Abstract
The issue of ‘insight’ in psychiatric practice has a long and complicated history, and the term can be interpreted in many different ways. Insight in Psychiatry provides a comprehensive overview of psychiatric aspects of insight beyond just psychotic disorders. The book is divided into two parts. Part 1 gives an historical overview of insight in psychiatry, tracing perspectives and the evolution of ideas in French, British and German literature. This section is comprehensive, albeit also being rather dense, with a large amount of information covering many diffi- cult concepts.
Part 1 also includes a useful overview of ‘where things are at’ with respect to empirical clinical studies in the field. This section has its main emphasis on the ‘functional’ psychotic illnesses and organic disorders. One could argue that a full consideration of insight should put more emphasis on other disorders in which ‘insight’ can be lost. For example, insight (or lack thereof) in obsessive- compulsive disorder and the so-called somotoform disorders is given but passing mention, probably reflecting the lack of empirical literature on those maladies.
Part 2 provides the author's particular conceptualization of insight, with chapters detailing her view of a ‘structure of insight’ covering whether awareness of illness and insight require discrete consideration and an expostulation of the relationship between awareness and insight. This part of the book is closely written and articulates the author's particular stance well with useful accompanying supportive material and reference to Part 1. At the end of the day, however, I was left wondering a little bit about where it actually left clinicians in terms of application to their individual patients.
In summary, this is a well-thought-through and comprehensive volume although it does have gaps in terms of consideration of disorders beyond these psychoses and organic disorders.
David J. Castle
Melbourne, Australia