Book Review: Psychiatric Aspects of HIV/AIDS

Francisco Fernandez and Pedro Ruiz (eds); Philadelphia: Lippincott Williams & Wilkins, 2006480 pages • $59.95 (hardcover)

Reviewed by Bradley N. Gaynes, MD, MPH

In the era of Google and PubMed, a medical reference book finds itself in a precarious position. Is there a role for a bundled, unchangeable hard copy of data that may become outdated in the near (and more easily accessed) future? For some under-researched areas that span different branches of medicine and, accordingly, lack a singular synthesis of information from both areas, the answer can be "yes," especially for a concise, thoughtful, and well-written synthesis. This book falls into that category.

Psychiatric Aspects of HIV/AIDS, edited by longtime collaborators and HIV/AIDS and psychiatry researchers Drs Fernandez and Ruiz, is an accessible and coherent compilation covering a broad spectrum of topics with concise chapters. The text is organized into 7 sections that underscore the full biopsychosocial nature of the disease: "Background" (including epidemiology and current virologic understanding of the disease); "Diagnostic Tools"; "Psychiatric Comorbidity"; "Medical Comorbidity"; "Special Populations"; "Special Issues"; and "Policy Issues." The breadth of these sections allows the book to attend to a variety of audiences.

The "Background" section, which addresses the epidemiology and transmission of HIV/AIDS, will be especially helpful to mental health clinicians in the trenches who may not have a current public health or scientific perspective on the illness. "Diagnostic Tools" reviews the key parts of the psychiatric presentation of HIV/AIDS. I found the chapter on neuropsychological testing to be particularly useful.

Readers who are interested in relevant topics beyond the traditional medical and psychiatric perspectives of HIV/AIDS will likely find the sections on "Special Populations," "Special Issues," and "Policy Issues" the most innovative and thought-provoking parts of the book. It is here that the full spectrum of the biopsychosocial implications of HIV/ AIDS is fleshed out and preventive strategies are considered. Indeed, it is these sections that bridge the gaps that the authors are most concerned with--between clinicians on the one hand, and policy makers, researchers, allied professional groups, and those concerned with the myriad effects of HIV/AIDS on the other.

Despite the range of topics addressed in this book, the chapters themselves are succinct--readers looking for an in-depth discussion of each topic will not find it here, although relevant references are provided. For example, clinicians will not find this book to be a detailed clinical manual, but they will find a pertinent review of key psychotropic considerations, which can be used for informing and developing an effective treatment strategy.

The one area that I felt was missing from this book was the appreciation of the need to refer to Internet reference sources. Many informative and evidence-based Web sites exist for those interested in the psychiatric aspects of HIV/AIDS for patients, policy makers, and clinicians alike. Such an inclusion would have made this book even more relevant in the era of rapid information production. Nevertheless, this book laudably reaches its goal of providing a broad framework on which to add the psychological, social, spiritual, psychiatric, and neurobehavioral aspects of the disease to the standard biologic ones.

Dr Gaynes is associate professor of psychiatry at the University of North Carolina School of Medicine, Chapel Hill.