Amy Wenzel has succeeded in creating a scholarly, immensely readable text, which focuses with great precision on the specific area of perinatal anxiety disorders. This is an area which has often been overshadowed by other psychiatric disorders in the puerperium. Therefore, this book is a welcome addition to the panoply of perinatal psychiatry texts which too frequently pay insufficient regard to this topic.
The text is well structured, with a useful introduction orienting the reader to the subject and the way arguments are to be constructed. This is followed by Part 1, which explores each of the major anxiety disorders sequentially, following a standardised approach. Each chapter looks at the prevalence of the disorder, its effects, potential comorbidity with depression, possible aetiology and a most useful section focusing on practical implications. Each section gives a comprehensive review of the data, explained in easy-to-understand terms. Where limitations in the literature are identified – which is frequent – Wenzel demonstrates a thoughtful application of the evidence obtained in the general population to this specific perinatal population. She eloquently generates hypotheses from the existing evidence base and suggests areas where further research should focus. The chapters are enhanced by robust and comprehensive referencing. Simultaneously, the use of case vignettes brings the subject to life, reminding the reader of the very real consequences these debilitating disorders can have.
Part 2 moves away from the description of specific disorders to look at clinical management. This is divided into four chapters looking at assessment, pharmacotherapy, psychotherapy, and self-help strategies. Each chapter regards each disorder in turn as appropriate and then considers common themes. Being an American Psychological Association publication, there is unsurprisingly a North American bias, and although there will inevitably be some overlap with the UK, there will also be some marked differences. Notably, the assessment processes will differ in terms of screening, there is an emphasis on the US Food and Drug Administration (FDA) medication guidelines and the self-help texts recommended may not be appropriate for different cultures.
On the whole, this is a useful contribution, well constructed and well researched. Wenzel’s passion for the subject shines through on every page and is exemplified by her opening comments: ‘What a delight this book was to write!’ I am pleased to say it is an equal delight to read.