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Memory Disorders in Psychiatric Practice
  1. BRIAN TOONE

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    Memory Disorders in Psychiatric Practice. Edited by g e berriosand j r hodges. (Pp 520, £39.95). Cambridge: Cambridge University Press, 2000. ISBN 0 521 57671 7.

    Until the end of the 19th century little distinction was made between complaints of poor memory due to disorders that have since been shown to be organic in nature and memory disturbances of a less certain prominence—for example, Ganserian states. Since then, and increasingly over the past decade, memory disorder as a clinical concept has narrowed to embrace only those disorders in which memory impairment can be objectively demonstrated and measured. The authors deplore this development and the main purpose and thrust of this volume is to rectify it. They, a psychiatrist and a neurologist, together run a memory “complaints“ clinic and this is fitting as it is the diverging pattern taken by these two clinical disciplines as much as the emergence of cognitive neuropsychology that is responsible for the fragmentation of the clinical concept of memory disorder.

    The contributions are from psychologists, psychiatrists, and neurologists; some are clinicians, some researchers; a third are from Cambridge. The book is divided into thirds. The first sector comprises general underpinning topics—for example, historical aspects, neuropsychology of memory etc. A chapter on the psychopharmacology is particularly good value.

    The rationale for the second section is less clear. Chapters on organic disorders—for example, transient global amnesia—rub shoulders with chapters on depressive pseudodementia and on the functional psychoses. But it contains some of the best contributions. A better summary of the dementias would be hard to achieve in the space available. Likewise De Renzi on the amnesia syndrome. The Cambridge Clinic is described with the authority that comes from assessing 100 patients a year over 8 years (although the number of self report scales used in the psychiatric assessment must be a computational nightmare).

    The final section is given over to the “clinically disenfranchised” areas of memory disorder. Paradoxically, given the authors stance, this is the least successful part of the book. The choice of topic is sometimes surprising: flashbulb and flashback memories may be of interest in their own right, but they are unlikely to figure prominently in most memory clinics and sit rather awkwardly here. There is little on the effect of normal aging on memory or on alcohol related memory disorders. The writing is at times uneven and in too many chapters detailed accounts of historical development take precedence over contemporary analysis. There are nevertheless useful contributions on the neuropsychological investigation of malingering and a refreshingly pragmatic chapter on recovered and forced memories.

    This is a book which, although something of a curate's egg, approaches memory as a clinical subject with a breadth and comprehensiveness unlikely to be found elsewhere. It is to be strongly recommended, not least for those already engaged or planning to set up memory clinics and to psychiatrists with a desire to learn more about higher mental function.

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