The British Journal of Psychiatry
The Overlap of Affective and Schizophrenic Spectra
Nick Craddock

If this book is not of interest, the reader has no business being a psychiatrist.

The official classifications, ICD–10 and DSM–IV, that psychiatrists are currently required to use are sets of descriptive categories that were designed to provide clinicians and researchers with a reasonably reliable language to aid communication and decision-making. Developed from the opinions of committees of experts rather than on the basis of useful data regarding aetiology and pathogenesis, the categories are essentially a modified version of the basic dichotomous scheme proposed by Kraepelin at the end of the 19th century. As has been argued in editorials within this journal, there is an ever-increasing and progressively more robust body of data that demonstrates the need for modern psychiatry to free itself from a historically based dichotomous classification and move towards approaches that recognise alternative diagnostic entities that more closely reflect the illnesses of our patients (Craddock & Owen, 2005; Marneros, 2006; Angst, 2007).

This book approaches mood and psychotic disorders from such an alternative perspective, namely considering clinical spectra of affective and schizophrenic symptomatology that may overlap within the same individuals either at the same or at different times during life. The editors are well-known for their work in this area. There are 14 chapters that deal with a broad range of clinical, biological and psychological issues using a spectrum approach. The authors of these chapters include leaders in the field who have published important data and theoretical papers that examine the overlap in mood and psychotic symptomatology beyond the traditional schizophrenia/mood disorder categories. The book is well written and provides an excellent an accessible overview of relevant research.

If psychiatry is to translate the opportunities offered by new research methodologies into benefits for patients, we must move to a classificatory approach that is worthy of the 21st century. This book provides a wealth of useful, clinically relevant information that will be of interest to any reader who accepts the importance of taking account of a patient’s illness beyond simple allocation to an operational diagnostic category. All psychiatrists involved in the management of individuals with mood and psychotic illnesses should read this book.