self-help texts (a reflection perhaps of the wider ‘culture of fitness’ and con- ceptions of health and the body prevalent in Anglo–American society described in chapters by Goldstein and O’Connor). The book is organized into four sections which look in turn at why CAM is currently so popular; who are the users and providers of CAM; what methods can be utilized in researching CAM; and finally what lies ahead for CAM and its role in the wider health care system. The ‘international frame of reference’ is mainly limited to the Anglophone world of the USA, Canada and Britain. Based on a review of empirical studies, Fumham and Vincent conclude that CAM users (at least in western in- dustrialized societies) are heterogeneous in their health beliefs and levels of scepticism about conventional medicine. The reasons why people use CAM are inextricably linked to who the users are. Thus the analysis in section two serves to fill out the profile of a CAM user. How- ever, studies are not consistent in their conclusions. As might be expected CAM users are more likely to suffer from chronic illnesses, are more highly educated and more affluent than non-users. Valente, Wellman and Pescosolido in their respective chapters make innovative use of network analysis to assess how users access alternative medicine. The final section is the most interest- ing from a policy perspective. Shanna analyses the ‘wider web’ of relationships that provide the context for CAM. She presents a convincing account of the re-emergence of medical pluralism in Britain. Such diversity of provision, however, raises issues of access. Public policymakers will have to respond with an open debate about what to fund and on what grounds. Saks takes up the issue of professional regulation and sets out the pros and cons of greater professionaliza- tion of CAM practitioners. Organizations such as the Foundation for Integrated Medicine (www.fimed.org) believe the future of CAM lies in its integration with conventional medical treatment. How- ever, this view is not unanimously shared. Best and Glik provide a fitting con- clusion to the book. They present a wider view of integrated health services and set out an agenda for ‘integrative research’. This book is a refreshing read for anyone working in health care, particularly those interested in the research and policy challenges posed by the rising popularity of CAM. However, one should be careful when generalizing the findings. More research is needed to understand the impact on the supply of and demand for CAM of country- specific factors, such as national culture, the culture of medicine, the prevalence of particular CAM treatments and re- imbursement policies. Anna Dixon, Lecturer in European Health Policy, London School of Economics and Political Science, UK Thornicroft G, Szmukler G, editors. Textbook of community psychiatry. New York: Oxford University Press, 2001. 585 pp. ISBN 019 2629972 This book is a very welcome addition to any psychiatrist’s library of definitive texts. The editors have gathered together a celebrity line-up of expert contributors making this one of the most topical psy- chiatric textbooks of recent years. The editors introduce the book with a thorough and clear validation of the necessity for a specific text on commun- ity psychiatry. They suggest a ‘scientific’ definition of the term community psy- chiatry, emphasizing its role in the pro- vision of appropriate levels of evidence- based mental health services. Each chapter flows seamlessly from those preceding it, providing a fluid overview of the subject in question. The historical evolution of community care and the influence of social policy on community psychiatry provide a coherent starting point. The book then leads the reader through a description of the epi- demiological background and methods that have influenced current approaches to evidence-based practice in commun- ity psychiatry. This is followed by a thorough exploration of frequently used concepts such as ‘quality of life’, ‘needs’ and ‘costs’. The complex issues surrounding the planning and organization of commun- ity mental health services are clearly described, with particular reference to the balance that has to be made between clinical ideals and budgetary restraints. Different models of service delivery (such as case management and assertive outreach) are reviewed in detail with up-to-date reference to differing opinions about the pros and cons of these specialist services. As well as an interesting section about the interfaces between community psychiatry, psychi- atric sub-specialties and primary care, there is also a section on prevention of mental disorders from the perspectives of the community, early intervention services and rehabilitation. My only criticism is the brevity of the chapter on outpatient services, but perhaps this underlines the dearth of literature on this ubiquitous, yet over- looked element of community psychi- atric services. From the opening chapter, the im- portance of a coherent, well organized and comprehensive approach to psychi- atric practice in the community which is inclusive of users, carers and non- statuatory community services, is stressed. It is especially refreshing to see that this book has made a concerted effort to in- clude topical issues such as the assess- ment and treatment of refugees and the stigma of mental disorder. The final, in- novative section deals with ethical dilemmas currently facing community psychiatrists such as those raised by the new Mental Health Act in the form of involuntary community treatment. In summary, this is a very good book that provides an extremely thorough re- view of current thinking in psychiatry. These days one could argue that all psy- chiatry is community psychiatry. What this textbook provides is a conceptual framework for the understanding of the issues relevant to good clinical practice of psychiatry in the community. Dr Helen Killaspy, Academic Dept Psychiatry, Royal Free Hospital, Pond Street, London NW3 2PF, UK, e-mail: h.killaspy@rfc.ucl.ac.uk Abramson JH, Abramson ZH. Making sense of data: a self-instruction manual on the interpretation of epidemiological data. Third edition. New York: Oxford University Press, 2001. 367 pp. ISBN 0 19 514524 (cloth), ISBN 0 19 514524 9 (pbk) This book aims at providing readers with the basic epidemiological knowledge and skills that are required for the appraisal of published reports as well as one’s own findings. It includes six chapters. The first two chapters intro- duce basic concepts for the appraisal of epidemiological findings, including the discussion of association, confounding, rates, odds, and standardisation. The third chapter helps the reader develop critical skills by discussing validity, reliability, as well as screening. Chapters D and E cover more complex issues for the appraisal of data (association between variables, misclassification, statistical significance, confounding, multivariate analysis, results from different study designs). EUROPEAN JOURNAL OF PUBLIC HEALTH VOL. 13 2003 NO. 2 186 by guest on July 8, 2011 eurpub.oxfordjournals.org Downloaded from View publication stats View publication stats