Abstract
I am told that this book is one of the British ‘big three’. These are The Essentials of Postgraduate Psychiatry, known as the Maudsley book, Oxford Textbook of Psychiatry, which seems quite popular in Australia, and this one, the Edinburgh book, almost all the contributors being from that city. The Maudsley has had three editions in 18 years, the Oxford three editions in 13 years and this one has had a revision every 5 years since 1973. This suggests its continued popularity.
I asked some psychiatric registrars in training whether a standard textbook is still a necessity and I was strongly assured that it is: ‘It's the only way you can get a broad understanding of the whole field of study’. This being so, choice becomes important. My personal perspective is different; continuing education and a need to remain up to date being of paramount importance.
Companion to Psychiatric Studies follows a standard format, with chapters on all the main subjects one would expect; unfortunately, to read up certain topics fully, it is necessary to refer to the index and pick up the topics from different chapters. I looked at adjustment disorder, this being a common diagnosis in my field of work, only to find it presented as an unfamiliar concept in the chapter ‘Psychiatry in relation to other areas of medicine’.
There are three new chapters in this edition. The chapter ‘Psychiatric disorders specific to women’ I found unstimulating. ‘Legal and ethical aspects of psychiatry’ very successfully emphasised how this field has broadened and become much more important and much more complex. ‘Evidence based medicine and psychiatry’ is enthusiastically written and this subject will undoubtedly become very important in the area of accountability, not only in a personal sense, but also in the medico-political arena.
The chapters on the basic sciences are thorough and up-to-date. ‘Research design, measurement and statistics’ is clearly written and non-threatening to the tyro. I like the British approach to interviewing and mental state examination. A flaw for me is the faithfulness to the concept of neurosis, which I thought had just about outlived its usefulness. The attitude of the authors is somewhat apologetic, which makes me wonder whether they themselves had some doubts! I think the conditions listed would have been better discussed as separate topics and I couldn't find any discussion about the interface between personality and neurosis.
It seems to me that in psychiatry, as in so many other aspects of life, we are becoming closer to the USA and further away from Europe. Already I feel distant from the format in which some of the topics are discussed. In Australia, the locus of treatment in psychiatry has moved quickly and decisively away from the institutions and into the community. Resources are being directed into community care to a significant extent and this will require new learning and new emphasis over the entire field of psychiatric endeavour. I could find no wide discussion of psychiatry in the community in this book; only a brief account in the chapter entitled ‘Current controversies in psychiatry: Service delivery’. This chapter contained two other topics, which were ‘Co-morbidity’ and ‘The false memory syndrome’. The brief discussion on community psychiatry emphasises the fact that the UK is in it's fifth decade of moving towards a community-oriented mental health service and still hasn't got it right! I hope we can do better.
In a review of this book, another journal prophesied a certain pass in the Membership of the Royal College of Psychiatrists for any student who could regurgitate most of the information from it. I couldn't disagree with that. This book is a must for the library, but I think that those aspiring to the Fellowship of RANZCP would do well to consider their choice very carefully.