Modern Trends in Pharmacopsychiatry, Vol. 28,
B.E. Leonard (Series editor); A. Halaris & B.E. Leonard (volume editor), Inflammation in psychiatry, Karger, Basel, 2013. Hardback: 208 pages. ISBN: 978-3-318-02310-7.
Even though a notion of a relationship between inflammation and psychiatric symptoms has been present throughout the history of modern medicine, it has for many years been neglected as the brain was believed to be an immune privileged organ. During the last few decades, particularly after the introduction of enzyme-linked immunosorbent assays, this notion has chanced, with a substantial amount of evidence emerging to suggest that the immune system is indeed an integral part of the central nervous system (CNS) and plays an important part in psychiatric disorders. Even though the discipline of psychoneuroimmunology increasingly is an integral and accepted part of psychiatry, it is still a fairly new field and literature summarising the recent discoveries is therefore highly warranted.
Inflammation in psychiatry consists of 14 chapters, preceded by the foreword by the volume editors Halaris and Leonard. The first chapter of the book is an introduction to neuroinflammation in psychiatry. This chapter elaborates on the mechanisms behind neuroinflammation, the cells involved and the interactions between periphery and brain as well as between CNS immune cells and neurons. This chapter is followed by reviews on different areas of psychoneuroimmunology. The level of detail varies substantially between chapters. Some chapters are quite generic and offer primarily basic information whereas others are highly specialised and related to rather narrow topics. This makes it a little difficult to determine who the target audience is. Having said that, the book has several excellent chapters and provides a comprehensive overview of the field. I will highlight some of these: Chapter 7 relates to the brain–gut axis – an exciting new target and a well-written chapter. Some compelling results are reviewed, focusing on the impact of stress on the brain–gut axis and emphasising on the bidirectional relationship between the gut biota and the CNS. Further, the exciting possibility of using probiotic bacteria as treatment for certain psychiatric disorders is presented. Another well-written and interesting chapter is Chapter 10, concerning glucocorticoids and inflammation and the relationship with depression. Here, a very good description of the role of glucocorticoids in depression and how glucocorticoids and inflammation interact is presented. This chapter nicely merges the cytokine theory of depression with the glucocorticoid theory of depression. The fact that glucocorticoids are known to be anti-inflammatory and that depressed patients show an increased production of glucocorticoids due to an overactivated hypothalamic–pituitary–adrenal axis appear paradoxical when compared with the cytokine theory of depression. The authors present several possible scenarios that could all shed light on this paradox. Additionally, Chapter 13 on peripheral inflammation and cognitive ageing is worth highlighting. The strength of this chapter is that not only is it a decent review of the topic, but the authors exemplify extensively using their own research including figures and charts to ease the understanding.
Overall, this book is a good review on the current interest areas of psychoneuroimmunology edited by two pioneers of the field. The topics covered are highly relevant and up to date. Unfortunately, there is quite a high degree of overlap between the chapters. Some repetition is of course unavoidable when dealing with an edited volume but in this book most chapters begin with a rather long introduction to the field, which is almost identical between chapters, leading to quite a high degree of overlap from chapter to chapter. Instead, one could have spent these pages on another exciting topic, such as the evolutionary imperatives on the relationship between depression and inflammation, which is only very briefly mentioned. Furthermore, a table of abbreviations would help the reader substantially as some chapters make great use of non-standard abbreviations and between chapters there is a lack of consistency. An example is the abbreviation PIC, which in one chapter refers to ‘picolinic acid’ but in another chapter means ‘proinflammatory cytokines’.
To summarise, this book does indeed cover many of the popular topics in modern psychoneuroimmunology and should therefore be of interest for clinicians and researchers with an overall interest of the field or a specific interest in one of the more specialised topics covered.
