This book adopts medical and biological approaches, though not exclusively, in the understanding and treatment of bipolar disorder. While fully acknowledging that clinical research on and understanding of later-life bipolar disorder is very limited compared with the knowledge base on the disorder in the younger population, this book provides a comprehensive account of many important aspects of the disorder in older people. The 14 chapters are divided into four sections: epidemiology and assessment, treatment, complexity and co-morbidity, and specialised care delivery and research. Together they address the presentation of bipolar disorder in later life, rating scales of assessment, pharmacological treatment, effects of cultural factors, issues pertinent to quality of care, and legal and ethical considerations. There is one chapter on cultural issues in the diagnosis and treatment of bipolar disorder. The remainder, as the name of the book implies, include research findings and issues pertinent to older people, while relevant and necessary comparisons with the younger population are made. The chapters on assessment of persons with bipolar disorder in long-term care settings, substance abuse among older adults with bipolar disorder and medical co-morbidity in late-life bipolar disorder are all very informative and practical.

While it remains true that bipolar disorder is traditionally attributed to biological and genetic processes, there has been an increasing recognition over the past decade that psychological factors play an important role in the development and maintenance of the disorder. To this end it is disappointing that the book has paid only scant attention to the psychological processes in the disorder. Nor has it considered recent developments in the psychological treatment of bipolar disorder apart from mentioning that cognitive-behavioural therapy, social-rhythm therapy and inter-personal therapy may play a part in medication adherence. There is a chapter on the psychosocial interventions for older adults with bipolar disorders, which provides some useful case vignettes of individuals participating in the programme. However, this chapter falls short of providing any detailed description of evidence-based psychological therapy for the disorder. Another omission, which would have been relevant to include, is a discussion on the nature and role of hypomania in bipolar episodes as early warning signals of the disorder, a topic which has been widely researched in recent years. This book is most relevant to those with a background or interest in psychiatry and it contains some useful references for medical students and others who are undertaking research in the area.