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Issues in preventive psychiatry

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    Issues in preventive psychiatry. Edited by george n christodoulou, duscia lecic-tosevski, and vassilis p kontaxakis. (Pp148, US$97.50) Published by Karger, Basel, 1999. ISBN 3 8055 6912-2

    This book comprises a selection of papers taken from a world psychiatry association symposium on preventive psychiatry. Two contributors are from the United States, one from Egypt, the remainder from Europe, particularly south eastern Europe. The preface opens with a reference to an earlier World Health Organisation (WHO) report which estimated that as many as one third to one half of all mental and neurological disorders could be averted by primary preventive measures. But it went on to note that in most spheres primary prevention had been neglected due principally to a lack of awareness of available effective methods, a deficiency that the book aimed to redress. Encouraged by this introduction the reader may then hope to become acquainted with some of the strategies and methodologies of preventive psychiatry and even to read of a few of its successes. If so, disappointment lies in store. Most of the writers approach their subject through a protective smoke screen of broad generalisations; few emerge from it to offer a detailed account of how any aspect of preventive psychiatry works on the ground. Some avoid the topic altogether: two of the more succinct chapters describe a process of deinstitutionalisation in Greece—a subject not without interest, but one that is only loosely connected with the book's principal purpose. Whether, and if so, how preventive psychiatry succeeds receives little attention. Surprisingly little relevant outcome data are presented. Much of the writing is stilted and lacks fluency. As with so many postsymposia offerings, thematic coherence is wanting.

    It is difficult to know who would benefit from reading this book. Preventive psychiatry may not be the easiest subject to write about, but if it is to reach the audience it deserves, it will need a more coherent and persuasive platform than this collection of contributions provides.