The psychiatry of stroke

OVERALL RATING Good

STRENGTHS Comprehensive and well organized; easy access to various topics of interest

WEAKNESSES Tries to reach too many audiences, creating an uneven approach

AUDIENCE Health care professionals and lay public

The second edition of Peter Birkett’s The Psychiatry of Stroke is a comprehensive, well-organized approach to the topic. The author, a psychiatrist, has vast experience in working with stroke survivors. The book is organized into 3 main sections. The first section seems to be aimed at a lay audience, as it uses basic definitions to explain the background, the causative factors, and the basic science of stroke. There is also a chapter that provides a brief overview of neuroanatomy and neuropsychopharmacology.

The second section, “Psychiatric Syndromes,” shines with chapters dedicated to common psychiatric syndromes associated with stroke (eg, depression, anxiety, dementia, disinhibition, sexuality, anger, and violence), providing information on causes, management, and a summary for each. This is of tremendous benefit as a quick reference for all practitioners who do not treat stroke patients on a regular basis. The language in this section can be a challenge to even the most sophisticated nonpractitioner.

The last section, “Outcome and Effects,” explains the process of recovery, the spectrum of care, the role of family, and the stroke treatment team, as well as the legal, ethical, and financial issues common to stroke patients. This section, however, appears to be geared mostly toward a lay audience.

To try to reach all audiences the book contains a 22-page glossary and 47 pages of references, mostly from the scientific literature. The author acknowledges the attempt at broad appeal and the inherent risks of doing so, stating the following: “The wide aim at readership must produce inconsistencies in voice and sophistication, and errors in style. I hope that these errors are in the direction of oversimplification rather than obscurity.” Notwithstanding these faults, this book is a good overview of an important topic and an excellent reference on psychiatry of stroke for practitioners who occasionally deal with stroke patients.

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