The belief that mind and body are intimately connected is not new, but it has often rested more on faith and anecdote than on science. During the last decade, research has begun to define the immunologic, neurochemical, and behavioral pathways that link medical illness with mental and emotional states. Medical-Psychiatric Practice is the third volume in a series intended to update practitioners on this research and its clinical implications.

Although this book is described as a textbook of medical-psychiatric practice, it is not a comprehensive guide to research or clinical practice in this area. Instead, it is more of an "update," a multiauthor monograph that summarizes recent research and clinical developments in specific topic areas. Two of the 10 chapters are devoted to recent advances in psychopharmacology (with a special emphasis on prescribing psychotropic drugs to persons with major medical illness). Four chapters review recent developments in the assessment and management of psychiatric syndromes in specific clinical populations (such as patients with Parkinson disease, lupus, human immunodeficiency virus infection, mild head injury, and bone marrow transplantation). The other three chapters describe current knowledge of the causes, assessment, and management of specific "psychosomatic" or "overlap" syndromes (such as the chronic fatigue syndrome, multiple chemical sensitivity, and the vulvar pain syndromes).

In general, the contributions are excellent. Individual chapters are clearly written, well organized, and as up-to-date as one could wish given the typical timeline for book publishing. Although the chapters vary somewhat in aim and style, consistency is better than in most multiauthor texts. The chapters on specific clinical situations are extremely thorough and maintain a practical clinical focus. The index deserves special mention for its accuracy and detail.

This book is likely to be more useful to a specialized audience than to the general reader. For consultation psychiatrists and others with a special interest in medical-psychiatric practice, it is a thorough summary of recent findings on several common clinical problems, and a cover-to-cover reading could be a wise investment. For the average general internist or medical specialist, it is a valuable reference for use as needed. The student or practitioner seeking a more general approach to the management of mental health problems in medical practice would be better served by other sources.

Gregory Simon, MD, MPH

Group Health Cooperative

Seattle