The predominantly biological direction of present-day psychiatry has by no means crowded out new work on its phenomenological and historical aspects. Germany has always been the main focus of phenomenological interest, and this tradition remains strongly alive, as Marneros & Pillmann show in an important contribution from the Martin Luther University of Halle-Wittenberg. They say that understanding of brief and acute psychotic disorders - with a short duration and generally good prognosis - has remained minimal. The core of this book is an account of their own longitudinal study, which they say was ‘not epidemiological, but clinical’. In a 4-year period, 1036 in-patients with non-organic psychotic or affective disorders were screened at their university hospital, 4.1% of whom received a diagnosis of brief acute psychotic disorder. This is consistent with the rates obtained in previous studies. Unfortunately, I found this account of their study obscure at times, with the method not clearly separated from the results and discussion.

The ‘decisive characteristic’ of brief acute psychotic disorder was found to be ‘the polymorphic and brief symptomatology’. For both research and clinical purposes, the authors recommend that these disorders should be separated from schizophrenia, schizoaffective disorder and affective disorders - a fairly comprehensive exclusion. Surprisingly, they report that the majority of patients with brief acute psychotic disorders are female and that age at onset is higher than that for schizophrenia or bipolar schizoaffective disorder. Long-term pharmacotherapy, especially with antipsychotics, is advised for all three kinds of psychotic disorder, with the addition of mood stabilisers for some (not for schizophrenia). The outcome of brief acute psychotic disorders was found to be favourable in the extended follow-up, but the disorders were usually recurrent.

The main purpose of this work is to reduce the heterogeneity of groups of patients diagnosed as having ‘schizophrenia’ or ‘affective disorders’, by removing a small but (arguably) well-defined group which has significantly different characteristics from the rest. The authors say that we need ‘exact clinical diagnoses and psychopathological understanding’ of these atypical psychoses if we are to treat them appropriately and gain more reliable knowledge about them. Although its content is rather dense, in general the book is clearly laid out, with frequent boxed summaries. It is marred by a poor standard of scientific English. For a fairly short book, the price can only be described as bizarre; a cheaper paperback version must surely follow.

Among the byways of psychiatric history, the contribution of August Wimmer (1872-1937) in Copenhagen must surely be one of the least frequented. His major writing on psychogenic psychoses was never translated from Danish into any other language, but this has now been done by Johan Schioldann, a Danish psychiatrist settled in Australia. A characteristically learned introduction by German Berrios sets this newly discovered work in its wider context.