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Psychiatric Issues in Epilepsy: A Practical Guide to Diagnosis and Treatment, 2nd ed

Psychiatric Issues in Epilepsy: A Practical Guide to Diagnosis and Treatment, 2nd ed by Alan B. Ettinger, MD, and Andres M. Kanner, MD, 544 pp, with illus, $99, ISBN 978-0-7817-8591-4, Lippincott Williams & Wilkins, Philadelphia, Pennsylvania, 2007. This is a book on the psychiatry and psychology of epilepsy, written mostly by neurologists for neurologists and epileptologists. Psychiatrists would benefit as well, but other specialists and generalists will be overwhelmed with this information. It also is North Americanocentric; physicians on other continents may have different patient populations. This second edition has been improved and certainly is comprehensive for the topic it covers. Chapters integrate well. There are no serious overlaps. Chapters 10 and higher get very detailed. Scientific progress has been relatively slow in the field of psychiatric comorbidities in patients with epilepsy. Chapter 8 puts it plain and simple: “People with epilepsy (PWE) have psychiatric problems which need diagnosis and treatment. However, our billing models for patient care, and restricted areas of expertise (few of us are both practicing Neurologists and Psychiatrists) may impede a more comprehensive approach to care.” The lack of collaboration between the 2 fields was notably lamented in the first edition. Advances in epidemiology and basic research are the foundations to put this marriage on firmer ground and lead to a more unified and effective treatment approach. Chapter 4 deflates widely held inaccurate beliefs of the risks of lowering seizure threshold secondary to antidepressant medication. Information is critical to reduce the fear and paralysis physicians have in treating patients with both epileptic and psychotrophic drugs for their comorbid conditions. Therefore, I consider chapter 4 and part of chapter 13 especially valuable. I would have liked to see the authors emphasize that prescribing certain classes of antidepressants to persons with epilepsy is not an absolute contraindication and that increasing the dose of antiepileptic medications or altering antiepileptic pharmacotherapy may compensate, or improve, psychiatric problems. Many physicians who are not epileptologists appear to have an unhealthy fear of seizures and deprive their patients of needed care for their depression or mood disorder, both powerful effectors on the patient's quality of life. Seizures beget seizures, and also maybe mental disorders. Conversely, the early manifestation of mental illness may represent the developing pathology of epilepsy before the first clinical seizure occurs. This duality of pathology runs through the book. Following this reasoning may lead to innovative ways to prevent either disorder. Reading through the book will require perseverance for a nonacademic physician, as it offers no easy black-and-white issues and no simple solutions. But the authors show refreshing candor on clinical issues and the reader gets an unbiased and realistic view. Although most literature is based on adults, several chapters address health issues specific to children and the growing geriatric population. Chapter after chapter suffers the old problem of using objective test results like “seizure focus,” brain imaging, or brain function (as assessed on magnetic resonance spectroscopy, single-photon emission computed tomography, or functional magnetic resonance imaging) as an absolute benchmark to compare with results on depression or other affective disorders. Furthermore, many psychiatrists and neurologists use the terms interictal spike focus and ictal focus synonymously. They are neither identical nor of equal value in the pathophysiology of epilepsy. I will end by noting the inclusion of a commendable chapter on social workers and how they often make more of a difference in the patients' lives than psychiatrists and neurologists. A technical point, the book's print is pixelated (bitmapped). Tables and figures are gray scale, and this completely fails in Figure 14.1. There are very few typographic errors. The price of the book is very reasonable. Prose ★★★ Illustrations ★★ Science ★★★★ Usefulness ★★★ Back to top Article Information Correspondence: Dr Dasheiff, Neurology Service /111H, VA North Texas Health Care System, 4500 S Lancaster Rd, Dallas, TX 75216 (richard.dasheiff@va.gov). Financial Disclosure: None reported. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Psychiatric Issues in Epilepsy: A Practical Guide to Diagnosis and Treatment, 2nd ed

Archives of Neurology , Volume 64 (9) – Sep 1, 2007

Psychiatric Issues in Epilepsy: A Practical Guide to Diagnosis and Treatment, 2nd ed

