Family Therapy and Major Psychopathology

362 Am J Psychiatry 140:3, March 1983 system in the development of tardive dyskinesia. The reader is left with a sober view of how little is known and proven despite an abundance of “data.” Chapter 6, on neurophysiology and neuropathology, is a very good overview of the neurological aspects of tardive dyskinesia. Chapter 7 is a brief but useful discussion of dyskinesia in children and adolescents. Chapter 8 is about dyskinesia with nonneuroleptic drugs, and it provides valuable insights into how iatrogenic dyskinesia may be associated with a wide variety of commonly used drugs in addition to neuroleptics. Chapter 9 describes various animal models of tardive dyskinesia, their utility, and their validity. It is more of a general outline than a comprehensive review of the field, and is thus appropriate in a book written mainly for the clinician rather than the basic scientist. Chapter 10, a review of the literature on the treatment of tardive dyskinesia, is a veritable tour de force. Nary a case report in the most arcane journal (up to 1 98 1) has escaped the scholarly search of the authors. The tables in this chapter are by far the most complete compendium of drug trials in tardive dyskinesia, ranging from the well controlled to the sheerly anecdotal. The synthesis of and the insights into this mammoth literature are superb accomplishments of herculean proportions. In chapter 1 1, the authors present suggestions for the clinical use of neuroleptics in the light of the perspectives generated in the previous 1 0 chapters. An appendix containing the Abnormal Involuntary Movement Scale (AIMS) and the Simpson Dyskinesia Scale is included at the end. Given the extensive coverage of so many diverse areas in this book, it was a bit surprising that there was no section on the physical measurement and clinical quantification of tardive dyskinesia for treatment, research, and follow-up purposes. The references for the entire book are alphabetically listed and take up more than 32 pages, an eloquent testimony to the extensive research effort invested in the text. This book must be regarded as the definitive work on tardive dyskinesia at this time. It is comprehensive, cohesive, and very readable. It is also very well edited and indexed. It not only belongs in every psychiatrist’s library but should be required reading for psychiatric residents, because tardive dyskinesia is a major scientific, clinical, social, ethical, and legal issue. This book will be extremely helpful in understanding what the problems are, what questions remain to be answered through research, and how to manage patients rationally until answers are found.