Reference books no longer enjoy the esteem they once did. In universities around the world, libraries are being closed or subsumed into information technology departments. The convenience and immediacy of the internet has allowed the computer and even the smartphone to supersede the textbook as the ‘go-to’ reference for most clinicians and researchers. The accelerating pace of change has made it more difficult to for published books to keep up to date with the latest developments. It is harder than ever to find the time to read such books, and the funds to pay for them. In short, reference books are increasingly regarded as outdated, both in form and content. In this context, the 3rd edition of Schizophrenia, edited by Danny Weinberger and Paul Harrison, has a far greater challenge even than the previous edition, eight years ago. I am therefore happy to report that this book unmistakably demonstrates the continued relevance of textbooks in the multimedia, internet age.
This third edition is the first to be co-edited by Paul Harrison, following the retirement Stephen Hirsch. It has been extensively revised, with many of the chapters extensively reconfigured, eleven chapters discarded and seven added. The book is now organized into four sections: ‘descriptive aspects’, ‘biological aspects’, ‘physical treatments’ and ‘psychosocial aspects’. The scope is truly international: no less than twenty of the 33 chapters are co-authored by researchers from more than one continent. The editors have assembled the very best in the field – McGrath and Jones on epidemiology, Weinberger on neurodevelopment, Geddes, Lieberman and Kane on drug treatments, Kendler on genetics, and many other equally esteemed authors. Every chapter follows a standardized format and is extensively cross-referenced with others, with very little of the repetition, contradiction and overlap that bedevils some multi-authored texts. Stand-out chapters for me included that by Nancy Andreasen on the history of the schizophrenia concept, and the chapter on secondary schizophrenias, which exposed and cleared up my previously muddled thinking in this area.
Comparing this edition with the first, published in 1995, I was pleasantly surprised by the extent of progress in almost all areas of schizophrenia research since that time. Almost all the discussions and questions that preoccupied the field then have moved on considerably, and new debates have emerged that were unforeseen 15 years ago. The confidence that risk alleles were on the horizon has proven correct, and although the same problems of non-replication persist, our understanding of the genetic architecture of schizophrenia, including the role of copy number variants, is much more refined. Previously neglected areas of research on social risk factors, cannabis, cognitive impairments and early intervention, to name but a few, have greatly advanced our understanding. Only in the field of therapeutics does the outlook feel less optimistic than in 1995 – the bubble of excitement that greeted the new generation of antipsychotic drugs has been punctured by the cold scalpel of evidence, and the therapeutic options in treatment resistance, have scarcely advanced since the re-introduction of clozapine 20 years ago.
Overall I thoroughly recommend this book as a well-integrated collection of thoughtful and up-to-date expositions on every aspect of schizophrenia, by some of the best scientists in the field. And if, like me, you can not tear yourself away from your screen, it is available as an e-book as well.