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Perspectives in affective disorders, Vol 21
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    Edited by W P Kaschka. Published by Karger, Basel, 2002, pp 204, €134.50. ISBN 3-8055-7439-8

    This book is a summary of an international symposium held in September 2001 to celebrate the 25th anniversary of the depression unit at the Weissenau Centre for Psychiatry in collaboration with the University of Ulm. This unit was founded as the first of its kind in Germany for the treatment of affective disorders and was the start of a development that has led to there being over 60 special depression units in that country. The symposium included a survey of past work and a summary of the present position and future prospects in basic research, diagnosis, therapy, and the care of affective disorders.

    Perhaps the most interesting part of this book is the first section of three chapters, which details the development of services for depressed patients in Germany. An elective admission to a purpose built and managed unit for the assessment and treatment of severe depression is extremely unusual in the UK, with its “one size fits all” inpatient care strategy. Intuitively depression units are appealing, but it is disappointing that no evidence is presented in this volume to support the statement that they result in a great improvement in outcome, apart from a claim that 90% of patients would recommend the unit to friends or relatives.

    The second section covers basic research in affective disorders, with contributions on genetics, functional imaging, and autonomic system control in depression. The third section of eight chapters is subtitled “Therapeutic perspectives in affective disorders”. There are some genuinely novel and valuable contributions here, including chapters on pharmacogenetic aspects of antidepressants, molecular mechanisms of action of mood stabilisers, and mechanisms and management of weight gain.

    This book is likely to have a limited readership outside Germany. The layout and presentation are rather dreary and although it will attract psychiatrists and psychologists with a specialist clinical or research interest in affective disorders, general clinicians are likely to pass it by.

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