Guide to the Psychiatry of Old Age. David Ames, Edmond Chiu, James Lindesay & Kenneth I. Shulman, Cambridge University Press, 2010, £29.99 pb, 158 pp. ISBN: 9780521681919

This short book gives an excellent overview of the broad field of old age psychiatry. The authors quote Brice Pitt in describing the specialty as ‘general psychiatry only more so!’ and this really sets the tone for the whole book. As one might expect from a publication linked to the International Psychogeriatric Association, the authors provide geographically diverse perspectives, coming from Australia, the UK and Canada.

In addition to the expected clinical chapters, the authors manage to squeeze in chapters on the development of old age psychiatry as a specialty, the structure of services and the future of the specialty. The first third of the book mainly deals with dementia and this is one of the few books I have come across that has a separate chapter on the behavioural and psychological symptoms of dementia.

The comprehensive ICD-10 and revised DSM-IV diagnostic criteria are tabulated for most disorders, but personally I would have preferred description rather than these easily accessible lists. The chapter on delirium is particularly good and very clearly describes this complex syndrome.

After outlining the ‘three D's’ of old age psychiatry (dementia, delirium and depression), the addition of mania, schizophrenia and other disorders seems rather like an afterthought. Indeed, the coverage of ‘the rest’ feels a little sketchy after the strong sections on the more organic side of old age psychiatry (I include depression because of the book's emphasis on vascular depression). The therapeutic approaches advanced are broad and, interestingly, given the mainly biological slant, the importance of early life events is highlighted.

The main difficulty with this book is deciding exactly who the readership is. The sparsely referenced chapters and selected further reading make for readability but leave many questions unanswered in the text. In any case, most higher trainees and specialists in old age psychiatry would instinctively turn to the Oxford Textbook of Old Age Psychiatry (Oxford, 2008) for reference. Still, I will certainly be recommending this guide to colleagues in geriatric medicine and interested core trainees, medical students and members of the multidisciplinary team.