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The Maudsley Handbook of Practical Psychiatry (5th edn)

Article  in  The British Journal of Psychiatry · March 2008

DOI: 10.1192/bjp.bp.106.031708

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 The British Journal of Psychiatry (2008)
192, 235–240
Book reviews
Edited by Sidney Crown, Femi Oyebode
and Rosalind Ramsay
Responses to
Traumatized Children
Edited by Amer A. Hosin.
Palgrave Macmillan. 2007.
321pp. £55.00 (hb).
ISBN 1403996806
There is no shortage of traumatic experience in the world. High
rates of prevalence are well documented, especially in areas
affected by war and natural disaster, as are the effects of trauma
on mental health. Children are especially vulnerable. In the past
half century or so there has been a U-turn in our understanding
of how children are affected by trauma and how best to help. It
used to be believed that children are not deeply affected by
trauma and, if not reminded, they will soon forget and recover.
We now know that this is not the case and children, especially
young children, can be affected in a lasting way by trauma unless
they receive timely, appropriate and effective help.1
But what is effective help, and what do we know about the
approaches that are most effective for children? This book seeks
to address these questions and others. For example, what are the
priorities for intervening in situations such as natural disaster?
What type of support can prevent the development of mental
health problems? Can resilience be enhanced? How can mental
health professionals make a useful contribution to the mental
health of refugees and children affected by war? The evidence base
for guiding mental health interventions remains scanty in many
key areas.
This ambitious book sets out to provide clinicians working in
the challenging and diverse field of child trauma with an accessible
summary of the available evidence and a guide to current good
practice across a broad range of topics, for example, diagnostic
assessment, building resilience, dealing with natural disaster such
as hurricane Katrina and work with refugees. The contributors are
experienced clinicians from the UK and the USA. Each chapter
provides a clinical perspective and also a helpful review of litera-
ture with extensive references. The chapter on psychopharmacol-
ogy, however, is disappointing, lacking adequate coverage of the
neurobiological or developmental perspectives. In addition to
the topics already mentioned, this book gives space for some im-
portant contextual issues, for example, the need to consider how
best to protect clinicians from the effects of secondary trauma
and burnout; working across different cultural perspectives and
the importance of working with parents and families of children
affected by trauma.
1 Morgan L, Scourfield J, Williams D, Jasper A, Lewis G. The Aberfan disaster:
33-year follow-up of survivors. Br J Psychiatry 2003; 182: 532–6.
Guinevere Tufnell Great Ormond St Hospital, London WC1N 3JH, UK. Email:
guinevere.tufnell@nhs.net
doi: 10.1192/bjp.bp.107.039610
The Maudsley Handbook
of Practical Psychiatry
(5th edn)
Edited by David Goldberg
& Robin Murray. Oxford University
Press. 2006. 256pp. £24.95 (pb).
ISBN 0199299765
Practical skills in any subject are best learnt by apprenticeship,
wherein the less experienced student learns from a more experi-
enced teacher. This is especially important in psychiatry where
the practical skills of assessment, formulation and management
require a teacher to have wide experience to be able to teach their
students the nuances of assessing psychiatric patients where no
two patients present the same way. The challenge for the editors
was to provide a simple and structured guide to practical skills
in the assessment and management of patients in psychiatry, while
also covering the wide variations in, and associated challenges of,
psychiatric presentations.
The eleven chapters cover four main themes: interviews and
assessment, mental state examination, formulation/summary
and management. Practical guidance is included for interviewing
children, adults and elderly and neuropsychiatric assessment. Also
covered are different interview situations including wards, out-
patients and emergency departments. The areas that new trainees
find difficult during assessment (i.e. personality, sexual abuse,
family relationships) are covered in adequate detail.
The chapters on mental state examination and formulation/
summary are brief, yet cover the necessary subject matter.
Management covers early treatment interventions and when to
refer to experts. The treatment plans provided for different dis-
orders are to the point and in-line with current guidelines. The
wide variety of conditions for which information on when to refer
is provided should prove a useful resource for trainees.
Deserving a special mention is the chapter on special interview
situations. The wealth of experience of the editors is most evident
here, where guidance on many a difficult situation that trainees
face daily has been provided in one place. The section on special
problems covers a range of disorders/situations requiring different
approaches. The final chapter provides information on legal and
service organisation issues. The appendices contain information
that will be useful on a daily basis to a trainee in psychiatry.
