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Dr. Benjamin J. Sadock speaks with LWW's Jenna Williams about developments in the field of mental health and the new edition of Kaplan and Sadock's Comprehensive Textbook of Psychiatry.

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1. This is the ninth edition of Kaplan and Sadock’s Comprehensive Textbook of Psychiatry to be published; what are some of the additions or updates we can expect to see in this edition?
This edition has over 50 new sections that have never appeared before that cover new topics and new advances in psychiatry. Many previous contributors have been replaced by new contributors to keep the book current and vital. The book has increased in size compared to the last edition with over 4000 pages of text.

2. You must have seen some great changes in the field of psychiatry since the Textbook was first published in 1967. Can you tell us something about these changes, and comment on how the Textbook has developed over its nine editions?
Since the first edition of CTP was published in 1967 there has been an explosion of knowledge in the neural sciences and psychopharmacology. For example, the first edition had only 35 pages covering the use of drugs in psychiatry; this edition has over 400. In the area of neural sciences, the number of pages has increased more than 100 percent over that contained in the first edition.

3. One of the highlights of the book is the updated sections on Neural Sciences and Neuropsychiatry. What new developments have there been in these fields recently and why are they so important?
Neural science covers a wide range of topics that range from functional neuroanatomy to the genetics of psychiatric disorders. Advances in neurochemistry and neurophysiology have been enormous. Neuroimaging has been particularly important in allowing behavioral scientists to see how the brain and mind function in both health and disease.

The neural sciences represent one of the fastest growing fields in psychiatry and every section has been updated and revised. There are four new sections in this area. They include Novel Neurotransmitters which describe the chemical messengers that influence behavior in health and disease and which are the cutting edge of the field. The Neural Science of Pain Systems is a new section that has direct application to diseases associated with severe pain and covers how doctors can use the latest knowledge to treat pain most effectively. The Neural Science of Social Interaction explains how the brain functions in interpersonal relationships and a new section, the Basic Science of Self explains consciousness from a neuropsychological point of view.

Throughout eight prior editions, "CTP" has been established as the cornerstone text in the field of psychiatry and mental health. This Ninth Edition provides a wealth of new and updated information in neural science, genetics, neuropsychiatry ... MORE

View the Table of Contents

4. Recently there has been a substantial amount of attention focussed on developing awareness of and treating mental disorders in low- and middle-income countries, where resources allocated to mental health awareness are limited. Do you have any thoughts on this?
Psychiatry has become global in scope enabling a greater awareness of the number of mentally ill around the world. Organizations like the World Psychiatric Association and the World Health Organization would benefit from increased funding to attend to these needs.

5. What are some of the new directions regarding research on schizophrenia?
Understanding the cause of schizophrenia and developing effective treatment methods for the disorder represents as much of a challenge as it did 50 years ago. Great advances have been made in mapping the abnormal neural pathways and the disordered neurochemical factors that account for the signs and symptoms of schizophrenia; but there is still no cure.

There are now three sections instead of one [in the book] that cover the rapidly growing field of neuroimaging in schizophrenia: Structural Brain Imaging, Functional Brain Imaging and Molecular Brain Imaging. A new section, Post-partum Tissue Findings in Schizophrenia describes, for the first time in a major textbook, the actual brain changes that can be seen under the microscope in the brains of schizophrenic patients. Three new sections, Phenotypes of Schizophrenia, Phenomenology of Schizophrenia and Psychosis as a Defining Dimension describe this disorder in a new and exciting way. Other new sections include Medical Health in Schizophrenia and The Concept of Recovery in Schizophrenia. Together, this section is the most comprehensive of any textbook published.

6. To return to the Textbook: Pedro Ruiz has been brought onboard as a co-author for the ninth addition for the first time. What prompted this addition, and what do you feel that Prof Ruiz has contributed to this edition?
Dr. Ruiz contributed immensely to the development of this new edition. He is an expert in Transcultural Psychiatry about which he wrote a chapter in the book. He was also instrumental in identifying experts in their respective fields and inviting them to participate. He is President of the World Psychiatric Association and organized a section in the book on World Aspects of Psychiatry, which is unique.

