In this book, based on the proceedings of the first meeting for the European Foundation for Psychiatry at the Maudsley Hospital, a number of experts have written with the brief of challenging established opinions about the nature of schizophrenia. The result is a kind of snapshot of the frontline of schizophrenia research, with 23 chapters addressing neuroimaging, genetics, epidemiology, psychopharmacology, early detection, and psychological treatments. Each chapter is short – the longest on ‘Why antipsychotics are anti-psychotic’ (Kapur & Mamo) is 14 pages, and some are much shorter.
The overall impression conveyed to the reader is of the vibrancy and excitement of research on severe mental illness. Moreover, each chapter provides a quick route by which the interested student can locate the latest research findings in the relevant area. The quality of the chapters is such that it is difficult to single out any for special praise or criticism. However, despite these excellent characteristics, the book does have some important limitations.
First, despite their brief to challenge the orthodox, many of the authors fail to do this. Indeed, the most obvious challenge to the orthodox view, namely the argument that the concept of ‘schizophrenia’ is long overdue for retirement, is not addressed directly by any of the authors although, in an interesting series of chapters, several address the distinction between schizophrenia and bipolar disorder using evidence from genetics (Bramon & Sham), structural neuroimaging (McDonald), studies of emotional processing (Phillips) and developmental studies (Cannon & Dean). In his foreword, Peter McGuffin remarks that, ‘Although it is no longer fashionable, as it once was, to propose that schizophrenia is a ‘myth’…. It is still not uncommon to hear some senior clinical psychologists (and an occasional psychiatrist) suggest that the diagnosis should be abandoned altogether’, and goes on to imply that the research findings reported in the book provide an antidote to this kind of foolishness.
A second limitation is that the book is biased towards the biological. Social or psychological perspectives, although surely as capable of generating controversy as biological approaches, are awarded very little space. With the exception of a very thoughtful chapter by Jim van Os entitled ‘Can the social environment cause schizophrenia?’, social risk factors for psychosis are hardly mentioned.
Despite these limitations, I found this book to be useful, mainly because many of the contributors very succinctly summarise recent developments in their fields. For this reason, it is likely to appeal to teachers of psychopathology (either to psychology or psychiatry students). It will certainly make a useful addition to university libraries and can be recommended to undergraduates taking optional advanced courses and students studying mental illness at postgraduate level.
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