Book Review
Verduin, MD, Book Editor
Kaplan and Sadock’s Synopsis of Psychiatry, Eleventh Edition
Edited by Benjamin J. Sadock, MD, Virginia A. Sadock, MD,
and Pedro Ruiz, MD
Wolters Kluwer, 2014
1472 pages, $123.99, ISBN 978-1-60913-971-1
The eleventh edition of Kaplan and Sadock’s Syn-
opsis of Psychiatry is a comprehensive survey of
psychiatry published in a single volume. Its authors
are the editors of an encyclopedic, 2-volume, mul-
tiauthored set, the Comprehensive Textbook of Psy-
chiatry,1 on which the Synopsis is based. These
publications have been part of the psychiatric lit-
erature for over 4 decades, with the most recent
edition of the Comprehensive Textbook of Psychiatry
published in 2009. Thus, the 3 authors ambitiously
chose to publish an updated edition of the Synopsis
without the benefit of an updated Comprehensive
Textbook of Psychiatry.
This edition of the Synopsis contains much to be
admired: (1) an astonishing breadth of coverage,
from molecules to neural pathways to individuals to
systems of care; (2) an equally broad theoretical
perspective that applies the biopsychosocial model
and includes psychodynamics; (3) a clear, con-
sistent, down-to-earth writing style; (4) richly
descriptive and often colorful illustrative clinical
vignettes; (5) numerous summary tables; and (6) an
excellent glossary, new to this edition. Whether the
reader is a trainee or an experienced practitioner,
there is something here for everyone.
I found the chapters on sexuality, gender, and
neurocognitive disorders to be among the best in the
book, current and informative. I also especially liked
the sections that present a coherent clinical
approach, such as “General Principles of Psycho-
pharmacology” and “Psychiatric Emergencies in
Adults.” I learned the most from some of the sections
that would tend not to be included in a less com-
prehensive textbook. In particular, there are excel-
lent chapters on “Complementary and Alternative
Medicine in Psychiatry” and “End-of-Life Issues.” I
enjoyed the exposure to topics completely unfamiliar
68 January 2016
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Marcia L.
outstanding
excellent
good
fair
poor
Reviewed by JANIS L. CUTLER, MD
to me, such as “Positive Psychology,” and the
refresher on topics such as “Sociobiology and Ethol-
ogy” that now have added meaning and application
in psychiatry since I first learned about them long
ago in college science courses. I appreciated
the strong emphasis on psychiatry’s place within the
house of medicine, reflected in such choices as
the inclusion of epilepsy and other disorders with
neuropsychiatric findings, the section on “Obesity
and the Metabolic Syndrome,” and a section on
“Psychiatry and Reproductive Medicine” that cov-
ered the more usual disorders as well as a review of
the stages of pregnancy and the procedures com-
prising an abortion.
Overall I enjoyed the historical background
information that introduces many sections. The text
is not interrupted by references, making it very
readable; a limited number of current relevant ref-
erences are included at the end of each section. The
interspersing of interesting photographs through-
out the book provides a nice break from the text.
Less important information is segregated with a
smaller font and clinical material is highlighted in
tinted boxes.
It would be virtually impossible to produce a work
of this size without error. Trying to be selective in
which nits to pick, I will limit myself to the sur-
prising misspelling of “mnemonic” as “pneumonic”
and the incorrect years listed for nearly every ref-
erence in the Delirium section (almost as if a
Janis L. Cutler, MD, is Professor of Clinical Psychiatry,
College of Physicians and Surgeons of Columbia University,
New York, NY.
Copyright © 2016 Wolters Kluwer Health, Inc. All rights
reserved.
DOI: 10.1097/PRA.0000000000000126
Journal of Psychiatric Practice Vol. 22, No. 1
 BOOK REVIEW
copyeditor were disoriented and thought we were in
the 22nd century!). More important, the updating of
the material appears somewhat inconsistent.
