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It is difficult to think of any medical book that has done so much to raise the profile of a specialty as Organic Psychiatry by Alwyn W Lishman has done for neuropsychiatry. The third edition of Organic Psychiatry, published in 1997, will remain a classic for many years to come. Its focus on the clinical description of neuropsychiatric syndromes and the clarity and elegance of the writing will ensure that. It is a tribute to the book that, as in the cases of popular literary works, a film should be based on it, or in this case two videos, a workbook, and an answer book. By contrast with the Hollywood tradition that renders the book of the film obsolete, this teaching package requires the reader to go back to the original source to get the best of the other components of the package.
The package, which also includes the Organic Psychiatry book, is described as a teaching resource in neuropsychiatry for self paced learning and is aimed at English speaking students. The workbook and videotapes contain seven modules: examination of the neuropsychiatric mental state, investigations (EEG, imaging, and neuropsychology), head injury, epilepsy, infection, dementia, and movement disorders. The various modules are introduced by Professor Goldberg, who interviews the contributing neuropsychiatrists, in a setting somewhat reminiscent of Bird and Fortune, emphasising the importance of taking a careful history and making a differential diagnosis. The workbook provides a brief background to these modules and directs the student to the Lishman for further reading and to the relevant section of the video. After each module the student is invited to answer questions and feedback is provided in the workbook.
We are warned that the modules do not provide exhaustive coverage, as they have been selected for their relevance. However, the choice seems rather idiosyncratic at times and 1 suspect that it must have been dictated to some extent by the availability of patients. The package is a team effort and many well known neuropsychiatrists are seen interviewing patients or, in the case of Professor Lishman, demonstrating the neuropsychiatric examination on a normal subject. To assemble and edit all the clinical material contained on the tapes must have been a considerable, but worthwhile, effort and it will repay the student to go over these vignettes for the interests of the clinical cases. All modules contain interesting material, but I particularly enjoyed the first two (examination of the mental state and commonly used investigations), because they are more exhaustive in their coverage than anything that follows and the many examples of abnormal mental states provided blend particularly well with the demonstration of the neuropsychiatric examination. It is a pity in other modules that abnormal investigations are not shown alongside the clinical interviews. It would have been appropriate for example, to show the imaging of patients with frontal lobe syndromes or Alzheimer's disease and the EEGs of the various epileptic patients interviewed. Abnormal examples of imaging and EEGs appear in the workbook, but are not always related to the clinical material on the tapes.
All in all, this is a very valuable teaching package for trainees in different areas of clinical neurosciences. I hope that to keep up with technology, the publishers will consider producing a CD Rom version in the future.
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