Basic Child Psychiatry

Article excerpt

Child Psychiatry Basic Child Psychiatry Philip Barker. Oxford (UK): Blackwell Science Limited; 2004 248 p. CANS52.95.

Reviewer rating: Good

At a time when there is an acute shortage of child and adolescent psychiatrists in Canada and the rest of the world, those who practise or are training to practise family medicine or general adult psychiatry increasingly find themselves having to assess and manage children and adolescents with psychiatric problems. Considering that the cumulative prevalence rate of psychiatric disorders among children and adolescents is about 5% to 22%, there is indeed an urgent need to educate primary care physicians, pediatricians, general psychiatrists, and health workers to enable them to recognize and manage some of these disorders.

As the title suggests, this is an introduction to the basics of child psychiatry. The book is divided into 23 short chapters that encompass all diagnostic groups in child psychiatry, starting with a brief review of developmental factors and ending with one on prevention. All chapters are well organized and written clearly and concisely with most salient and current references at the end of the book for those wishing to further pursue any of the topics. Chapter 4, on epidemiology, gives a brief description of major research into incidence and prevalence of child and adolescent psychiatric disorders. It provides a context in which to view each of the diagnostic groups. Chapter 5 "Assessing Children and Their Families" is a tour de force. At 19 pages, it is the longest chapter. It virtually walks the reader step by step through the interview and assessment process with sample questions to elicit information, strategies for maximizing attainment of rapport, and comprehensive history taking. The chapter ends with a useful grid for formulating the information of predisposers, precipitators, perperuators, and protectors in the 4 domains of constitutional, temperamental, physical, and environmental factors. This chapter is a testimony to the author's clinical experience and expertise in direct care of children and their families. There are 12 chapters dedicated to major disorders, including a chapter on reaction to stress. These chapters are organized systematically with definitions and prevalence, causes, descriptions, assessment and treatment, and outcome for each disorder.

Chapter 17, "Mind Body Relationship," takes dichotomous concepts and thoughtfully demonstrates their interdependence and circularity, helping to divert attempts from linear causality and solutions to more appropriate multidimensional thinking. …