In 2005, I received a phone call from Patricia Casey, Professor (now Emeritus) of Psychiatry at University College Dublin. Would I be interested in working on a new edition of Fish’s Clinical Psychopathology with her? I stood up at once – the gravity of the occasion clearly required this – and I answered with the most emphatic Yes that I have ever uttered (apart from my wedding vows, of course). Certainly, I would revise Fish with her. Could we start today?

In truth, I was a little confused by the call. Fish was the very stuff of legends and I, frankly, was not. Could an early-career psychiatrist really undertake a task as serious as co-revising Fish? Was I up to it?

I should, perhaps, explain a little about psychopathology and about Fish. Psychopathology is the science and study of psychological and psychiatric symptoms. A clear understanding of clinical psychopathology lies at the heart of effective delivery of psychiatric care.

For many years, the classic text-book in this field was a 128-page volume written in 1967 by Frank Fish, titled Clinical Psychopathology: Signs and Symptoms in Psychiatry. A classic of precision and concision, Fish’s Clinical Psychopathology soon became an essential text for medical students, psychiatric trainees and all healthcare workers involved in the delivery of mental health services. A revised edition, edited by Max Hamilton, appeared in 1974 and was reprinted as a second edition in 1985.

By the 2000s, Fish was essentially impossible to obtain and most trainees heard about it but not seen it. Legends fade over time, however, and there was a real risk that Fish’s superb handbook would disappear into the distant past. Thus, the third edition, co-revised by Patricia Casey and me, was published in 2007 by Gaskell, an imprint of the Royal College of Psychiatrists. The purpose of the third edition was to introduce this classic text to a new generation of psychiatrists and trainees, and to reacquaint existing aficionados with the elegant insights and enduring values of Fish’s original work.

Following publication, a great majority of people welcomed our lightly edited, updated text, and a small number objected to the notion that Fish needed any changes or updating. The book was soon the best-selling title ever published by the Royal College of Psychiatrists. It was translated into Italian (2009) and Japanese (2010), and a South Asian edition was recently published by Cambridge University Press.
And now Patricia and I have produced a fourth edition with Cambridge University Press, with updated references, new material relating to the most recent diagnostic classification systems, and an additional chapter looking at controversies in classifying psychiatric disorders and – of course – the fundamental roles and uses of psychopathology.

This work has been a joy. And if the new edition makes the insights of Frank Fish available to a new generation of readers and trainees, it will have all been richly worthwhile.

The 4th Edition of Fish’s Clinical Psychopathology is available in paperback, ebook and on Cambridge Core.

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