Abstract
As advertised on the cover, this pithy text will appeal mostly to senior psychiatry trainees preparing for postgraduate psychiatry exams. Similar in style to Essential Psychiatry [1], the format includes highly structured brief chapters broken up into demarcated sections peppered with summary boxes illustrating the main points. Like Rose's text, the way in which the information is presented clearly, succinctly and systematically is as useful as the actual information itself, and I believe it is a useful template for answering the Royal Australian and New Zealand College of Psychiatrists (RANZCP) written exam questions. The book is one of a series of volumes which bring together popular articles from the Royal College of Psychiatrists' professional development journal Advances in Psychiatric Treatment. I think it generally achieves its aim of looking at the key clinical topics relating to modern therapeutic practice and ‘balancing the realities and uncertainties of day-to-day clinical psychiatry and the aspirations of evidence-based medicine’.
This volume of the series is very much centred on what Kendell [2] calls ‘the heartland of psychiatry and the core of its clinical practice’. This will please some, but others will be concerned by the frequent reference to ‘severe mental illness’ in this context. The book focuses on practical management issues related to acutely disturbed psychiatric inpatients, looking at both pharmacological and psychosocial approaches. A strength of the book, I believe, is that many of us won't have heard of many of the authors (all British), which rings true to the editor's claim that most of them are ‘busy clinicians’ rather than widely published academics with international profiles.
Included in the book are chapters on the topical issues of comorbid substance misuse, homelessness, psychoses in elderly and postnatal patients, and learning disabilities. There are also chapters on assessing patients for fitness to be interviewed by police and preparing medicolegal reports. Many chapters give a brief account of the recent history of the terms and ideas related to the chapter's topic, in some instances describing ‘fashions’, before getting down to practicalities. I found this to be a refreshing approach since one quickly got an impression of the author's viewpoint on their subject. Other chapters are more basic literature reviews on key topics; I found the chapter on neuroleptic malignant syndrome to be particularly clear and practical.
Being a British text, some of the material is not relevant to Australian practitioners, such as the use of sulpiride and amylobarbitone and specific references to the English Mental Health Act and the British health system, health policies and certain practice routines. It is interesting, nevertheless, to have this window into day-to-day British psychiatric practice. In the clinically orientated chapters, the authors describe their routine practice, and one certainly gets the impression they are speaking from considerable personal experience. Some clinician readers will disagree with aspects of what they suggest, for instance the use of clonazepam routinely in the setting of acute phase psychosis recommended on page 32. There are commentaries by other authors on some of the chapters which often make very good points but not always, unfortunately, fully citing their sources. One such assertion on page 12, that ‘…increased proportions of agency staff are associated with increased levels of violence on a unit’ rang true with my own experience but I was disappointed by the lack of a citation.
Overall, I think this book would be a worthwhile purchase for senior trainees preparing for the RANZCP exams. Hopefully, in the future Australasian versions could be compiled.