 2012. Some changes from the current edition will be made, and the editors have tried to anticipate as many of those changes as possible. Our contributors, many of whom are consultants to the taskforce working on DSM-V, have been asked to discuss that new material in their sections. The DSM is the “law of the land” and, as mentioned above, is the nomenclature used throughout this textbook. Some of our contributors, however, have reservations about various aspects of the DSM and have been encouraged to comment as appropriate about those reservations. As future editions of DSM appear, this textbook, as always, will allow room for dissent before and especially after every new version appears. It will continue to provide a forum for discussion, evaluation, criticism, and disagreement, while duly acknowledging the official nomenclature.
ICD-10
This textbook was the first U.S. textbook to include the full definitions and diagnostic criteria of mental disorders used in the tenth revision of the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD-10). There are textual differences between DSM and ICD, but according to treaties between the United States and the World Health Organization, the diagnostic code numbers must be identical to ensure uniform reporting of national and international psychiatric statistics. Currently, both DSM and ICD diagnoses and numerical codes are accepted by Medicare, Medicaid, and private insurance companies for reimbursement purposes in the United States. Readers can find the DSM-IV-TR classification with the equivalent ICD-10 classification listed in Chapter 9, Classification in Psychiatry. Color cues differentiate DSM and ICD diagnostic tables as a further aid to the reader.
Proprietary Rights and Permissions
The American Psychiatric Association (APA) charges permission fees to individuals (including members of the APA) who wish to reproduce the DSM-IV-TR tables listing the diagnostic criteria of mental illnesses in scientific papers, journals, or textbooks. Online rights require additional fees. By contrast, the WHO states that the diagnostic criteria tables contained in ICD-10 may be reproduced freely and without fees of any kind. In view of the fact that DSM was the work of over 60 organizations such as the American Psychological Association (APA) and the National Association of Social Workers (NASW), among many others, including the National Institute of Mental Health (NIMH), we believe that these tables should not be the proprietary right of any one organization. In the introduction to DSM-IV-TR, the goal is clearly stated: “… to facilitate research and improve communication among clinicians and researchers.” The APA should follow the lead of the WHO in this regard, and not charge permission fees for diagnostic criteria that, in our opinion, belong in the public domain.
Contributing Editors
The preparation and organization of the Comprehensive Textbook of Psychiatry required the help of a distinguished and knowledgeable group of contributing editors. These men and women, experts in their respective fields, kept us informed of not only the latest advances in their respective fields but also provided us with the names of contributors most knowledgeable in a particular area of psychiatry and the behavioral sciences. We thank them for their help, their time, their expertise, and their personal involvement in this endeavor.
In addition to Jack Grebb, M.D. (1953–2007) whom we already mentioned, there are nine other distinguished contributors to thank: Robert Robinson, M.D. who organized the section on Neuropsychiatry; Eric Strain, M.D. who organized the section of Substance Related Disorders; Norman Sussman, M.D. who organized the section on Biological Psychiatry; Carol A. Tamminga, M.D. who organized the section on Schizophrenia: Hagop S Akiskal, M.D. who organized the section on Mood Disorders; Daniel Pine, M.D., who organized the section on Anxiety Disorders; Constantine Lykestos, M.D. who organized the Psychosomatic Medicine section; Caroly Pataki, M.D. who organized the section on Child and Adolescent Psychiatry; and Dilip V. Jeste, M.D., who organized the Geriatric Psychiatry section. The editors thank them again for their prodigious efforts for which we and the field of psychiatry are in their debt.
SECTION HEADINGS
- Neural Sciences
- Neuropsychiatry and Behavioral Neurology
- Contributions of the Psychological Sciences
- Contributions of the Sociocultural Sciences
- Quantitative and Experimental Methods in Psychiatry
- Theories of Personality and Psychotherapy
- Diagnosis and Psychiatry: Examination of the Psychiatric Patient
- Clinical Manifestations of Psychiatric Disorders
- Classification in Psychiatry
- Delirium, Dementia, and Amnestic and Other Cognitive Disorders and Mental Disorders Due to a General Medical Condition
- Substance-Related Disorders
- Schizophrenia and Other Psychotic Disorders
- Mood Disorders
- Anxiety Disorders
- Somatoform Disorders
- Factitious Disorders
- Dissociative Disorders
- Normal Human Sexuality and Sexual and Gender Identity Disorders
- Eating Disorders
- Sleep Disorders
- Impulse-Control Disorders Not Elsewhere Classified
- Adjustment Disorders
- Personality Disorders
- Psychosomatic Medicine
- Relational Problems
- Additional Conditions That May Be A Focus of Clinical Attention
- Culture-Bound Syndromes
- Special Areas of Interest
- Psychiatric Emergencies
- Psychotherapies
- Biological Therapies
- Child Psychiatry
- Psychiatric Examination
- Genetic Influences on Child and Adolescent Psychiatric Treatment
- Mental Retardation
- Learning Disorders
- Motor Skills Disorder: Developmental Coordination Disorder
- Communication Disorders
- Pervasive Developmental Disorders
- Attention-Deficit Disorders
- Disruptive Behavior Disorders
- Feeding and Eating Disorders of Infancy and Early Childhood
- Tic Disorders
- Elimination Disorders
- Other Disorders of Infancy, Childhood, and Adolescence
- Mood Disorders in Children and Adolescents
- Anxiety Disorders in Children
- Early-Onset Schizophrenia
- Child Psychiatry: Psychiatric Treatment
- Child Psychiatry: Special Areas of Interest
- Adulthood
- Geriatric Psychiatry
- Public Psychiatry
- Psychiatric Education
- Ethics and Forensic Psychiatry
- Psychiatry: Past and Future
Product Details
- Hardcover: 4884 pages
- Publisher: Lippincott Williams & Wilkins; 9th edition (June 8, 2009)
- Language: English
- ISBN-10: 0781768993
- ISBN-13: 978-0781768993
- Product Dimensions: 11.7 x 9.5 x 6.7 inches
List Price: $399.95