This is a big book, bigger than its first and second editions. Its growth reflects that of the field of child and adolescent psychiatry. Our understanding of normal child development and of the roots of psychopathology has advanced from a primarily psychodynamic paradigm to a sophisticated appreciation of the ways in which genetic, neurophysiological and environmental variables interact to influence adaptation.
Advances in neuroimaging, psychoneuroendocrinology and psychoneuroimmunology are beginning to shed light on the different ways in which human development can go awry. As we literally and figuratively unravel the human genome and compare ourselves to the other denizens of our planet, we begin to appreciate those characteristics we share and those that distinguish us from more primitive species.
Our increasing recognition of the differences between the neuroanatomy, neurophysiology and psychoneuroendocrinology of males and females from infancy through adulthood has moved us beyond simplistic social explanations for behavioral differences. Scientific advances in the understanding of gender identity and behavior have encouraged not only a reexamination of the differences between the ways that boys and girls think and feel, but also a reassessment of the ways that we measure intelligence and even morality.
In tandem with our increasing knowledge regarding the ways that genetic and neurophysiological variables affect behavior has come an increasing appreciation of the numerous ways in which social and cultural variables influence adaptation. Mental illness is understood and expressed in different ways in different settings. We are just beginning to recognize our own prejudices and the ways that they, and the availability or lack of treatment resources influence the diagnoses and dispositions we make.
Most important, the devastating effects of poverty, grinding poverty, on the growth, development, mental health and adaptation of children of every race and culture has been well documented. We can now identify its effects at the biochemical, neurophysiological, neuroanatomical and behavioral levels. Unfortunately we are less skilled at preventing and reversing these consequences.
This big purple book contains an account of where we stand clinically and scientifically. It confronts us with the chasm that separates what we know about the causes and treatments of children’s psychiatric disorders and what we as a society actually provide. It reminds us that the current constraints imposed on caregivers, the extreme criteria for admission to hospital, and the absurdly limited lengths of stay permitted under our current delivery systems, deprive the majority of mentally ill children in our country of the optimal care we know how to provide.
At this point in our own development as a society our social values and priorities have a long way to go to catch up with our scientific understanding and our sophisticated technology. We must keep in mind that in the face of all that we know about human development and the ongoing myelinisation of the frontal lobes into the third decade of life and beyond, we nevertheless allow our children to be tried as adults and executed for crimes committed before their eighteenth birthdays. Let us hope that before the fourth edition of this book appears, our ethical values will have caught up with our scientific knowledge.
This purple book contains the knowledge and wisdom of 200 experts in their respective clinical and research disciplines.
Size: 14 mb
Free download Child and Adolescent Psychiatry: A Comprehensive Textbook By Melvin Lewis – 3rd edition