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Disease, Pain and Suicidal Behaviour by Elsebeth Nyler Stenager PhD MD and Egon Stenager MD. Haworth Press, 10 Alice Street, Binghamton NY13904-1580, USA, 1998 (ISBN 07890 029507). 127 pages. $18.

The authors of this book, a husband and wife team, are working in Denmark and have written many previous publications.

The book is well written and divided into logical chapters. Each chapter is then further divided into sections that make it very easy to look up an area of interest.

I found the chapter ‘General aspects of suicidal behaviour’ of particular interest, especially the frequency of suicide in the USA and Europe. This was higher than I believed. However, some authors suggest that because of differences of recording on death certificates in some countries, the actual rate there is higher and it has been under-

estimated by perhaps eight to ten times.

The World Health Organisation has noted this change and adopted as its 12th goal in the target for Health for All: The Health Policy for Europe, 1998:

By the year 2000 there should be a sustained and continuing reduction in the prevalence of mental disorders, an improvement in the quality of life of all people with such disorders, and a reversal of the rising trends in suicide and attempted suicide.

The same chapter also outlines several interesting statistics such as how the suicide rate differs in different countries, 44 per 100,000 in former communist countries and 20 per 100,000 in Germany and France. In the past, women more than men took or tried to take their own lives, but today this is not so, the men have caught up.

The book also looks a t suicide in various conditions, eg suicide in

epilepsy, Parkinson’s disease and mental disorder. I t gives a brief description of the disease, a review of literature and then the authors offer their own conclusion.

A note for physiotherapists - the book suggests an increased risk of suicide where mental illness or chronic pain are present.

The bibliography is great; I like the way the authors have divided it into chapters.

Generally this is a good little book with lots of information and facts on the various conditions, an eye- catching cover and easy to read. Other people in the department picked it up because of the cover and stayed to flip through, often reading a section relating to a patient they were working with,

I suggest this little book would be useful to physiotherapists working in mental health or neurology.

Christine Marsh MCSP

Moving in on Pain edited by Michael 0 Shacklock. Butter- worth-Heinemann, Oxford, 1995 (ISBN 0 7506 8926 9). Illus. 216 pages. f 16.99.

This book was published following the ‘Moving in on Pain’ conference held in April 1995. It is a collection of the papers presented a t that conference. The main theme is the recognition that pain in our society causes tremendous social, economic and personal cost, yet traditional methods of pain relief and treat- ment have often failed to address the problem.

The papers have been divided into five main sections - Images of Pain, Discussion Papers, Psychological Aspects, Clinical Aspects, and Effects of Treatment and Physical

Manoeuvres. The papers are short summaries, well-written and under- standable. I t means each chapter stands on its own and it can easily be dipped into for the relevant subject. Each paper is well refer- enced, the diagrams are clearly labelled and the tables are easily understood.

Things have begun to change since the conference but this book still provides an essential back- ground to our knowledge of pain. I would draw particular attention to the paper on ‘Clinical reasoning and pain’ which emphasises the need for lateral thinking and ‘Moving out of pain: Hands-on or hands-off which argues that the two are not mutually exclusive.

Adventures in Senior Living Learning how to make retirement meaningful and enjoyable

by J Lawrence Driskill, Ha worth Press, 10 Alice Street, Binghamton, N Y 13904- 1580, USA, 1997 (ISBN 0 7890 0254 X). Illus. 7,180pages. $18.

What do you do when you retire? Care for an Alzheimer’s diseased spouse? Engage in prostitute rescue work? Take widows and widowers out t o lunch? Conduct training sessions in Christian giving? These are among the retirement activities

recorded in the series of interviews with individuals which make up this book.

I t is an American book, although the photograph of Phyllis Love ‘Osanna’ Gooding, aged 70 years, shows her by Stonehenge. It is also written from the Christian point of view - the author is pastor of a Japanese-American church in Cali- fornia. Within these parameters it is an interesting series of case histories of active retirement.

Laurence Dopson

Throughout the book it is high- lighted that as clinicians we should place more emphasis on pain mechanisms rather than just the structural source of a patient’s pain.

Patients in chronic pain may present with a combination of peripherally evoked nociception, centrally evoked pain, sympatheti- cally related pain and psychological mechanisms.

The complexity of the neural pathways together with the concepts of plasticity and central sensitisation are also explained.

The book also identifies the need for an inter-disciplinary approach to patients with chronic pain - the physical, psychological and social contribution to the pain experience.

Additionally, the clinically-based papers identify treatments for physiotherapy management of neurogenic pain presenting as entrapment neuropathies - for example - thoracic outlet syndrome and peri-anallperineal pain.

The book is aimed a t health professionals but specifically physio- therapists. I think it forms essential reading for those who are involved in helping patients in pain - either acute or chronic. I would definitely recommend it as a departmental reference book or for individuals,

S u e Mickleburgh BA MCSP

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Physiotherapy, April 1998, vol84, no 4