Understanding Depression: A Complete Guide to Its Diagnosis and Treatment, 2nd ed.

Abstract

This book is written for laypeople who want to understand mood disorders from a biological perspective. It could also be used by primary care physicians for purposes of patient education. This is the second edition; the first was published in 1993.1 Both of the authors are pioneers in biological psychiatry. Dr. Klein is an emeritus professor at the New York State Psychiatric Institute. Dr. Wender is an emeritus professor at the University of Utah School of Medicine and a lecturer at Harvard Medical School. The book contains chapters on recognizing depression (with a helpful self-rating questionnaire), distinguishing depression from bipolar mood disorders, causes of mood disorders, diagnosis and treatment of depression, a brief guide to psychophar-macologic drugs, illnesses related to depression, and how to get help. This is a readable book for laypersons and includes excellent case examples. The information about antidepressants is up-to-date and informative. Psychiatrists and primary care physicians regularly have to contend with public misinformation about antidepressants; the chapter on these medications would go a long way toward properly educating patients about the risks and benefits of these drugs. There are also sections on sleep aids, antipsychotics, anticonvulsants, and benzodiazepines. Herbal treatments are also addressed. This publication strongly focuses on the biological model of depression, which has been the authors' lifetime area of study. They have less expertise on non-biological models of treatment, and it shows in this book. Drs. Klein and Wender acknowledge the relationship between biological predisposition and life stress, though they heavily favor medical treatment over psychotherapy. They incorrectly state that there is little evidence that cognitive-behavioral therapy is more effective than placebo in treating depression (page 105). Nor do the authors touch upon lifestyle issues such as maintaining active schedules and exercise. Readers might also get the impression that psychiatrists are the only individuals qualified to treat depression. It is well known, particularly in non-urban settings, that antidepres-sants are primarily prescribed by primary care physicians. With the shortcomings aside, I would recommend this book for any layperson looking for authoritative information about the biology of mood disorders.