235
Book reviews
The breadth and richness of the editors’ clinical and teaching
experience has been distilled into a succinct yet erudite handbook
of practical psychiatry. It is a refreshing change that, despite being
a handbook, it does not just contain endless lists. The narrative
style is simple, yet authoritative. In fact, reading the book trans-
ported me back to when I was inducted into psychiatry and one
of my favourite professors would say, ‘This is the way it is
done . . . ’, which is one of the strengths of this book.
This is a must read for trainees new to psychiatry and an
interesting one for medical students during their placements in
psychiatry.
Pavan Mallikarjun Division of Psychiatry, University of Nottingham, A Floor,
South Block, Queens Medical Centre, Nottingham NG7 2UH, UK.
Email: pavan.mallikarjun@nottingham.ac.uk
doi: 10.1192/bjp.bp.106.031708
Oxford Textbook
of Psychotherapy
Edited by Glen O. Gabbard,
Judith S. Beck & Jeremy Holmes.
Oxford University Press. 2005.
545pp. £65.00 (hb).
ISBN 0198520646
Disenchanted with the temporary cure affected by ‘mesmerism’,
Freud turned his focus to the patient once more. The patient
was asked to relax on the couch, close his eyes, and (as Freud
placed his palm on the patient’s forehead) tell his story. The
patient began to talk unrestrictedly; and Freud listened. Later he
discovered that he needn’t even touch the patient. All Freud had
to do was to listen.
Psychotherapy has evolved since Freud’s time and a multitude
of psychotherapy schools abound. The editors of the Oxford
Textbook of Psychotherapy have cautiously orchestrated a meeting
of a hundred authorities from both sides of the Atlantic. The
barriers between behaviourism and dynamism have been pole-
vaulted, and a conciliatory approach is employed in explaining
the major modalities of therapy. One chapter (Chapter 10) deals
exlusively with the concept of integrative therapy and a
‘common factors’ approach.
Psychotherapeutic treatments of schizophrenia by Turkington
et al (Chapter 14) is an example offering a splendid ten-page read.
Beginning with William Tuke and the founding of the Retreat at
York in 1792, the chapter follows the development of psycho-
dynamic, cognitive–behavioural and family interventions for
schizophrenia. Theoretical discussion of each model is accompa-
nied by key practice principles, case examples and challenges.
The authors evaluate the evidence base for every approach and
provide comprehensive references.
Such chapters are independent, which allows the reader to
select particular sections of the book. The thematic range of the
textbook is exhaustive, from chapters on cross-cultural issues
and sexual orientation to topics like psychotherapy supervision.
The merit of the textbook is also in what it is not. It is not a
manual, or a collection of prescriptive guidelines. It is not one
236
school of therapy against another but neither does it espouse a
‘one-size fits all’ mantra. Such absolutism would be pernicious
to psychotherapeutic thinking. Instead the reader is invited to read
about all the psychotherapies available for different conditions,
and then form their own opinion. Such an attitude underlies
how psychotherapy works on the therapist, as well as on the patient.
The presentation of the book could be improved. The cover is
a gaudy orange with an image of a close up photograph of a tree
trunk while the text is devoid of any artwork. There is disconnect-
edness in the text at times; however, this is inevitable given the
multiple authorship.
As with psychotherapy itself, some parts of the Oxford Text-
book of Psychotherapy resonate with one’s personal persuasion. It
is essential reading for all who wish to hone their own Freudian
art of listening.
Muzzaffar Husain Maudsley Hospital, Denmark Hill, London SE5 8AZ, UK. Email:
mazaffar.husain@iop.kcl.ac.uk
doi: 10.1192/bjp.bp.105.017806
Language in Psychiatry:
A Handbook of Clinical
Practice
By Jonathan Fine.
Equinox Publishing. 2006.
352pp. £65.00 (hb).
ISBN 1904768121
‘There is a necessary relationship between language and psychiatric
disorders’, and with this every psychiatrist would surely agree.
Language in Psychiatry has some chapters explaining how linguis-
tics can be used to clarify psychiatric symptomatology and others
examining the language of individual disorders. It expresses its
credentials in the first sentence by advocating ‘listening in psy-
chiatry’. The author introduces the psychiatrist to a new ‘language’,
satisfactorily explained – clinical history strategies, lexicogrammar,
the speech community, information space, theme and rheme –
and states that language is disorder, not just a sign of disorder.