Sometimes it is a matter of terminology. For
example, “due to a general medical condition” is
often used when “due to another medical condition”
is required to be consistent with the fifth edition of
the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5),2 and the term “organic” creeps
in from time to time despite the explanation else-
where that it has been discarded as all psychiatric
disorders can be considered organic. In some cases,
the errors in terminology may lead to confusion in
reference to the DSM-5. For example, the text often
refers to substance abuse and dependence, even
though the DSM-5 subsumed those terms under the
broader category of substance use disorders. In
other cases, the error goes beyond simply termi-
nology. For example, the descriptions of the newly
defined DSM-5 somatic symptom disorder and the
modified and newly named illness anxiety disorder,
previously known as hypochondriasis, are inter-
changed. Many, but not all, errors seem related to
the transition to the DSM-5. The otherwise excel-
lent chapter on “Complementary and Alternative
Medicine in Psychiatry” includes a link to the out-
of-date USDA Food Pyramid, which was replaced in
2010 by new guidelines called MyPlate, although
the link directed me to MyPlate.
Although a small proportion of the total, a couple
of erroneous statements regarding medication
treatment jumped out at me. In the chapter on
substance-related disorders, acamprosate is said to
be “not yet available in the United States” although
it has been available in the United States for over a
decade; it is appropriately referred to as being
indicated for maintenance of abstinence in the
chapter on “Psychopharmacological Treatment.”
Citalopram’s upper dose limit is incorrectly listed as
60 mg in a table in the chapter on “Mood Disorders,”
although the recently set correct upper limit of 40
mg is described in the chapter on psychopharma-
cology. On the basis of these comparisons, one
might conclude that the “Psychopharmacological
Treatment” chapter was more carefully updated
than the treatment sections of the chapters on
specific disorders. Certain other aspects of the
book seem a bit dated. For example, the term
Journal of Psychiatric Practice Vol. 22, No. 1
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
“noncompliance” is used repeatedly throughout
despite the fact that the term has fallen into dis-
favor, replaced by the more appropriately patient-
centered “nonadherence,” which has also been
adopted by the DSM-5. A detailed case description
of psychodynamic psychotherapy for obsessive-
compulsive disorder seemed jarring, given that
historically such patients suffered due to a lack of
efficacious treatment options until serotonin reup-
take inhibitors and cognitive behavior therapy
became available.
Finally, regarding the organization of the Syn-
opsis, the authors seem to recognize that it is not
the kind of book that someone reads from cover to
cover, but instead a volume that one dips into here
and there, and certain well chosen redundancies are
much appreciated. For example, features that point
to a medical cause of a mental disorder are high-
lighted in the chapter on “Emergency Psychiatric
Medicine” as well as in the chapter on “Neuro-
cognitive Disorders.” In contrast, given the ten-
dency for the average reader to sample, I found
myself wishing for more cross-referencing. For
example, a reference to the utility of the Hamilton
Rating Scale for Depression in the chapter on “Mood
Disorders” did not mention that the scale was
reproduced in an earlier chapter on the “Examina-
tion and Diagnosis of the Psychiatric Patient.” And
I was surprised that “Attenuated Psychosis Syn-
drome” was not included in the chapter on psychotic
disorders only to find it in the section on “Child
Psychiatry” at the end of the book. I could have
discovered this by checking the thorough index, but
it did not occur to me to look.
In sum, I believe that my time with the Synopsis
was well spent, and I plan to return to it often.
I recommend it as a comprehensive reference,
broadly knowledgeable and wise, for trainees,
practicing psychiatrists, nonpsychiatric physicians,
and nonphysician mental health providers alike.
REFERENCES
1. Sadock BJ, Sadock VA, Ruiz P. Kaplan and Sadock’s
Comprehensive Textbook of Psychiatry, 9th ed. Philadel-
phia, PA: Lippincott Williams & Wilkins; 2009.
2. American Psychiatric Association (APA). Diagnostic and
Statistical Manual of Mental Disorders, 5th ed. Arling-
ton, VA: APA; 2013.
January 2016 69