This exceptional reference book by Drs Frederick Goodwin and Kay Jamison has become a classic in psychiatry. Clinicians, patients, families, and researchers have eagerly awaited the publication of this Second Edition, following the original version published in 1990. As reflected in the title, the authors emphasize an inclusive concept of mood disorders, credited to Emil Kraepelin, in which recurrent mood disorders are to be considered under the rubric of manic-depressive illness. This second edition, unlike the first edition, includes contributions of expert collaborators, who are leaders in the area of recurrent depression and bipolar disorders. The text is divided into five parts: (1) Clinical Description and Diagnosis, (2) Clinical Studies, (3) Psychological Studies, (4) Path physiology, and (5) Treatment.
In Part I, the authors focus on clinical phenomenology and diagnosis. The central conclusion is that a unified concept of manic-depressive illness must emphasize models of recurrence and cyclicity, with somewhat less emphasis on polarity, as reflected in the diagnostic criteria of DSM-III and DSM-IV. This emphasis leads to a broader, rather than narrower concept of the illness. Investigation and research must necessarily focus on the biology of recurrence. The authors present new research on the diagnostic assessment of mixed states and bipolar depression. This part of the book includes an eloquent and comprehensive historical overview of the conditions of melancholia and mania and a systematic description of the development of the bipolar spectrum conceptualization. The classic, but almost forgotten, summary of the Stages of Mania appears on page 42. The exceptional descriptive summary of cyclothymia appears on pages 22–86.
In Part II, the authors address clinical aspects of the illness, relative to epidemiology, course, outcome, and treatment planning. Substantial evidence supporting the early onset form of the disease is highlighted. Increasing clinical data detailing the common co-occurrence with substance abuse and dependence, post-traumatic stress disorder, other anxiety disorders, eating disorder, attention deficit disorder, and obesity is delineated. The authors devote considerable attention to mortality due to suicide in manic-depressive illness. The chapters on co-morbidity and suicide are particularly thorough and represent an excellent resource for clinicians and researchers.
In Part III, the authors communicate current knowledge accumulated about the neuropsychological deficits in recurrent mood disorders. In bipolar disorder, a consistent neuropsychological finding is a normal verbal IQ and relative deficit in performance IQ, not due to mood-dependent effects on task performance. Drs Goodwin and Jamison provide a comprehensive review of personality functioning and behavioural manifestations in depression and mania. The overview of creativity in manic-depressive illness is particularly poignant and scholarly. A superb overview of bipolar disorders and marital and family functioning is found in chapter 10.
In Part IV, the authors review all neurobiological research accumulated over the past two decades. The chapters include new information related to genetics, structural and functional neuroimaging, sleep and rhythm alteration, as well as neuroendocrine abnormalities. Chapter 13 encompasses the historical and current research related to the genetic underpinnings of manic-depressive illness. The chapter on neurobiology provides a unique overview of specific medications and their effects on brain neurotransmitter and brain signalling systems in manic-depressive illness. An elegant putative summary of major intracellular signalling pathways influenced by lithium and valproate is illustrated in chapter 15. The chapter also summarizes current understanding of stress and associated neuroendocrine changes, which occur in the course of bipolar disorders.
In Part V, Drs Goodwin and Jamison detail all available information on treatment outcomes in manic-depressive illness. This includes attention to acute, continuation, and maintenance or prophylactic treatment procedures and results. In particular, the authors articulate an integrated view of medical and psychological interventions. The chapters underscore the role of lithium as the gold standard in treatment, despite clinicians' tendencies to use newer, less efficacious treatments. The lead authors appropriately devote careful attention to medication adherence, which remains a central reason for poor response and potential lethal outcome in manic-depressive illness. An excellent review of all international treatment guidelines is included in chapter 17. Practical guidelines for improving medication adherence are offered on pages 850–851 in chapter 21.
In summary, Drs Goodwin and Jamison make an enormous contribution to psychiatry, authoring an integrated and comprehensive textbook on manic-depressive illness. Their thoughtfulness and writing are clear and consistent throughout the volume. The clinician and researcher may read the book from cover to cover or return to the book for specific references and questions regarding all aspects of manic-depression. The second edition joins the first edition on the bookcase of any clinician treating individuals with recurrent depression or bipolar disorder.
