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The Scientific Basis of Clinical Practice

Edited by Owen M. Wolkowitz, M.D., and Anthony J. Rothschild, M.D.

  • ISBN 978-0-88048-857-0
  • Item #8857

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The mind-body connection is one of the hottest topics in medicine today, documented by enormous amounts of data regarding hormone effects on the brain and behavior.

Yet it is only now—with the debut of this thought-provoking volume—that we find an up-to-date, sophisticated reference that focuses on the clinical relevance of behavioral endocrinology and is written for practicing clinicians and researchers.

This wide-ranging volume shows how the principles and emerging findings of psychoneuroendocrinology can inform modern clinical practice and lead to new breakthroughs in future science and practice. Here, leading authorities—internationally respected researchers and practicing clinicians—review empirical findings in their areas of expertise, highlight the clinical significance of these findings, and provide, wherever appropriate, clinical guidelines for the management of patients.

Beginning with a lively history of psychoneuroendocrinology (including its many false starts), this book continues on to discussions of the hypothalamic-pituitary-adrenal axis hormone system, the gonadal hormone system, and the thyroid hormone system from each of the three paths generally used for psychoneuroendocrinological investigation:

  • Alterations in endogenous hormone levels observed in primary psychiatric illness
  • Psychiatric concomitants or sequelae of hormonal dysregulation in primary endocrinologic illness
  • Behavioral effects of exogenously administered hormones or hormone antagonists (both the study of the side effects of hormonal medications and the use of hormones and hormone antagonists as psychotropic medications)

An unmatched diversity of topics reveals the full breadth and depth of this volume: diabetes mellitus, corticosteroid effects on mood and cognition, Cushing's syndrome and Addison's disease, oral contraceptives and estrogen replacement therapy, psychiatric illness associated with the menstrual cycle and perimenopause, postpartum behavioral changes, anabolic/androgenic steroid use, and a thorough review of thyroid function in psychiatric disorders.

Particularly fascinating are sections on the role of neuropeptides and hypothalamic-releasing factors in psychiatric illness, the use of laboratory tests and imaging procedures in evaluating hormonal function in psychiatric patients, the place of newer alternative hormonal medications such as melatonin and DHEA in therapeutics, and a provocative and compelling final chapter on the role stress plays in precipitating illness.

Designed for both clinician and researcher-scientist, this richly informative guide will also prove an invaluable addition to graduate courses in neuroscience, neuroendocrinology, the biological basis of behavior, and consultation psychiatry. Neuroscientists/neurologists, endocrinologists, obstetricians/gynecologists, internists, family practitioners, nurses, and interested laypersons round out the wide audience for this remarkable volume.


  • Contributors
  • Part I: Introduction
  • Chapter 1. Introduction and Overview
  • Chapter 2. Historical Roots of Psychoneuroendocrinology
  • Part II: Peptide Hormones
  • Chapter 3. Neuropeptides and Hypothalamic Releasing Factors in Psychiatric Illness
  • Chapter 4. Chronobiology and Melatonin
  • Chapter 5. Prolactin, Growth Hormone, Insulin, Glucagon, and Parathyroid Hormone: Psychobiological and Clinical Implications
  • Part III: Adrenocortical Hormones
  • Chapter 6. The Hypothalamic-Pituitary-Adrenal Axis and Psychiatric Illness
  • Chapter 7. Psychiatric Manifestations of Hyperadrenocorticism and Hypoadrenocorticism (Cushing's and Addison's Diseases)
  • Chapter 8. Psychiatric Effects of Glucocorticoid Hormone Medications
  • Chapter 9. Dehydroepiandrosterone in Psychoneuroendocrinology
  • Part IV: Gonadal Hormones
  • Chapter 10. Menstrual Cycle–Related and Perimenopause-Related Affective Disorders
  • Chapter 11. Endogenous Gonadal Hormones in Postpartum Psychiatric Disorders
  • Chapter 12. Clinical Psychotropic Effects of Gonadal Hormone Medications in Women
  • Chapter 13. Psychiatric Effects of Exogenous Anabolic-Androgenic Steroids
  • Part V: Thyroid Hormones
  • Chapter 14. Thyroid Function in Psychiatric Disorders
  • Chapter 15. Psychiatric and Behavioral Manifestations of Hyperthyroidism and Hypothyroidism
  • Chapter 16. Thyroid Hormone Treatment of Psychiatric Disorders
  • Part VI: Laboratory Testing
  • Chapter 17. Laboratory Evaluation of Neuroendocrine Systems
  • Chapter 18. Endocrine Imaging in Depression
  • Part VII: Stress
  • Chapter 19. Stress and Neuroendocrine Function: Individual Differences and Mechanisms Leading to Disease
  • Index


