This new edition guides the reader through psychiatric on-call clerking and ward rounds and as such is aimed at the junior doctor in psychiatry or clinical medical student on a psychiatry placement. It is presented as a themed series of questions and answers and the novel structure promises greater retention of the information. However, it is so heavily focused upon psychiatry in the USA that it would be of limited use to the UK trainee.

The content is arranged in a logical order from acute assessment through to management and prognosis, and the text is set out very clearly. There is concise instruction on focused interviewing for particular symptom clusters and in this and other sections it is very readable. However, the limited scope is brought into sharp focus by the discussion of differential diagnoses. Because the book is aimed at the American market, diagnoses are based upon DSM-IV with almost no recognition of ICD-10. Conditions such as schizophreniform disorder which are specific to DSM-IV are covered without any reference to other classification systems, potentially leading to much confusion for the new trainee.

Further difficulties lie in the epidemiological information, some of which should not be generalised to other countries. For example, attention-deficit hyperactivity disorder is listed as being prevalent in 5% of children, with no acknowledgement that American rates are higher than those reported elsewhere. The sections on ethnicity are not well written for an international readership. Much consideration is given to differences in Native American Indians but none to immigrant groups from the Indian Subcontinent which would be of much greater use to the UK reader.

The strong American orientation would matter less if the book was not intended as a practical guide to working in psychiatry. Much more culturally sensitive information is required for a practical guide. There are too many differences from UK practice, ranging from emergency department procedures to drug names and licensing conditions.

I would not regard this as a good purchase for UK or Irish trainees. There are better handy pocket books on the market. It would, however, be useful reading for anyone considering an elective or placement in the USA.