Neurobiology of Mental Illness. Charney DS, Nestler EJ, Bunney BS, editors. Oxford: Oxford University Press, Inc.; 2001. 984 pp with index. ISBN 0-19-514780-4 (paper). CDN$143.95.
It is truly amazing that the scientific information related to neurobiology of mental illness has filled a volume this large. This reflects the enormous progress of neuroscience and related disciplines such as molecular genetics and neuroimaging in the last 2 decades.
The task to organize this wealth of information into a comprehensive and all-encompassing volume was certainly a great and difficult undertaking, considering that the book has 139 contributors from 44 institutions. The well-deserved credit goes to the editors (Charney, Nestler and Bunney) and section editors (Heninger, Bunney, Nemeroff, Charney, Hyman, Davis and Leckman), all leading experts in the field, for giving the volume a conceptual and organizational uniformity that makes the book an easy-to-read resource.
The 70 chapters are divided into 9 parts. The first part, edited by Nestler, gives an overview of brain development, neurochemical systems and electrophysiology of the central nervous system, signal transduction, neuronal plasticity and principles of molecular neurobiology. All of the chapters include well-designed illustrations of various concepts and mechanisms. Part 2 (Methods of Clinical Neurobiological Research, edited by Heninger) includes chapters on clinical epidemiology, molecular genetics, electrophysiology, neurochemistry, neuroendocrinology, neuroimmunology and neuroimaging. Outstanding in this part is a superb chapter by Heninger on special challenges in the investigation of the neurobiology of mental illness. This chapter, in a nutshell, addresses the essence of the volume: current problems in assessment and classification of mental illness, lack of valid models, complexity of neuronal systems subserving behaviour and challenges in evaluating the interaction between neurobiology and behaviour. Heninger concludes that advances in brain imaging and molecular genetics offer a good reason to be optimistic for future advances in identifying the neurobiological basis of mental illness.
The next 5 parts of the volume deal with major psychiatric disorders: psychoses (edited by Bunney), mood disorders (Nemeroff), anxiety disorders (Charney), substance abuse disorders (Hyman) and dementia (Davis). These parts are organized in a similar fashion; they all include chapters on diagnostic classification, molecular genetics, animal models, neurobiology, neurochemistry, neuroimaging and pharmacotherapy. Many of the chapters include, apart from conclusions, a section on directions for future studies.
It would be interesting to revisit these sections in the next edition to assess the progress in the field. The chapters are reasonably equivalent in their coverage of various topics. In particular, the chapters on molecular biology, neurochemistry and neuroimaging are excellent in comprehensive coverage of recent progress in these areas. In this reviewer’s opinion, the chapters on historical context of diagnostic classification of psychiatric disorders were somewhat out of the scope of this book and could have been dealt with more briefly in a common chapter concentrating mainly on the implications, when present, for neurobiology. Because of the uniform organization of various parts of the volume, some overlap of material was unavoidable. This was most evident in chapters on neurochemistry, molecular genetics and neuroimaging.
Part 8, devoted to psychiatric disorders of childhood onset (edited by Leckman), includes chapters on molecular genetics of childhood psychiatric disorders and on neurobiology of autism, Tourette’s syndrome, attention deficit hyperactivity disorder, and psychotic, mood and anxiety disorders. This section did not include a chapter on implications of diagnostic classification for neurobiology, although it would have been useful for the emerging field of research in this area.
The last part of the book deals with special topics such as the neurobiology of personality disorders, aggression, human sexuality, social attachment, eating disorders, menstrual cycle related mood disorders and sleep. The referencing of individual chapters is thorough and up to date, as is the indexing of the volume. All this makes the volume an excellent reference source.
The layout of the book is quite attractive. The figures are clear and have good legends. In some instances, though, the font is unnecessarily large compared with the text, and some figures take up a disproportionate amount of space. On the other hand, the headings and subheadings could have been more distinct to take away from the monotony of text-only pages. There are only a few colour plates in the book; one would hope that future editions will contain more colour images — they would be more illustrative, particularly in the chapters on brain imaging.
Neurobiology of Mental Illness is the most comprehensive and authoritative volume representing the progress made in biological psychiatry over last few decades. The book is superbly organized and edited and will undoubtedly serve as a premiere source of information for psychiatrists, neuroscientists, psychologists and others in the field. In addition to being an excellent reference book, it will, because of its conceptual content, also serve as a guide for researchers in the field of biological psychiatry and related disciplines.
The editors indicate in the preface that the “book will change dramatically with subsequent editions, because progress continues at an exciting pace in our field.” We are therefore looking forward to the next edition which, we hope, will be published in a not-too-distant future.