I have not passed on several books Iive read over the past months that I believe would be of interest to those concerned about children, culture and psychiatric drugs. Here are some of them with brief reviews.

Therapy Culture: Cultivating Vulnerability in an Uncertain Age by Frank Furedi (Rutledge, 2004). Furedi, a British sociologist, takes on the broad issues of why we are so focused on feelings in Western culture and details how feeling ìbadî has become unacceptable, to be ìtreatedî by experts who in the process take away our own power and agency. This is not a light read or easy book but is seminal to our understanding on why Ritalin and Prozac have become so central in our childrenís lives.

The Rise of Viagra by Meika Loe (New York University Press, 2004). The parallels between Viagra and Ritalin are obvious, two universal performance enhancing drugs. Loe details how Viagra has changed our understanding of sex, relationships between men and women and marriage. Her concerns about Viagraís impact are understandable but more recent experience indicates that the drugís long term effects on men and their sexual performance may have been overestimated.

The Concepts of Psychiatry: A Pluralistic Approach to Mind and Mental Illness
by S. Nassir Ghaemi (Johns Hopkins University Press, 2003). This book caught my attention billed as a critique of the biopsychosocial view of behavior and psychiatry. The biopsychosocial perspective has been a fundamental cornerstone to my thinking about children's behavior and their problems so I was interested in a viewpoint that could be effectively critical and offer an alternative. I was needlessly worried. Ghaemi criticisms are weak and his alternatives strike me as muddled and all over the place. He would defend his position as something called pluralism but to me it felt like a defense of the department of psychiatry at the Harvard Medical School where he teaches. Also not an easy read.

The Age of Melancholy, Major Depression and Its Social Origins by Dan G. Blazer (Rutledge, 2005). I read this in anticipation of reading the next book, Against Depression by Peter Kramer. Blazer convincingly makes a case for depression having biological and genetic roots but requiring a certain environment and culture to express itself. He believes the American culture (and its lack of meaning) is especially conducive to the expression of depression in the society. He wants to revivify the socially progressive movement of "social psychiatry" that died in the early 1970s.

Against Depression by Peter Kramer (Viking 2005). Written by my friend, Peter Kramer, this book contains some of the best science writing I've ever read. Kramer's language and clarity make it a pleasure to read. His breadth of scope in his analysis of depression is profound, taking in not only biological processes, but examining depression within literature and art in Western culture. His polemic: depression is a chronic unremitting unrelenting worsening condition in adults and should be treated aggressively and early with medication. His view is understandable as an adult psychiatrist. My view as a behavioral pediatrician dealing primarily with children and teens is far more optimistic. Indeed to categorize and treat as pathological the children I see is to too early condemn them to life long patienthood. The children I see do improve, often quickly with effective family intervention. Some will benefit from medication. My main complaint about Against Depression is Kramer doesn't sufficiently emphasize that even genetic/biological conditions (psychiatric or otherwise) require certain environments for full expression. Still, Against Depression is a book that should be read.