and Self-Examination, both originally published (on paper) in 1998. Kaplan and Sadock’s books are well known, and generations of psychiatry and neurology residents have relied on them to get through their specialty examinations. While not as extensive as Kaplan & Sadock’s Comprehensive Textbook of Psychiatry, the Synopsis covers the wide field of contemporary psychiatry and its most important psychodynamic, biological, cultural, and social principles. The prose is engaging and clear. Since this is not a comprehensive treatise, bibliographic references are given at the end of each section, but they are not referenced in the text. The inclusion of the ICD-10 classification alongside the DSM-IV categories gives the 8th edition a welcome international perspective. Detailed case histories, both contemporary and historical, enrich the text. The tables are clear, and with the figures, they make important concepts easier to understand and recall. There are several new chapters, including an excellent new section on “Brain and Behaviour,” and an interesting one on neurasthenia and chronic fatigue syndrome. The questions included in the Study Guide are detailed enough to allow preparation for specialty board examinations.

The installation of the set-up program was simple, and I could start browsing in only a few minutes. The basic commands for moving around the text are intuitive for anyone familiar with point-and-click systems and hypertext links on the World Wide Web. Almost immediately, one can start scrolling down the text, find a specific topic, and make use of a highlighter to mark important passages. To take full advantage of the many features in a book on CD, however, the reader must go through the tutorial, review the subject index, and become familiar with some terms such as “pop up window” or “on and off state.” This takes time, but in the end perseverance pays off, and the use of the enhanced functions makes for a rewarding interactive experience.

Among the many features of this CD, the search capabilities are the most valuable tools. The text, the figure library, and the drug database can all be searched. Queries can be made for single words, phrases, or patterns of words. Boolean

operators, similar to those used to search MEDLINE, allow the performance of more complex searches. The search engine includes a thesaurus and a dictionary, which make searches for synonyms and stem words possible. Sections found with these tools can be bookmarked for later retrieval or tagged for subsequent transfer into a word-processing program.

Some aspects of the production can be improved. Although the layout of the text is attractive and the colour scheme is “easy on the eyes,” the font used in the text is too small. After more than a few minutes, this becomes a problem for the reader. The figures are of good quality and complement the text well, and a zoom feature is available for viewing images. Only a portion of the figure can be enlarged at a time, however. A vexing problem is that the book is arranged as a continuous scroll, and chapters are not self-contained. A modular structure, with each chapter as a separate file, would make navigation through the book easier. Printing tables, figures, and text is simple, but it is difficult to get a sense from the screen of how many pages are being sent to the printer: a print preview function is needed.

The CD comes with a quiz section that incorporates the Study Guide. It allows the registration of multiple users and keeps a record of each user’s performance. It has the same content as the hard copy Study Guide, with 2 important differences: first, the case-based questions are not included in a separate section; and, second, I was unable to find the chapter on “Objective Examinations in Psychiatry” that is included in the printed version. The Study Guide on CD is interactive; after answering a question, one has the option of looking up the correct answer with a short explanation or being taken to the pertinent section in the Synopsis. As computer-based examinations become more common, the format used in the electronic Study Guide will become even more valuable. It must be stressed that the CD is simply the electronic version of 2 books published in 1998. Some of the material is dated; the most recent references are from 1997. In addition, the CD-ROM fails to take advantage of all the opportunities provided by electronic media.

Subsequent versions can be improved by the inclusion of video and audio clips. A video of a patient with tardive dyskinesia or neuroleptic malignant syndrome, for example, would enrich the discussion of the dopamine receptor antagonists immensely.

This electronic text compares favourably in price with the 2 printed books. It will be a useful tool on the ward, in the emergency room, and in the office. The search functions can be used to their greatest advantage when specific questions arise about a diagnosis, the dosing of a drug, or medication interactions. It will also be valuable in the residents’ on-call room or library, where more than one resident can use it to answer the Study Guide questions, to start a discussion, or to review aspects of a case seen while on call. The figures and tables can be transferred into transparencies for presentations. For personal study, however, I still prefer the printed version: it is easier to read, to carry around, and to “make my own” through notes on the margins, underlined passages, and comments. A laptop with a CD-ROM cannot replace the gratification provided by the feel, smell, and appearance of a printed book.

Review By

Neil A Rector, PhD
Toronto, Ontario

Tremendous gains have been made in the standardization of clinical assessment and treatment interventions, although there is growing recognition that psychiatric difficulties, and anxiety disorders in particular, are articulated and represented in culture-specific ways. Appendix 1 of the DSM-IV now includes directions for the clinician to take into account a person’s cultural identity to arrive at a more ethnically informed diagnostic formulation. It also includes culturally bound psychiatric syndromes