Edited by Jordan W. Smoller, M.D., Sc.D., Beth Rosen Sheidly, M.S., C.G.C., Ming T. Tsuang, M.D., Ph.D., D.Sc.
American Psychiatric Publishing, Washington, D.C., 2008
Book Review Editor Paula T. Trzepacz, M.D.
Modern genetic analyses have dramatically improved our understanding and treatment of many diseases. Although psychiatry has been relatively late in joining this revolution, psychiatric genetics is now a rapidly growing field with considerable promise. However, the growing research is often poorly understood and utilized by most clinicians. Psychiatric Genetics: Applications in Clinical Practice is intended to bridge this gap and make current research more accessible in daily practice.
The book is divided into three parts: general principles, genetics of specific disorders, and special topics. The section on general principles begins with a primer on psychiatric genetics, with an emphasis on linkage and association studies. It also introduces terminology and, most importantly, describes the information that can be learned from each type of study and their limitations. Another chapter covers principles of genetic counseling, so the clinician may better understand and utilize the resources genetic counselors provide. The third chapter focuses on risk communication. Written to assist the clinician in communicating information more effectively with patients, many practitioners will also find it valuable for better understanding the meaning of risks described in the genetic literature.
The second part covers the genetics of specific disorders, including childhood-onset disorders, psychotic disorders, mood and anxiety disorders, and Alzheimer’s disease. Each chapter describes the genetic epidemiology of the disorder, reviewing the evidence for heritability and familial transmission without mention of particular genes. Material on molecular genetics reviews the evidence implicating specific genes, focusing on the strongest candidates based on our current understanding of psychopharmacology. A chapter on neuropsychiatric aspects of genetic disorders describes the behavioral aspects of genetic disorders that are likely to be referred to a psychiatrist.
The third part covers special topics that are likely to arise in the context of genetic counseling for psychiatric disorders. One chapter covers the teratogenicity of psychotropic medications. Another chapter covers ethical, legal, and social implications, especially the broader duties of the clinician to persons other than the patient. Finally, a chapter on future directions describes the applications of genetic testing in the clinical arena that are likely to be available in the near future.
In a complex field such as psychiatric genetics, no single book is suitable for all audiences. Psychiatric Genetics is intended for the psychiatrist wishing to have a broad overview of the field to better interpret the clinical literature and be able to provide general advice for patients concerned about their genetic risk for mental illness. It is not suitable for those needing to understand the latest "cutting-edge" genetic technologies. Similarly, researchers needing detailed information on specific genetic contributions to psychiatric disorders or on methods of genetic analysis will find this volume inadequate. Within its stated scope and purpose, it succeeds admirably, distilling a vast amount of information into an easily readable volume emphasizing practical implications of genetics. Those within its proposed audience will find Psychiatric Genetics a valuable addition to their libraries.
Dr. Kennedy is a Postdoctoral Fellow in Statistical Genetics at the University of Alabama at Birmingham.