One of the fundamental disciplines in psychiatry, without doubt, is psychopathology. It is one of the skills that is unique to psychiatrists and enables them to venture into an unknown realm – the patient's mind – and make sense of a myriad of experiences endured by the patient. Unfortunately, in recent years there has been a decline in the importance that has been given to this discipline, to the extent that I have seen it reduced to a mere list of signs and symptoms. Thankfully, there are reasons for hope and one scholar who has been instrumental in the promotion and development of psychopathology is Professor Femi Oyebode. His new book, Psychopathology of Rare and Unusual Syndromes, approaches psychopathology from the viewpoint of its rare syndromes.
In this book, Oyebode takes us through a wide range of unusual syndromes in psychiatry, showing the diverse range of human experience. These syndromes might be rare, but they show that the capacity of the human mind to perceive and participate in the world is indeed extensive. In addition, the book reminds us that not everyone with mental illness suffers from the common mental disorders. Although these syndromes would not be on top of our list of differential diagnoses, there are people who suffer from them and it is important to be aware of them.
The book has sections on abnormalities of belief, perception, self, memory, experience of the body and behaviour. I was particularly pleased to see conditions such as Diogenes syndrome, body integrity identity disorder and the Ganser state included, as I have had patients suffering from them. Each chapter of the book includes a description of the condition, explanatory hypotheses and, best of all, case vignettes that make this book a joy to read. Oyebode's prose is excellent as always. The book is well researched, with a comprehensive list of references.
The most important contribution of this book is to bring our focus back to psychopathology. These conditions might be rare and unusual, but the way the book maps onto different areas of psychopathology makes it easy to link each section to the corresponding one in general psychopathology textbooks. Reliance on diagnostic manuals prevents psychiatrists from understanding the wide range of experiences of patients with such disorders and prevents them from being able to understand those experiences and help patients to make sense of them. By showing this wide range of patients’ experiences, this book could direct professionals towards further study of psychopathology.
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