The fourth edition of Essential Psychiatry is a completely revised version of Essentials of Postgraduate Psychiatry. It claims to be a comprehensive and up-to-date overview of effective clinical practice backed by research evidence. It is aimed at a wide audience of psychiatrists, members of multidisciplinary teams, as well as psychiatry trainees. This edition has contributions from prominent authors around the world, which is an advantage over the previous editions that have been criticized for being too ‘Maudsley-centric’.
Although the layout has been completely revised, there is still room for improvement. There is now good use of tables, fact boxes and a comprehensive index enabling the reader to navigate through the rich text from cover to cover. However, a trainee preparing for exams trying to dip in and out of this textbook may find it harder to locate important topics due to the plain style of presentation without the use of colour, or multiple subheadings, which some of the other competing textbooks make use of.
On the other hand, this textbook covers all the important topics and is well edited without much overlap between chapters. There is good comparison between ICD and DSM classification systems throughout, highlighting the similarities and differences. The basic sciences such as neuroanatomy, neurochemistry and neuroendocrinology are well integrated in individual chapters.
From a trainee's point of view the first section ‘The Tools of Psychiatry’ is an excellent introduction to descriptive psychopathology, psychiatric classification, research methods, neuroimaging and genetic epidemiology. The chapter on research methods is particularly good as this presents information in a clear and understandable way for non-researchers. However, this first section is more theoretical and lacks advice on practical clinical issues, such as interviewing techniques.
Several new chapters have been added such as transcultural psychiatry and chapters on psychotherapy. There is also an emphasis on service delivery models within primary- and secondary-care settings. This is essential for anyone working in psychiatry today, and sets this book apart from other standard texts.
The chapters on important psychiatric disorders such as schizophrenia and affective disorders are outstanding. They incorporate cutting-edge research to inform clinical practice. All the specialities including neuropsychiatry are covered. The chapters on child psychiatry, old age psychiatry and personality disorders are well written. There is a good depth and breath of coverage of eating disorders, and the authors cleverly point towards useful internet sites for further information.
Omissions in textbooks aiming to be comprehensive can always be found if someone looks hard enough. Certain topics seem to have been neglected completely such as dissociative disorders. Psychiatry of intellectual disabilities does not cover genetic syndromes and mental illnesses in detail. Whilst the chapter on alcohol gives a good narrative of physical complications along with a practical guide to the treatment of alcohol problems, it is weak on psychiatric complications such as depression and anxiety.
Legal and ethical issues are briefly mentioned under general hospital psychiatry and forensic psychiatry. However, compulsory treatment, mental capacity, confidentiality, consent, etc. are relevant to all of psychiatry and therefore could merit a separate chapter. Specific discussions in relevant chapters such as psychiatry of old age and intellectual disabilities are also needed.
In summary, Essential Psychiatry, Fourth Edition is an excellent reference book with up-to-date evidence-based knowledge which will be an invaluable resource for psychiatrists and mental health professionals alike. Although postgraduate trainees preparing for exams may prefer a more exam-oriented book, for a comprehensive understanding of fundamental issues in psychiatry this textbook is a must-have.