The psychiatrist’s assessment of atypicality of speech becomes
more refined when the distinction is made between ‘observed’ and
‘expected’ on linguistic principles, rather than reporting that the
patient speaks oddly. The primary phenomenon in language dis-
order is atypicality of meaning: ‘odd meanings and odd wordings
of meanings’; how can we structure what is odd about language?
The three major categories of meaning (experience of the external
world, the relationship to the listener and fitting the language into
context) may be compromised in psychiatric disorders. Genre –
that is how language is organised to achieve processes in context
– is important for mental illness.
This book is unashamedly didactic, which is just as well as
most Anglo-American psychiatrists were never formally taught
English grammar. It takes what the patient says seriously, worthy
of detailed analysis. One can attempt to link specific disturbance
of language and the organisation of language to particular

conditions, by ‘the mapping of language onto disorders’. ‘The close
study of language contributes to understanding the phenomenology’.
Unfortunately, Language in Psychiatry is less successful when it
deals with some disorders. It covers pervasive developmental
disorders, attention-deficit hyperactivity disorder, psychotic dis-
orders, mood disorders and personality disorders. One wonders
why the personality disorder chapter is there – how does their
language differ from normal? Schizophrenia is particularly dis-
appointing with nothing explanatory on neologism, stock words
and phrases, and so on. There is also the surprising omission of
organic disorders such as dementia and delirium, with persevera-
tion mentioned only in the context of schizophrenia. Whereas the
linguistics is soundly based, psychiatry is linked to the rather sparse
descriptions of DSM–IV rather than to a more general psychiatric
text; this is a limitation but it offers the psychiatrist an opportunity
to put clinical flesh on these nosological bones. Psychiatrists could
better help their patients by adding linguistic analysis, which is
well introduced here, to listening to their patients.
Andrew Sims c/o Royal College of Psychiatrists, 17 Belgrave Square, London
SW1X 8PG, UK. Email: ruth-andrewsims@ukgateway.net
doi: 10.1192/bjp.bp.106.031641
Shunned: Discrimination
against People
with Mental Illness
By Graham Thornicroft.
Oxford University Press. 2006.
328pp. £24.95 (pb).
ISBN 0198570988
Shunned is a book exploring discrimination against people with
mental health problems. It asks a lot of questions, quotes many
mental health service users, looks at a huge number of research
findings and comes up with some answers. It seems to have been
written with a lot of passion for finding ways to defeat the
inequality faced by those with mental health difficulties.
As a source of information on what research has been done to
study stigma and discrimination, it is second-to-none. I cannot
imagine that there is a recent academic paper in the English
language that has not been tracked down and studied. It certainly
filled in a lot of the holes in my knowledge. However, for all of the
quotes from service users, the language and approach does not
seem to be aimed at the general public.
The book is divided into areas of the mental health service
user’s life such as family, neighbours and work, and asks questions
about the evidence for discrimination in each of these. There are
frequent passages from individuals and their families about
aspects of their lives in their own words. It then widens out to
cover areas of society, for example mental health services and
the media. These are also explored for their attitudes. Towards
the end of the book there are suggestions for action that
individuals and groups might take to defeat such inequality.
Book reviews
Although I enjoyed reading Shunned, I found myself getting
irritated by a couple of things. First, the use of quotes from service
users/consumers seems to be more important than their cultural
context. There are pages where the text discusses one part of the
world while the quotes are from another. Does culture count for
that little? Also, the same quotes are sometimes used more than
once, in one case on two subsequent pages.
The other thing I was uncomfortable with was the assumption
that seems to pervade the book that all service users want the same
things and want to be integrated into society. There are a sub-
stantial number of people among mental health service users
who delight in being different, wacky and non-conformist, and
others who are happy to live in what others would consider to
be a lonely way. We have to acknowledge and explain these people
to the general public as well.
Overall, I think this book will be of value to everyone working
in mental health. Indeed, it should be obligatory reading for
anyone thinking of running a anti-stigma or anti-discrimination
campaign so that they can avoid things that have been shown
not to work. It could also be a starting point for debates among
service users on how they really want to interact with their society.
I do not agree with all of it, but I am very glad I have read it.
Janey Antoniou c/o Royal College of Psychiatrists, 17 Belgrave Square, London
SW1X 8PG, UK. Email: publications@rcpsych.ac.uk
doi: 10.1192/bjp.bp.106.031377
Culture and Mental
Health. A Comprehensive
Textbook
Edited by Kamaldeep Bhui
& Dinesh Bhugra.
Hodder Arnold. 2007.
376pp. £99.00 (hb).
