This book is more than simply an extended review of what we know of the condition that appears in ICD-10 and DSM-IV as severe depression with psychotic features. The authors set out their stall in the preface, making it clear that they believe this to be an illness in every sense of the word, there being little use of the less emphatic word ‘disorder’. The introduction starts with the real story of Andrea Yates of Houston, Texas who drowned her five children one by one in the bathroom of her house. The authors continue in their emphatic style to directly say that she did not have ‘major depression’ but ‘psychotic depression. She was improperly diagnosed, evaluated and certainly inadequately treated.’ It is a characteristic of this book that the authors have a view point and from the outset, in very clear terms, they make a strong and compelling attack on the current classification of depressive disorders which actually cuts deeper than simply wishing to place psychotic depression apart from other depressions. They make a strong case for resurrecting the traditional split of endogenous or melancholic depression from the depressive reactions to adverse life events.

Given Edward Shorter's authorship of a history of psychiatry (Shorter, Reference Shorter1997), it is not surprising that this introduction is followed by a review of the evolution of the classifications of depression through history, plotting the ebb and flow of the idea of different types of depression before the current classification systems scrapped this clear distinction.

In chapter 3 we begin with a look at the inadequacies of the DSM-IV and ICD-10 classification system for psychotic depression. The authors then move on to offer their own diagnostic categories as ‘A typology of psychotic depression’. They illustrate each of the seven subtypes they propose by a selection of brief case descriptions. The final part of this chapter outlines their belief that the psychotic depression experience can be so profound and unsettling that many people are left with post-traumatic symptoms in the long term.

The next few chapters focus on treatment for psychotic depression. Given their contention that this is an illness it is not surprising that there is little mention of psychoanalytical and other psychological perspectives in this condition. There is a strong emphasis on ECT as the treatment of choice and the inadequacy of drug treatment for this condition. However, they review most biological treatment options and this is one of the parts of the book with a profusion of references. The last chapter looks at treatment of psychotic depression with reference to the authors' typology of psychotic depression, the perceived value of this depending on the extent to which their typology rang true with one's own clinical experience.

There are only a few times in this book when you feel that you are reading a well-referenced review article. I started with an expectation of a large, easy to read Cochranesque review of the best available evidence on psychotic depression. In fact, what I got was a highly readable account of the subject which challenged many previously held ideas about the diagnosis and treatment of depression generally. It is noticeable that in nearly every clinical area that I have practised psychiatry that on a regular basis many other qualifiers are added to the terms from the diagnostic manuals. Terms such as reactive depression, agitated depression, retarded depression and melancholic depression thrive. ‘Major’ and ‘clinical’ are words sometimes added to the word depression to mean something like ‘real’ or ‘proper’ and it would seem that within their head clinicians retain some notion of the endogenous versus reactive split that leaks out in such phrases.

So as a simple review of an area of knowledge this is not the book I was expecting. However, in many ways it achieved more. As a polemic against the official diagnostic classification, as an attempt to replace this with the authors' own classification system drawn from clinical experience, and as a clear guide to the authors' views on treatment it succeeded. Its strength as a book is its clear line of well-argued ideas and its strong emphasis on case reports and subjective experience of illness. Its weak points are systematically reviewing large areas of literature. Overall I believe that the strengths of this book are what make it ultimately work as a book and it also succeeds in being easy to read with pleasure and interest.