No self-respecting worker in deliberate self-harm and suicide prevention, either clinical or research, can afford to be without access to this comprehensive handbook — possession (or at least, a copy in one's local library) and regular use, may well become a marker of serious involvement in the subject! Every university department of psychiatry, and every major hospital with a medical accident and emergency department striving to carry out their work to a high standard will need to have this accessible and well-thumbed.

This is the most comprehensive, up-todate, informative and well-written source of information on suicide and suicidal behaviour. It integrates knowledge in terms of the interaction between the individual and the environment with relation to all aspects of suicidal behaviour. There are four parts. The first, on understanding suicidal behaviour, deals in detail with background factors for suicide and deliberate self-harm: epidemiology worldwide, psychology, ethology, sociology and genetics. Psychiatric aspects of suicidal behaviour are considered in terms of depression, anxiety disorders, schizophrenia, substance misuse and personality disorders. An excellent chapter integrates these aetiological factors and delineates the pathways to suicide, how these different factors combine.

The second part considers different populations (children, adolescents and the elderly) and their association with suicide. It also looks at associations with sexuality and the reproductive cycle, employment and the labour market, the impact of suicide on relatives and friends, ethical and legal issues, repeated suicidal attempts, physically and psychiatrically ill populations, and the link between suicide and violence.

The third part covers pharmacological and psychological approaches for the treatment of suicidal behaviour. In particular, it considers people who attempt suicide in adolescence and their treatment, prevention in the elderly and management in the general hospital. There is a chapter on multi-disciplinary approaches to management. In addition to the methods of treatment described, the evaluation of outcome data is also extremely valuable for planning services.

The final section is concerned with the prevention of suicide and attempted suicide. It looks at the prediction of suicide and also at strategies for the general population, including a chapter specifically on approaches that may be useful in Asia and the Far East. Prevention in particular populations is then reviewed, including prevention among psychiatric patients, in schools and in primary care. There is discussion of the role of mass media in suicide prevention and a chapter on how volunteers can be used.

I do have a few gripes about this volume. The chapters are not all uniformly readable and some authors appear to have been writing more for specialists in their own fields than clinicians and researcher-sacross the whole area. I could find no reference to debt and its significant self-harm. However, the criticisms are minor and the plaudits major. This is an invaluable work of reference which will be essential for clinicians and researchers for many years to come.