ISBN 9780340810460
All of medicine and medical conditions have to be considered
within the context of culture: the culture in which patients and
their families live; the culture that has produced the healthcare
providers; and the culture in which the doctor–patient encounter
is negotiated. From a consideration of lifestyles, sociocultural
values and ideas of health, to acceptance of and adherence to
medical interventions, both physical and mental health issues
are intricately tied to the culture in which health or ill-health is
experienced. However, culture has a particular salience for mental
health not least because of the fact that many mental disorders are
still defined relative to an implicit or explicit cultural norm.
Given its importance to mental health, it is surprising that the
traditional way of considering culture often does not go beyond a
discourse on ‘culture-bound syndromes’ or on ‘masked’ depres-
sion or ‘somatisation’. Typically, an insufficient focus on the
various contextual factors that may produce differences in the
experience and expression of psychological distress leads to the
hood being taken for the monk: differences that have their origin
in poverty or in the ways health systems are organised are ascribed
to the broader culture in which patients live.
237
Book reviews
This book represents a departure from that beaten track. A
textbook on culture and mental health that has chapters on epi-
demiological method and mental health law is truly unique. This
book is not about the reification of ‘culture-bound’ syndromes
nor is it constrained by a narrow definition of culture. Rather, it
presents evidence, much of it from legitimate cultural representa-
tives, for why the experience of psychiatric syndromes and the
treatment for such have to be considered within the context of
the culture of the patients experiencing such syndromes.
The result is an impressive opus that lives up to its promise
of being comprehensive. The first part of the book has chapters
dealing with basic sciences and provides a much-needed
grounding for readers who want to be able to critically review
what they read in the literature regarding, for example, cross-
cultural studies. The second part has chapters, of varying lengths
and details, dealing with cultural aspects of mental health in
various regions of the world. However, the section flips between
nations (Russia, South Africa, etc.) and regions (West Africa,
South Asia, etc.), thus, perhaps, losing some consistency of
organisation. That notwithstanding, this part of the book is a
treasure trove, drawing on local experiences and sensitive analysis
of the ways in which culture, in the broadest sense, shapes the
experience of mental disorders and the delivery of services to those
affected. An informed discussion of culture in the context of
mental health must avoid inflation of differences as much at their
deflation. This book strikes the right balance and deserves wide
readership among practitioners and trainees.
Oye Gureje, University College Hospital, Ibadan, PMB 5116, Nigeria.
Email: ogureje@comui.edu.ng
doi: 10.1192/bjp.bp.107.042101
Rationality
and Compulsion
By Lennart Nordenfelt.
Oxford University Press. 2007.
224pp. £29.95 (pb).
ISBN 9780199214853
Rationality and Compulsion is a very useful resource for those
philosophers of mind who might wonder what the practical
dimension of their work is, and to those psychiatrists who are
interested in the philosophical issues raised by the study of mental
disorders. Nordenfelt has the great merit of writing clearly and
developing the book around a very transparent structure. First,
he combines his insights in philosophy of action and philosophy
of health to create a solid theoretical apparatus, and then draws
from that some conclusions about rationality that he applies to
the case of compulsion. The theses put forward are well-argued
and overall convincing, although the reader sometimes gets the
impression that they are being rushed through a very intricate
terrain and not made totally aware of the implications of what
they are tempted to agree with. But this is inescapable in an
ambitious work such as Nordenfelt’s.
238
My concerns are of a different sort. The book does exactly
what it says on the tin: it applies action theory to psychiatry.
Methodologically, this is a fairly safe option. Take a theory which
explains when certain actions are rational, and use it to answer the
question of whether a certain type of behaviour occurring in a
certain type of mental disorder can be legitimately characterised
as an instance of intentional behaviour which satisfies the relevant
norms of rationality. If you think the theory works, and has
advantages over its competitors, then you will get a good illustra-
tion of it by throwing in some interesting examples from
psychiatry, where an initially puzzling phenomenon is made
clearer by the application of the theory of your choice.
However, this is a classic case of imposing independently
motivated theoretical distinctions onto real-life problems without
properly acknowledging that the analysis of those problems can
feed back into the theory. The study of mental disorders does
not simply illustrate how elegantly our theoretical commitments
can provide answers to questions about intentionality and
rationality. Rather, it helps us redefine what intentionality and
rationality are. Regrettably, there is little of this feedback loop in
Nordenfelt’s work.
