Abstract
Reviewed by: J Guy Edwards, FRCPsych, FRCP, FRCGP(Hon), HonMFPH, DPM, Retired Consultant Psychiatrist, UK
John Geddes, Nancy Andreasen and Guy Goodwin are to be congratulated for assembling such an impressive, international team of authors and providing us with this excellent textbook. It is a ‘must’ for any large psychiatric, psychology, medical, university and pharmaceutical library, or would be a most valuable acquisition for sociology, criminology and medico-legal libraries.
More than 300 authors – most from the UK, other European countries and the USA, smaller numbers from Australia, and smaller numbers still from other countries – have contributed 146 chapters to 24 sections of the book. They deal with topics covering practically every important aspect of psychiatry ranging from genetics to the psychiatry of late life. The chapters are well referenced, the one on antipsychotic and anticholinergic drugs having as many as 260. Several chapters provide helpful illustrations, some coloured.
Purchase of the book comes with five years’ free online access, which allows for intuitive search and browse functions, downloading to Powerpoint and PDF, and other useful features.
The book has a strong neuroscientific orientation with an emphasis on genetics, molecular biology and neuroimaging. In their chapters, the authors have provided helpful introductions to these subjects for the uninitiated and those less familiar with their subjects. But it is not only neuroscience that is dealt with; commendably, there are also chapters on broader aspects of psychiatry, such as the patient’s perspective, stigma, ethics and global mental health.
What will be of most interest to forensic psychiatrists, others involved in psychiatry and the law, and readers of the Medico-Legal Journal is the last section of the book. This comprises seven excellent chapters written by 13 authors on the association between psychiatric disorders and offending, the developmental approach to understanding the needs of youngsters and their contact with the criminal justice system, the sexual offender, stalking, domestic abuse and violence, assessment of the risk of violence, homicide and the expert witness in court.
Other chapters that are relevant to medico-legal work include those on personality, impulse control, conduct and substance use disorders, and on malingering. And there is a vast amount of authoritative information on diagnosis and treatment throughout the book that expert witnesses and lawyers might wish to refer to in cases of alleged medical or other clinical negligence.
The book started life as the New Oxford Textbook of Psychiatry, edited by the late Michael Gelder, the late Juan Lopez-Ibor and Nancy Andreasen. The second edition brought John Geddes into the editorial team and the present editors now also include Guy Goodwin. Guided by their experienced leadership and expertise, consecutive editions of the book have gone from strength to strength.
The current edition has been reduced from two volumes to one, avoiding much of the replication and overlap that existed in the second volume. There have been other changes too – all for the better. A particularly welcome feature is the use throughout the book of the most up-to-date international classifications of psychiatric and behavioural disorders – DSM-5 (Diagnostic and Statistical Manual, 5th edition, American Psychiatric Association) and ICD-11 (International Classification of Diseases, 11th revision, WHO).
References to the most important available evidence for the effectiveness of treatments are also provided throughout. Treatment and management of patients, mostly multidisciplinary, are critically discussed.
The editors’ decision not to pre-specify the chapters for conformity but allow each of them to be presented as free-standing contributions is acceptable but, if there were to be a future edition of the book, I suggest consideration be given to deviate from this decision to the extent of presenting at the beginning or end of each chapter a list of, say, the 10 most important key points or take-away messages. I should also like to see more critical discussion of non-specific aspects of treatment and what terms like ‘effective in’ and ‘more effective than’ actually mean in everyday, real-life psychiatry – questions that we should all be asking much more often than we do.
The book would also benefit from adding many subjects currently not included in the index at the end of the book. Examples include ‘rating’, ‘over-diagnosis’, ‘over-prescribing’ and, surprising for a textbook of psychiatry, ‘Mental Health Act’.
Despite these suggestions, the third edition of the New Oxford Textbook of Psychiatry has not only lived up to the high standard expected of it but has exceeded expectations. It has provided comprehensive reviews of what is known and guidelines for future research, which are particularly important in psychiatry in which there are far, far more unanswered than answered questions.
Much gratitude is due to the distinguished editors for bringing us the book, the many first-class authors for contributing their chapters and Oxford University Press for their excellent production. The book will, in my view, continue to occupy a dominant place in the international medical literature and, at least for the foreseeable future, could well turn out to be the most widely used and influential reference work of its kind in psychiatry.