Reconceiving Schizophrenia Edited by Man Cheung Chung, K.W.M. (Bill) Fulford, & George Graham. Oxford University Press. 2007. 341pp. £29.95 (pb). ISBN 9780198526131

As a medical student I recall being told by a geriatrician that the longer they practised medicine, the harder they found it to confidently diagnose Parkinson's disease. At the time I was a little perplexed by this but now I begin to feel similarly about schizophrenia. The confidence I had in schizophrenia having a clear-cut clinical presentation, mapping onto a similarly discrete and specific pathophysiology, evaporated in my first few weeks of psychiatric training. Having been fortunate to have worked predominantly both clinically and academically in psychosis, this scepticism has been further compounded. Reconceiving Schizophrenia is part of the successful International Perspectives in Philosophy and Psychiatry series. It contains 16 chapters, all on schizophrenia, utilising philosophy to examine our assumptions and ways of understanding this most emblematic disorder for psychiatry.

The chapters are not formally subdivided into themes: introductory and review chapters open the volume. Chung's review is a helpful resource for any researcher interested in more philosophical approaches to schizophrenia and amazingly manages to distil the literature, from phenomenological psychiatry to psychiatric classification, in 34 pages. This is followed by four chapters exploring the role phenomenological psychiatry continues to play in understanding major mental illness. The latter half of the volume is more analytic and anglophone, with outstanding contributions from Hamilton and Stephens and Graham on delusions. Gillet offers a fascinating account of psychosis, drawing on Kant's Anthropology, and struggles with how meaning in schizophrenia can both be private and yet, in some senses, communicable. Poland's chapter is a timely discussion of ‘the schizophrenia concept’. It often seems that the idea of schizophrenia that anti-psychiatrists charge us with holding is one that is never held in practice. Indeed, it is perhaps a concept that one is disabused of as one learns the complexity of mental illness and the limits of science. Harré's chapter is a fascinating meta-account of the discourses and grammars used when mental illness is discussed, and how the file-selves of psychiatric records come into being and the use they are put to.

The volume contains many thought-provoking and worthwhile contributions, with little overlap of content, and all of them deserve detailed consideration. It serves as an amazing achievement of conceptual rigor in thinking about schizophrenia.