Lisa Bortolotti, Philosophy Department, University of Birmingham, Birmingham B15
2TT, UK. Email: l.bortolotti@bham.ac.uk
doi: 10.1192/bjp.bp.107.042184
The Early Course
of Schizophrenia
Edited by Tonmoy Sharma
& Philip D. Harvey.
Oxford University Press. 2006.
264pp. £29.95 (pb).
ISBN 0198568959
There was a shift surrounding schizophrenia in the latter decades
of the 20th century which continues today, away from a research
and therapeutic nilhism, towards optimism in gaining under-
standing of aetiology as well as effective treatments. Quite right
too, you might say. The lack of a single genetic culprit being
identified has not dented this enthusiasm, and the scope and
quality of research in the area is vast and increasing.
The market for new texts in schizophrenia, therefore, is
growing at an equal pace, and it can be difficult to decide which
should be a priority to read (and to buy).
Many a text on the market is little more than a collection of
loosely connected review papers and conference transcripts which
make the heart sink on opening – what can be inspiring to listen
to is not necessarily easy to read.
The Early Course of Schizophrenia, however, is much more than
this and is one of the best on the market at present. It is clear in its aims
and scope, focusing on recent advances in basic and clinical neuro-
sciences relevant to schizophrenia. It is easily accessible in size, yet
manages to cover most individual topic areas in considerable detail.

It is divided in to three sections, ‘Schizophrenia in the pre-
morbid period’, ‘Schizophrenia at the time of the first episode’
and ‘Treatment of early schizophrenia’.
I liked the first section best, not least because with its help I
was able clearly to return smart questions from a particularly
testing student – a mark of value for money if ever there was
one. Chapters of particular note include those on neurocognitive
deficits, first-episode schizophrenia and the prodromal period,
which managed to tackle pharmacological and behavioural inter-
ventions. These areas are covered better than that of treatment in the
first episode, which lacked similar scope by focusing exclusively on
pharmacology. On the whole the treatment section was weak com-
pared with the premorbid and first-episode sections, and in reality
one can question whether a comprehensive review of current treat-
ment in schizophrenia was beyond the range of this small text.
Novel topics that were included and made good reading
included gender differences in schizophrenia and late-onset
schizophrenia, both neglected areas of the field.
This is a great travel-size book to update adult psychiatrists
and those in child and adolescent mental health services, and will
also be of use to those coming up for membership. Definitely
worth its price tag.
Rachel Anne Upthegrove Early Intervention Service, 1 Miller St, Birmingham
B6 4NF, UK. Email: rachel.upthegrove@doctors.org.uk
doi: 10.1192/bjp.bp.106.026146
Freedom
and Neurobiology:
Reflections on Free Will,
Language and Political
Power
By John R. Searle.
Columbia University Press. 2007.
128pp. US$ 24.50 (hb).
ISBN 0231137524
How do we, ‘meaning creating’ agents fit in ‘with a universe that
consists entirely of mindless, meaningless, unfree, nonrational,
brute physical particles’ (p. 5)?
According to Searle, in order to answer this question we need to
understand the ‘basic facts of philosophy’ and the relationships be-
tween them. He identifies the basic facts as consciousness,
intentionality, language, free will, society and institutions, politics
and ethics. The task of the philosopher is to ask questions about them
in such a way that answers can be tested in the light of physics and
biology. This has been achieved to a considerable degree with con-
sciousness, intentionality and language. What about free will?
Spinoza thought free will is an illusion. He argued that our
actions are no less determined than the path of a stone that has
been set in a course of flight. Supposing the stone could ‘think’
halfway through the flight that it ‘wanted’ to reach the pre-
determined destination. If this were so, it would be subject to
the illusion of free will.
Searle wishes to salvage our subjective experience of free will as
a legitimate expression of freedom. He gives the example of a
Book reviews
restaurant diner who is asked by the waiter what he wants to
eat. It would be absurd for the response to be ‘Look, I am a
determinist. I will just wait and see what I order because I know
that my order is determined’ (p. 11)!
Searle draws a distinction between causes and reasons. Human
reasons differ from physical causes. Human reasons depend on
consciousness, intentionality, language, free will, etc. These are
properties of the brain in the same way that solidity is a property
of the molecules that constitute a wheel. Solidity matters because
it makes the wheel roll down a hill. Does free will matter in a
similar way or is it an illusion?
