The sheer size of this beautifully produced two-volume textbook begged a cherrypicking approach as a realistic alternative to months of full-time reading — by the end of which time review, reviewer and text might all be out of date!

Basic sciences are covered to the likely satisfaction of trainees preparing for examinations or psychiatrists engaged in continuing professional development. More space might have been given to evidence-based psychiatry (Geddes), in light of the importance accorded this area in training of psychiatrists. Risk assessment and prediction of violence (Mullen) will intimidate some clinicians, particularly those unable to interpret legal jargon: it is nicely balanced by Gunn and Wheat on principles of mental law. Service provision (Thornicroft and others) to populations and communities is covered in a series of contributions, none of which quite tests the goodness of fit of a strong private sector to a social model of care delivery. Short pieces on US health maintenance organisations (HMOs) and Australian services might not have gone amiss. Psychiatric intensive care units (PICUs) are not discussed outside forensic settings. Cooper and Oates communicate the essence of clinical assessment. Berrios and Pichot, as always, write well on the history of ideas and of clinical psychiatry, respectively. Slavney and Mc Hugh wrestle with the impossible task of making the education and training of psychiatrists entertaining: no doubt unintentionally, they convey that only in Baltimore is the matter properly understood. Suicide is addressed by Hawton and others in three essays, each of which skirts around the embarrassing possibility that psychiatrists may never know how to reliably predict or prevent it. Johnstone on the treatment of schizophrenia is good but could be better: she spends too much time on oral chlorpromazine and too little on novel antipsychotics, depot medication or the challenge of depressive symptoms. Parker on the classification of mood disorders is idiosyncratic. Goldberg and others rehearse widely respected views on the psychiatry of primary care without giving away how little real progress there has been over the past 40 years in this important field. Ballenger, in an otherwise excellent essay, merits some criticism for his implied preference for benzodiazepines as best evidence-based medication for panic disorder. Paykel and Scott, in a crafted essay on the treatment of mood disorders, balance perfectly the respective importance of pharmacological and psychotherapeutic interventions. Fink's assertion of the continuing importance of electroconvulsive therapy is as convincing as it is necessary, but would have been even better with more attention to transcranial magnetic stimulation. A strong team on eating disorders (Russell, Fairburn and others) gives little hope that certain aetiological riddles will soon be solved. Brockington on perinatal psychiatry refreshingly debunks fads about depression in pregnancy, postnatal depression and ‘post-abortion psychosis’. A team led by Mayou deals thoroughly with unexplained medical symptoms and other important issues bearing on medicine and psychiatry. Despite a scholarly introduction by López-Ibor and several interesting essays, personality disorder remains, here as elsewhere, psychiatry's Achilles' heel. Tyrer and Davidson (on management) had an unenviable task; with literally nothing evidence-based to offer, they round on colleagues who (like me) are prejudiced against admitting antisocial patients to general in-patient settings. This piece cannot in safety be read in isolation from the welcome essay on ethics (Fulford and Bloch) presented elsewhere.

Lack of expertise prevents me from commenting on specialist sections in any depth, but those on psychotherapy, child psychiatry, ‘mental retardation’, old age psychiatry, neuropsychiatry and forensic psychiatry look to be very good, including a piece on sequelae of brain injury (Fleminger) which is quite exemplary. The section on the contribution of psychodynamics is, unusually, a model of clarity. Henderson on epidemiology and Brown on sociology make their subjects come alive. And this is just a random selection.

This text is a serious heavyweight contender for all medical and departmental library short-lists of essential items. An important editorial achievement is the success with which even the most esoteric aspects of psychiatry have been made accessible to the general professional reader, suggesting that the work will make an educational impact well beyond specialist psychiatric practice. There is something here for everybody. Initially sceptical, I already treasure my own (free) copy. As in all texts aiming to be comprehensive, omissions can be found if one looks hard enough and not all 273 contributions can be of uniform excellence. Yet the general standard of writing is very high and printing, illustration and indexing leave nothing to be desired. An eclectic approach and international flavour are welcome innovations in a text of this size. The necessary breadth of the work says much about the historic failure of psychiatry to define its own boundaries. Nowadays, declarations of interest should be required of all authors whenever pharmacotherapuetic subjects arise. Inevitably, some sections will shortly become out of date: the withdrawal of droperidol, restriction of thioridazine, white matter abnormalities in the frontal lobes of people with antisocial personality disorder, new evidence for efficacy of cognitive therapies in delusional disorders and advances in molecular genetics are some latecomers waiting in the wings. An electronic version of the text, continually updated, would be a major and welcome innovation that could be unreservedly recommended: otherwise, dinosaur status will threaten unless new editions appear at unusual frequency and regularity. As of now, this may be the foremost international textbook of psychiatry.