Handbook of Medicine in Psychiatry. Peter Manu, Raymond E. Suarez & Barbara J. Barnett. American Psychiatric Publishing. 2006. 633 pp.US$69.00. ISBN 158562182X

Psychiatrists often find that their knowledge and skills in physical healthcare have slowly diminished over time but are still needed in practice. The Handbook of Medicine in Psychiatry has been written specifically for psychiatrists and provides evidence-based information on the causes, diagnosis and management of many medical disorders.

The American authors tackle the most common medical conditions, which they found in a retrospective case review of over 1000 psychiatric in-patients in the USA who had received a medical assessment. The chapters cover symptoms and signs, such as chest pain and red eye, as well as conditions such as obesity. Each chapter has the same format of clinical presentation, differential diagnosis, risk stratification, assessment and management in the psychiatric unit, and most have an assessment and treatment algorithm.

There are differences between the UK and USA in guidelines for the management and treatment of certain conditions, and in this book treatments recommended for hypertension differ from those in the current guidelines from the National Institute for Health and Clinical Excellence. The algorithm for the assessment and treatment of chest pain indicates electrocardiography (ECG) only for patients with suspected cardiac ischaemia. In the UK, ECG would also be undertaken for the investigation of other causes of chest pain such as panic attacks and serious conditions such as pulmonary embolism and aortic dissection. If followed exactly, this algorithm might lead to problems with diagnosis.

The chapter on cardiac arrest does not present an algorithm for advanced life support but treatments are shown in tables instead. There are differences from UK practice in recommended medication; for example, the initial dose of aspirin recommended for the treatment of myocardial infarction is given as 325 mg, whereas the recommended dose is 300 mg in the UK. This might not be clinically significant but could lead to confusion. Mannitol is listed as a treatment for constipation and enemas with tap water are recommended for the prevention of faecal impaction in the bed-ridden; both would be regarded as unusual treatments in the UK.

Psychiatrists who are unfamiliar with UK guidelines and standards of medical practice may not wish to rely solely on this book for medical information. In the UK, this book faces strong competition from the Oxford Handbook of Medicine and the Oxford Handbook of General Practice.