If free will makes a difference and is also biologically founded,
Searle argues, we must find a way of relating it to quantum
indeterminism in physics. However, he has already warned us in
the introduction that the ‘problem of free will is unusual among
contemporary philosophical problems in that we are nowhere
remotely near to having a solution’ (p. 11). In chapter one he sets
out why this is so and concludes that in order to understand free
will we need to understand ‘the self ’ biologically and this we have
also failed to do to date.
In the light of the above ignorance and uncertainty some
might conclude that the basic facts of philosophy might not
matter at present. In chapter two, which deals with ‘Society and
institutions and their relations to politics,’ Searle shows us why
this would be wrong.
Politics depends on political institutions such as the presidency,
parliament etc. These depend on citizens subjectively agreeing to
their status. Institutions have what Searle calls a ‘status function’.
It is its status function, agreed socially, that turns a green piece of
paper into a dollar note. This is an example of human reasons
differing from physical causes and, clearly, being of consequence.
This slim, elegantly written and intellectually rigorous volume
which consists of an introduction and two lectures given to
general audiences, sets out some core issues on the interface
between the philosophy of mind and the sciences. It can be read
with profit by all psychiatrists, both those inclined towards
Spinoza’s and those inclined towards Searle’s views.
George Ikkos Consultant Liaison Psychiatrist, Spinal Injuries Unit, Royal National
Orthopaedic Hospital, Brockley Hill, Stanmore, London HA7 4LP, UK.
Email: ikkos@doctors.org.uk
doi: 10.1192/bjp.bp.107.042739
Interventions Following
Mass Violence
and Disasters:
Strategies for Mental
Health Practice
Edited by Elspeth Cameron Ritchie,
Patricia J. Watson
& Matthew J. Friedman.
Guilford Press. 2006. 450pp.
£34.50 (hb). ISBN 1593852568
The events of 11 September 2001 have determined many develop-
ments in world affairs and it is not surprising that their influence
has reached mental health services. In the USA the trauma of 9/11
239
Book reviews
reinforced the anxieties of a nation troubled by other episodes of
mass violence such as the Oklahoma bombing and Columbine
massacres. The people of Britain also know what this feels like,
the 7 July bombings and mass violence in Dunblane and
Huntingdon are all too fresh in public minds. Therefore, this book
is timely in considering our response to mass violence and
disasters and how we can prepare for further episodes.
The area covered is detailed with 43 authors contributing to
the chapters, mostly academics, psychiatrists and psychologists
working in this field in the USA. Military psychiatry, mass
violence, disasters, individual violent assault and high-risk profes-
sions are touched upon, although there is a prominence through-
out of the mental health response to mass violence and in
particular the 9/11 atrocities. Aspects covered include planning
for disasters, preparing people who are likely to be traumatised
(such as soldiers and high-risk health workers) and organisational
and resource issues. This public health agenda is quite prominent,
with accounts of how authorities responded to events in the USA.
The coverage of mass violence includes early intervention,
intermediate and long-term treatment of victims, along with a
particularly interesting chapter on improving resilience in trauma-
tised populations. Other chapters focus on research and evalua-
tion of services for mass trauma, training staff, consultation
with communities and issues for special groups such as children
and Black and minority ethnic groups.
240
Despite the comprehensiveness of its coverage, there were
some disappointments. The focus on events in the USA (particu-
larly 9/11) meant that the mass violence that is so prevalent in
low- and middle-income countries is rarely addressed. When we
reflect on events in Cambodia, Rwanda and the Congo, it seems
clear that any discussion of mass violence needs to address the fact
that it usually takes place in these countries where mental health
resources are scarce or non-existent. However, the emphasis the
authors were seeking seems to be an academic discussion of
services in a high-income Western country. It is also surprising
that eye movement desensitisation and reprocessing is discussed
in only half a page out of over 400, despite its frequent use in
the treatment of post-traumatic stress disorder (and its inclusion
as a recommended treatment in the UK National Institute for
Health and Clinical Excellence guidelines).
Putting aside these reservations, this is an excellent and
learned resource for certain readers. Any professional involved
in public mental health responses to mass violence and disasters
in high-income Western countries would benefit from having a
copy to read and close to hand if the worst were to happen.
Richard Laugharne Wonford House Hospital, Exeter EX2 5AF, UK.
Email: r.laugharne@ex.ac.uk
doi: 10.1192/bjp.bp.106.024190
 The Maudsley Handbook of Practical Psychiatry (5th edn)
Pavan Mallikarjun
BJP 2008, 192:235-236.
Access the most recent version at DOI: 10.1192/bjp.bp.106.031708

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