STRESS A-Z - A Sourcebook for Facing Everyday Challenges by Ada P Kahn, PhD. Facts On File, Inc, New York, 1998, 390 pp, $40

Review by Del Meyer, MD

Stress is a contemporary and pervasive public health issue in the United States as evidenced in individuals, families, workplaces, homes, and communities. Medicine and psychology describe stress as any strain or interference that disturbs a person's normal functioning. Stress can be caused by external physical tensions such as noise or heat; internal physiologic ailments such as ulcers, angina, asthma; external psychologic factors such as practice frustrations; or internal psychologic turmoil of depression and anxieties.

Dr Kahn, who wrote the compendium, The Encyclopedia of Mental Health, (Sacramento Medicine June 1994) has carefully chosen contemporary issues in Stress A-Z, covering a variety of stress-related areas such as diet, environment, occupational illness and sick building syndrome, coping in today's work environment, downsizing, aging, and end-of-life issues. She treats child and spouse abuse as well as the larger topic of domestic violence, a much greater public health problem than is generally realized. She looks at sexual stress and even the stress related to condom usage, and throws in a little history--should it be credited to Dr Condom, a physician in the court of Charles II, or the Italian anatomist Fallopius in 1564? She looks at information anxiety, a product of our current information explosion and a form of stress that has not been generally appreciated. She examines culture shock, which may become an increasing problem in this era of world wide travel and migrations, and highlights anniversary reaction, holiday stress, and weekend depression.

In this era of medical cost cutting, the problem of stress becomes more important. It is estimated that two-thirds of the visits to physicians' offices are for stress-related problems. Physicians may experience more stress as consultations and special tests are discouraged and managed care restrictions are implemented. Patients are acquiring new insight and learning about health matters in response to HMOs and managed care, checking up on their diagnosis and treatment plans on the Internet, sometimes discontinuing their doctors medications because of anxiety occurring after reading about relatively mild and rare side effects.

As stress becomes a greater factor in everyday lives, we are presented with a very readable, user-friendly compendium. Stress A-Z includes more than 500 entries, many of which describe conditions we see every day--physical disorders with emotional components. By having the volume next to our desk top references, we can easily refer to it, suggest it for our patients or have them read it at the local library.

Del Meyer, MD