Bipolar Disorders: Basic Mechanisms and Therapeutic Implications. Edited by J.C. Soares & S. Gershon New York: Marcel Dekker. 2000. 580 pp. £39.95 (hb). ISBN 0 8247 0360 X

Now is an exciting time for research in bipolar disorder and this book captures the mood of the moment. It summarises neurobiological and psychopharmacological research into bipolar disorder at the end of the 20th century. Although there have been a number of other books on recent advances in bipolar disorder, most of these have concentrated on clinical features and response to treatment, and it is very useful to have a relatively up-to-date review of research on basic mechanisms and their therapeutic implications.

As is outlined in the foreword and in a useful summary chapter by Neumaier & Dunner (the latter described the concept of rapid cycling), bipolar disorder was one of the first areas of biological psychiatry research with funding and central support in the 1960s fuelled largely by the increasing use of lithium. However, research in unipolar depression and schizophrenia rapidly overtook bipolar disorder as the priority and it is only in the past 5-10 years that research has been regenerated in bipolar disease. There have been a number of triggers for this increasing interest, including the realisation that lithium has many flaws and drawbacks and that the socalled Kraepelinian dichotomy and classical bipolar illness are simplistic and misleading concepts. The catalyst for this increase in research has been the Stanley Foundation in the USA, whose munificence has fuelled much good work and the development of centres with a sufficient critical mass of researchers. There are some new and exciting leads, which are described in detail in this volume. Examples include the molecular and cellular mechanisms of lithium's action, structural and neuropathological abnormalities and the delineation of psychological changes. The number of topics and range of neurobiological research documented here are extensive and it is clear that not all of the abnormalities reported in this text are substantial. Many will prove to be evanescent and/or epiphenomena. However, it is timely to have this review and those researching into bipolar disorders would be well advised to have access to this book. It also includes some interesting reviews of topics not often looked at in detail such as secondary mania and biological factors relating to bipolar disorders in children, adolescents and late life.

Soares and Gershon should be congratulated on bringing together key opinion leaders in this field, albeit with a North American perspective. There is little overlap in the chapters, which shows firm editorial control.