Second edition. Dan G. Blazer II. 346 pages. St. Louis, Missouri: Mosby-Year Book; 1993. $32.00.
Recently, academic psychiatry has addressed the problem of comorbid conditions. Anxiety disorders in those with continuing substance abuse and depression in patients with life-threatening illnesses are notable examples. Depression in geriatric patients is another comorbid condition and the topic that Dr. Blazer, a noted geriatric psychiatrist from Duke University, discusses in this book.
Actually, this is the second edition of a text that was originally published in 1982. As Blazer notes in the preface, this edition is really a new book, given the rapid explosion of clinical and research findings in this field. Blazer should be commended for writing such a fine text that covers the vastness of the specialty in fewer than 350 pages. The audience for which it is intended crosses specialties and disciplines; the common ground is that it is intended for those actively involved in the care of elderly persons. Blazer is the only author of this revised edition, and the first chapter shows clearly that he has great command over the scope of the problem, its origins and potential causes, differential diagnosis, discrete subtypes, and treatment. Sometimes the discussion may be too detailed for those without formal psychiatric training; however, it is written in a lucid, coherent style, and the reader can choose the sections or chapters that are of particular interest without feeling that the entire text must be read. The author deftly moves from contemporary psychotherapy issues in the depressed geriatric patient to neuropsychiatric matters, such as the meaning of abnormal results of magnetic resonance imaging. The chapters on psychopharmacology and electroconvulsive therapy are comprehensive, current, and well referenced. A chapter on the assessment and management of the medically ill, depressed geriatric patient has many clinical pearls because this subgroup of patients poses unique obstacles to effective treatment.
The only flaw in this otherwise excellent text is the editing. Typographic errors occur frequently, and some of them create semantic errors that convey incorrect concepts. This is especially problematic for readers who have little formal psychiatric training and may need to rely on this book for all their knowledge of this subject. However, its otherwise fine chapters, text, and referencing amply compensate for this editorial deficiency.
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