7. On a personal note, what has it been like to work on the Textbook with your wife, co-author Virginia Sadock, who is also a highly respected expert in the field?
When Dr. Harold Kaplan, the founding editor of the textbook died in 1998, my wife stepped into the breach. She had been active in all aspects of the textbook for many editions and had been thanked as the “unsung heroine” of the book by Dr Kaplan and me in the Preface of each edition. She has sound judgment, excellent writing and editorial skills, and a personality that allows her to interact smoothly with over 500 contributors. It’s a pleasure working with her.

8. Anything else you would like to add?
Sir William Osler wrote a textbook of medicine that went into 16 editions. When asked what it was like to be involved in publishing so many books he said: “The birth of a successful textbook is like having a child. It keeps its author in unexpected bondage." I have a plaque above my desk with that quote.

View sample content from Kaplan and Sadock's Comprehensive Textbook of Psychiatry!
13-1 Mood Disorders
13-2 Mood Disorders - Epidemiology
13-3 Mood Disorders - Genetics
13-4 Mood Disorders - Neurobiology
13-5 Brain Circuits in Major Depressive Disorder and Bipolar Disorder

About the Author:

Benjamin James Sadock, M.D., is the Menas S. Gregory Professor of Psychiatry in the Department of Psychiatry at the New York University (NYU) School of Medicine. He is a graduate of Union College, received his M.D. degree from New York Medical College, and completed his internship at Albany Hospital. He completed his residency at Bellevue Psychiatric Hospital and then entered military service as Captain US Air Force, where he served as Acting Chief of Neuropsychiatry at Sheppard Air Force Base in Texas. He has held faculty and teaching appointments at Southwestern Medical School and Parkland Hospital in Dallas and at New York Medical College, St. Luke's Hospital, the New York State Psychiatric Institute, and metropolitan Hospital in New York City. Dr. Sadock joined the faculty of the NYU School of Medicine in 1980 and served in various positions: Director of Medical Student Education in Psychiatry, Co-Director of Residency Training Program in Psychiatry, and Director of Graduate Medical Education. Currently, Dr. Sadock is Co-Director of Student Mental Health Services, Psychiatric Consultant to the Admissions Committee, and Co-Director of Continuing Education in Psychiatry at the NYU School of Medicine. He is on the staff of Bellevue Hospital and Tisch Hospital and is a Consulting Psychiatrist at Lennox Hill Hospital.

Dr. Sadock is a Diplomat of the American Board of Psychiatry and Neurology and served as an Associate Examiner for the Board for more than a decade. He is a Distinguished Life Fellow of the American Psychiatric Association, a Fellow of the American College of Physicians, a Fellow of the New York Academy of Medicine, and a member of the Alpha Omega Alpha Honor Society. He is active in numerous psychiatric organizations and was president and founder of the NYU — Bellevue Psychiatric Society. Dr. Sadock was a member of the National Committee in Continuing Education in Psychiatry of the American Psychiatric Association, served on the Ad Hoc Committee on Sex Therapy Clinics of the American Medical Association, was a Delegate to the Conference on Recertification of the American Board of Medical Specialists, and was representative of the American Psychiatric Association Task Force on the national Board of Medical Examiners and the American Board of Psychiatry and Neurology. In 1985, he received the Academic Achievement Award from New York Medical College and was appointed Faculty Scholar at NYU School of Medicine in 2000.

He is the author or editor of more than 100 publications (including 49 books), a reviewer for psychiatric journals, and lectures on a broad range of topics in general psychiatry. Dr. Sadock maintains a private practice for diagnostic consultations and psychiatric treatments. He has been married to Virginia Alcott Sadock, M.D., Professor of Psychiatry at NYU School of Medicine, since completing his residency. Dr. Sadock enjoys opera, golf, skiing, traveling, and is an enthusiastic fly fisherman.