There is an ever increasing and progressively more robust body of data that demonstrates the need for modern psychiatry to free itself from the historically based, descriptive categorical classifications enshrined within DSM and ICD systems and move towards alternative approaches that recognise diagnostic entities that are more likely to reflect the pathological processes underlying the illnesses experienced by our patients.
To this end, this book starts from the assumption that psychosis is a neurobiological syndrome associated with abnormal functioning of frontal systems, temporal lobes and the dopaminergic projections to these areas, and that many structural and/or functional changes in these systems can lead to psychosis. Within this framework, detailed consideration is given to psychotic illness divided according to several major domains: primary psychotic disorders (including schizophrenia, delusional disorder, etc.), mood disorders, neurodevelopmental disorders, central nervous system disorders, substance misuse and medications, neurodegenerative disorders and sensory impairments.
The major strength of the book is that a wide variety of clinical scenarios involving psychosis are brought together within a single volume. This helps the clinician in a practical way by providing ease of access to information as well as being helpful in moving thinking away from the rigid constraints of operational diagnostic categories. It is particularly pleasing to have ‘organic’ causes discussed in detail as well as the issue of psychosis in autism. The book is nicely presented and provides an accessible overview of relevant research. A nice innovation is the use of a grading system (A–D) to indicate the level of evidence for the issues discussed – although, disappointingly, this was not used to maximum advantage.
As tends to be the case with multi-author edited volumes there is more chapter to chapter variation in quality and coverage of material than is desirable. Most surprisingly there is not a simple, clear summary of the main information for each chapter.
In summary, this book provides useful information in a helpful framework that moves thinking beyond the unhelpful constraints of our current operational classifications. It is likely to be of interest to trainee and practising psychiatrists across all psychiatric sub-specialties.
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