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Insight and Psychosis: Awareness of Illness in Schizophrenia and Related Disorders (2nd edn) Edited by Xavier Amador & Anthony David. Oxford: Oxford University Press. 2004. 402 pp. £29.95 (pb). ISBN 0198525680

Published online by Cambridge University Press:  02 January 2018

Rachel Upthegrove*
Affiliation:
Adult Psychiatry, Lyndon Clinic, Hobbs Meadow, Solihull B92 8PW, UK
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Abstract

Type
Book Reviews
Copyright
Copyright © 2005 The Royal College of Psychiatrists 

It's a slippery fish, a tangled web, a hall of mirrors. Beginning to think or read about insight can be the start of a tortuous journey leading anywhere from neuroscience to neuropsychology, philosophy, sociology, anthropology or phenomenology. The different spheres the concept contains is a reflection of its complexity as well as the difficulty we have in defining what we mean by insight. It is perhaps, then, quite remarkable that for many years it was considered an ‘all or none’ phenomenon and that lack of insight was, along the lines of 19th-century thinking, the prerequisite definition of insanity. And so the pillars of present-day psychiatry are founded on this quicksand of a concept. From the time of Lewis and Jaspers, the great and the good have in turn struggled to explore and redefine our thinking on insight. The crystallisation of this is contained within the pages of this eminently readable book, which manages to keep its subject grounded while encompassing huge scope.

I found the first edition of this book useful, and the second edition is undeniably an improvement. It is a treat to dip into and out of when one wants to raise one's head and contemplate just what it is we do day to day. The second edition has been comprehensively restructured and updated, and every chapter shows signs of rework. Most chapters are self-contained and many begin by exploring a definition of insight.

Divided into four parts (phenomenology and psychology; neuropsychology; insight, culture and society; and clinical and personal implications of poor insight), there is balance here and the editors have clearly resisted the temptation to weight the contents too much in favour of the neuropsychological. New chapters include Beck & Warman's ‘Cognitive insight: theory and assessment’, which adds the weight of heavy guns behind the increasingly popular idea that psychological assessments and treatment have a core role to play in schizophrenia. Also of value in keeping the work grounded are the personal perspectives eloquently portrayed by Frederick Frese and the topical views on mental health law in Ken Kress's new chapter.

Priced very reasonably, bordering on cheap, and now in paperback with a snazzy new cover, this is an essential read for any clinician or researcher starting off in the field of schizophrenia.

References

Edited by Xavier Amador & Anthony David. Oxford: Oxford University Press. 2004. 402 pp. £29.95 (pb). ISBN 0198525680

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