Disordered Mind and Brain: The Neural Basis of Mental Symptoms By Peter Liddle. London: Gaskell. 2001. 301 pp. £ 40.00 (hb). ISBN 1 901242 65 X

The nagging doubt that many of us fostered at the time of the building of the Channel tunnel was would the two teams actually meet in the middle? One is faced with the same uncomfortable reservations when, as a psychopathologist, one starts to read a book on the neural basis of mental symptoms. However, this work is important for all psychiatrists and essential for academics. Congratulations to Gaskell for publishing this significant monograph.

Traditional neurobehavioural knowledge had demonstrated a link between a single neuroanatomical site and a neurophysiological function, for example, Broca's area and speech. Liddle demonstrates how the processes we are really interested in as psychiatrists — thinking, consciousness and judgment — are much more subtle than that and involve many more than one location in the brain, with highly complex interconnections. Can a single brain site serve two very different functions such as word selection and finger movement? If this can happen, is it the same type of component in each activity that is actually dealt with at that site? Exploring these and similar mysteries is fascinating. Mental activity, thinking, involves the firing of neurons from many sites distributed through the association cortex, basal ganglia and limbic system: such complex processes utilise a network and not a single site.

There are two starting points for this study, and they form the first two parts of the text, with the third part being an integration. So, Part I is on neuroanatomy and neurophysiology, covering the neural substrate of mental activity, the association cortex, the limbic system, corticosubcortical circuits, and neurotransmission and humoral influences. This section is an excellent course in up-to-date neurosciences and is equally valuable for MRCPsych candidates and senior consultants.

Part II deals with five symptom clusters, considering both neuroscientific and psychological aspects. For each topic, neurosciences includes neuroimaging, neurochemistry and pharmacology, with studies of cerebral activity related to the disordered function. The symptom clusters explored are reality distortion, disorganisation, psychomotor poverty and psychomotor excitation, depression and elation, and anxiety. This is a satisfactory and coherent way of approaching these disordered functions, starting with clinical observation and then adding findings from psychology and neuroscience. Each chapter ends with a synthesis.

Part III integrates the two previous parts by looking at four different mental disorders: schizophrenia, bipolar affective disorder, obsessive—compulsive disorder and psychopathy. This section seeks to be integrative rather than comprehensive and deals usefully with each disease or disorder that it investigates.

Have the psychopathologists and neuroscientists tunnelling under the Channel met in the middle? Not yet, but they are now probably digging in the right direction.