Abstract

by Alan B. Ettinger, MD, and Andres M. Kanner, MD, 544 pp, with illus, $99, ISBN 978-0-7817-8591-4, Lippincott Williams & Wilkins, Philadelphia, Pennsylvania, 2007. This is a book on the psychiatry and psychology of epilepsy, written mostly by neurologists for neurologists and epileptologists. Psychiatrists would benefit as well, but other specialists and generalists will be overwhelmed with this information. It also is North Americanocentric; physicians on other continents may have...
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Publisher
American Medical Association
Copyright
Copyright © 2007 American Medical Association. All Rights Reserved.
ISSN
0003-9942
DOI
10.1001/archneur.64.9.1354
Publisher site
See Article on Publisher Site

Abstract

by Alan B. Ettinger, MD, and Andres M. Kanner, MD, 544 pp, with illus, $99, ISBN 978-0-7817-8591-4, Lippincott Williams & Wilkins, Philadelphia, Pennsylvania, 2007. This is a book on the psychiatry and psychology of epilepsy, written mostly by neurologists for neurologists and epileptologists. Psychiatrists would benefit as well, but other specialists and generalists will be overwhelmed with this information. It also is North Americanocentric; physicians on other continents may have different patient populations. This second edition has been improved and certainly is comprehensive for the topic it covers. Chapters integrate well. There are no serious overlaps. Chapters 10 and higher get very detailed. Scientific progress has been relatively slow in the field of psychiatric comorbidities in patients with epilepsy. Chapter 8 puts it plain and simple: “People with epilepsy (PWE) have psychiatric problems which need diagnosis and treatment. However, our billing models for patient care, and restricted areas of expertise (few of us are both practicing Neurologists and Psychiatrists) may impede a more comprehensive approach to care.” The lack of collaboration between the 2 fields was notably lamented in the first edition. Advances in epidemiology and basic research are the foundations to put this marriage on firmer ground and lead to a more unified and effective treatment approach. Chapter 4 deflates widely held inaccurate beliefs of the risks of lowering seizure threshold secondary to antidepressant medication. Information is critical to reduce the fear and paralysis physicians have in treating patients with both epileptic and psychotrophic drugs for their comorbid conditions. Therefore, I consider chapter 4 and part of chapter 13 especially valuable. I would have liked to see the authors emphasize that prescribing certain classes of antidepressants to persons with epilepsy is not an absolute contraindication and that increasing the dose of antiepileptic medications or altering antiepileptic pharmacotherapy may compensate, or improve, psychiatric problems. Many physicians who are not epileptologists appear to have an unhealthy fear of seizures and deprive their patients of needed care for their depression or mood disorder, both powerful effectors on the patient's quality of life. Seizures beget seizures, and also maybe mental disorders. Conversely, the early manifestation of mental illness may represent the developing pathology of epilepsy before the first clinical seizure occurs. This duality of pathology runs through the book. Following this reasoning may lead to innovative ways to prevent either disorder. Reading through the book will require perseverance for a nonacademic physician, as it offers no easy black-and-white issues and no simple solutions. But the authors show refreshing candor on clinical issues and the reader gets an unbiased and realistic view. Although most literature is based on adults, several chapters address health issues specific to children and the growing geriatric population. Chapter after chapter suffers the old problem of using objective test results like “seizure focus,” brain imaging, or brain function (as assessed on magnetic resonance spectroscopy, single-photon emission computed tomography, or functional magnetic resonance imaging) as an absolute benchmark to compare with results on depression or other affective disorders. Furthermore, many psychiatrists and neurologists use the terms interictal spike focus and ictal focus synonymously. They are neither identical nor of equal value in the pathophysiology of epilepsy. I will end by noting the inclusion of a commendable chapter on social workers and how they often make more of a difference in the patients' lives than psychiatrists and neurologists. A technical point, the book's print is pixelated (bitmapped). Tables and figures are gray scale, and this completely fails in Figure 14.1. There are very few typographic errors. The price of the book is very reasonable. Prose ★★★ Illustrations ★★ Science ★★★★ Usefulness ★★★ Back to top Article Information Correspondence: Dr Dasheiff, Neurology Service /111H, VA North Texas Health Care System, 4500 S Lancaster Rd, Dallas, TX 75216 (richard.dasheiff@va.gov). Financial Disclosure: None reported.

Journal

Archives of NeurologyAmerican Medical Association

Published: Sep 1, 2007

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