Comprehensive Care of Schizophrenia: A Textbook of Clinical Management, 2nd edition

The editors of this volume, Dr. Jeffrey Lieberman and Dr. Robin Murray, are two of the world’s preeminent psychiatric researchers. Dr. Lieberman is the chairman of psychiatry at Columbia University as well as the president-elect of the American Psychiatric Association. Dr. Murray is a professor of psychiatry at the Institute of Psychiatry at the University of London. He is also a member of the Royal Society and has been knighted by the Queen of England.

This volume is a valuable update of the first edition of this book, published in 2003. There has been much progress in the field in the past decade, and the editors have gathered many of the foremost authorities on schizophrenia from throughout the world to produce a valuable overview of much of this progress.

As a person in recovery from schizophrenia, I was particularly pleased to see that the book attacks throughout what it refers to as “the myth of schizophrenia as a poor outcome disorder,” instilling a refreshing view of the likely course and outcome of this condition.

The various chapters give updates on many aspects of addressing schizophrenia that are becoming increasingly important as the 21st century progresses. Child and adolescent onset and early detection are both nicely addressed, as are cognitive-behavioral therapies and other nonbiological treatments. Topics such as violence, suicidal behavior, substance abuse, and medical comorbidity are also tackled.

Although this volume contains valuable material for any clinician working with persons with schizophrenia, I found three items of information particularly worthy of note. First, in the chapter addressing the pharmacologic treatment, the authors prominently characterize aripiprazole and bifeprunox, both partial dopamine agonists, as third-generation antipsychotics (TGAs) and explain why they view these agents as representing “a new strategy for attempting to normalize the dopamine imbalance in schizophrenia.” Not all of the authors of chapters mentioning psychotropics recognize this developing TGA classification, however.

Second, in the chapter on the pathobiology of schizophrenia, the authors seem remarkably prescient in stating that “The findings of hyperdopaminergic activity in the striatum have the greatest implications for current treatment strategies.” Third, in closing the book, a contributor lays out various views of five very articulate persons in recovery from schizophrenia. Their comments about their experiences of living with, and receiving treatment for, this disorder provide perspectives that clinicians should find refreshingly helpful.

Despite my strong endorsement of this volume, I do have some reservations. Beyond the one chapter by Volavka, Swanson, and Citrome, this book provides relatively little coverage of the interaction between mental health and criminal justice, which is unfortunate, considering the heightened media coverage of the violence of persons with mental illness and the extremely high incarceration rate of this population. Specialized mental health training for police officers (for crisis intervention teams) and the establishment of mental health courts have been spreading rapidly in the United States, but there is little mention of these developments in this volume.

Nevertheless, overall, I would strongly suggest that every clinician who serves persons with schizophrenia should read, and even study, this volume.