    Jay D. Amsterdam, M.D.
    Michael Bauer, M.D.
    Lee S. Cohen, M.D.
    Kishore M. Gadde, M.D.
    Philip W. Gold, M.D.
    Harry Gwirtsman, M.D.
    Uriel Halbreich, M.D.
    Mady Hornig, M.D.
    Rod J. Hughes, Ph.D.
    Russell Joffe, M.D.
    Linda S. Kahn, Ph.D.
    David L. Katz, M.D., J.D.
    K. Ranga R. Krishnan, M.D.
    Alfred J. Lewy, M.D., Ph.D.
    Steven E. Lindley, M.D.
    Peter T. Loosen, M.D., Ph.D.
    Bruce S. McEwen, Ph.D.
    David Michelson, M.D.
    Dominique L. Musselman, M.D
    Charles B. Nemeroff, M.D., Ph.D.
    David O'Connor, M.D.
    Harrison G. Pope Jr., M.D.
    Victor I. Reus, M.D.
    Magda Rittenbaum, M.D.
    Anthony J. Rothschild, M.D.
    David R. Rubinow, M.D.
    Robert L. Sack, M.D.
    Alan F. Schatzberg, M.D.
    Peter J. Schmidt, M.D.
    Stephen Sokolov, M.D.
    Monica N. Starkman, M.D., M.S.
    Martin Szuba, M.D.
    Steven J. Wamback, B.S.
    Lisa S. Weinstock, M.D.
    Peter Whybrow, M.D.
    Owen M. Wolkowitz, M.D.

About the Authors

Owen M. Wolkowitz, M.D., is Professor of Psychiatry and Director of the Psychopharmacology Assessment Clinic at the University of California, San Francisco, Medical Center. He was awarded the Curt P. Richter Prize in 1992 by the International Society of Psychoneuroendocrinology for his contributions to the field.

Anthony J. Rothschild, M.D., is the Irving S. and Betty Brudnick Professor and Director of Clinical Research, Department of Psychiatry, University of Massachusetts Medical School, and its clinical partner, UMass Memorial Medical Center, in Worchester, Massachusetts.

This is a remarkably thorough and comprehensive text that covers the waterfront on anything and everything regarding the interface of endocrinology and psychiatry. Its authors are top players in the field and it is clear that each has written a very well referenced chapter on their particular area of expertise. . . . As a landmark compendium of psychoneuroendocrinology, this is a terrific book. I would buy it and make sure that all my senior residents had a copy so that they would be up to date on this material.—George Arana, M.D., Professor, Vice Chair, and Associate Dean, Medical University of South Carolina; Director, Mental Health Service, Ralph H. Johnson VA Medical Center, Charleston, South Carolina

. . .provides an excellent basis for any trainee or junior investigator who is entering the field or reviewing it for board examinations and should be useful for the next decade. All chapters are very well written and clinically relevant-mostly to physicians and biological investigators, probably, and to social workers, many psychologists, and certainly nurse practitioners, who will also find this book a fascinating and useful background for their work. . . . The reader will be fascinated by the smorgasbord of information that is presented clearly and cogently in this book.—Psychiatric Services

I have not seen a book on this topic that is so relevant, easy to read, and clinically useful on a daily basis. It is packed with information on the important interplay between psychiatry and endocrinology, with a good amount of neurology. This book will be a valuable resource in my clinical and research practice. Four Stars!—Doody's Health Science Book Reviews

In an era when our profession must prove uniqueness of our skill set, as distinct from psychologists' skills, every psychiatrist should be versed in the topics covered in the book. . . . The chapters presented here review and then summarize clinically relevant pearls so that the practicing psychiatrist can give the best current knowledge to patients and non-psychiatric colleagues. This volume is most highly recommended with the psychiatrist primarily in mind. Nurse practitioners, researchers, psychologists, residents and medical students would also benefit. Most will probably refer to it frequently as our practice demands consistent, highest competency in the relationships between endocrine function and behavioral disturbances.—Psychiatric Times

As a whole, this book is certainly the first comprehensive integrated approach of modern psychoneuroendocrinology. It is a must for not only graduates but also basic and clinical researchers who need to understand better their own specific field of interest and are willing to play a more active role in holistic perspectives of human functioning and dysfunctioning.—Psychoneuroendocrinology

This authoritative volume, compiled and written by the leading lights in these fields, will serve as a highly useful source for those new to the area and as a superb review for those needing a refresher or update. Each of the 19 clearly written and highly referenced chapters provides historical context for the topic under consideration, offers sufficient basic biological underpinning and description to clearly explain the subjects at hand and to show how they fit into the larger schemes of biological psychiatry, and presents clinical and treatment implications of the discussions. . . . Readers will be able to turn to this volume for individual chapters or, alternatively, easily use the text for a graduate, post-graduate, or residency level seminar.—Bulletin of the Menninger Clinic

This fine textbook, edited by two eminent experts in the field with contributions from many others of equal stature, is a readable, practical, and well-researched volume that begins with a fascinating history of psychoneuroendocrinology and guides the reader through the various components of the endocrine system as they relate to psychopathology.—Psychosomatics

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