Geriatric Consultation Liaison Psychiatry Edited by Pamela Melding & Brian Draper Oxford: Oxford University Press. 2001. 396 pp. £32.50 (pb). ISBN 0 19 263084 9

This welcome book brings together knowledge pertinent to the care of older patients with mental health problems in a general hospital setting. It acknowledges that the needs of such patients are to some extent different and often more complex than those of younger patients.

The book is clearly and concisely written, from an international perspective, reminding us of the similar challenges faced by clinicians in different countries. A holistic view is emphasised throughout. Each chapter is clinically oriented, with numerous case vignettes to illustrate points made, reminiscent of patients we have all encountered.

The text is organised into five sections. The first covers the context of the geriatric consultation liaison referral, including a discussion of service organisation and of the implications of the ageing process and of pyschosocial issues. The section on assessment is comprehensive and draws attention to the particular difficulties encountered in liaison settings. The reader is reminded that liaison is a ‘very time-consuming pursuit’. Specific disorders, as they present in a general hospital context, are discussed in some detail, including an excellent chapter on the more challenging ‘undesirable’ patients encountered together with approaches to understanding and managing their problems. The section on treatment includes psychopharmacological and non-biological treatments as well as a review of electroconvulsive therapy in older patients with physical illness. The final section includes a helpful and thought-provoking discussion of ethical and legal issues that arise in this patient group. There is a glossary of terminology and a comprehensive index that facilitates the book's use for reference purposes.

For a clear exposition of the complexities associated with the assessment of older people in hospital, the interactions between psychiatric and physical disorder, the effects of ageing and the influence of personal experience on how people cope with disease, together with a very practical overview of treatment and management options available, this book can be firmly recommended. It will be of value to all old age psychiatrists, liaison psychiatrists and geriatricians and a source of guidance to trainee psychiatrists venturing onto medical wards for the first time. It will also be of interest to primary care physicians, as many of the issues discussed apply similarly in community settings.