Handbook Of Stress Medicine: An Organ System Approach

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Handbook Of Stress Medicine: An Organ System Approach

CRC Press Boca Raton, 1998, 423 pages, $ 99.95

This compendium is divided into five sections, The first, which covers concepts about the nature of stress, deals with various definitions of stress and their attendant problems, the importance of perception and coping, and challenges for future stress research. Section II, The Effect of Stress on Organ Systems, has chapters devoted to the cardiovascular, respiratory, gastrointestinal, neurological, immune, and endocrine, systems, with special ones devoted to problems of both male and female sexual dysfunction. Section III has chapters on the role of stress in specific disorders, including malignancy, AIDS, addiction, pain, anxiety states, and dental diseases. Other topics such as job stress, the psychodynamics of stress, biochemical indicators and other techniques to measure stress are found in Section IV. The final section has chapters on cognitive and behavioral methods of stress control, and pharmacologic treatment for anxiety disorders.

As stated in the Preface, the purpose of this book was to provide a scientifically based review of the relationship between stress and alterations in physiology of the major organ systems in the body and their pathological consequences, and this goal has been admirably achieved. While only a handful of the more than 40 authors would be considered luminaries in the field of stress research, this provides an advantage, since they have no private agenda or bias, as is often the case with experts who want to promote their own theories, and are less apt to give a balanced and unbiased presentation because of their own pet theories. Since the scope of this book obviously extends far beyond a discussion of the effects of stress on organ systems per se, it is unfortunate that other relevant topics of great popular interest and controversy were not considered. Some of these include alternative medicine approaches to stress reduction, such as the use of herbal medicines like kava, valerian, ginkgo and ginseng. No reference was made to the explosion of subtle energy therapies like aromatherapy, music, and the use of devices that emit various types of electromagnetic fields. Some of these, and particularly the latter, have now undergone rigorous clinical trials and double blind studies that have confirmed their efficacy and safety. In many instances, they are much more cost effective than drugs, and devoid of their harmful side effects and addictive tendencies, as has been shown with the Symtonic device for the treatment of insomnia and anxiety, and the use of neuroelectric therapy for addictive disorders and withdrawal symptoms. Other examples include the use of cranioelectrical stimulation in depression, which has been effective in patients who had failed to antidepressant medications.

There are some other minor shortcomings. Selye's original definition of stress was "the non specific response of the body to any demand for change", rather than "the rate of wear and tear", which he adopted decades letter when attempting to explain his theories to a lay public. The chapter on measuring stress omitted several important instruments, had none dealing with Type A, and no update on the Holmes-Rahe scale. Nevertheless, this is a very useful and authoritative text. It is well referenced, diagrams are of high quality, and can be highly recommended.

The American Institute of Stress.

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By Paul J. Rosch

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