International Journal of Psychiatry in Clinical Practice

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MCQs in Psychiatry Alex Mitchell To cite this article: Alex Mitchell (2004) MCQs in Psychiatry, International Journal of Psychiatry in Clinical Practice, 8:1, 66-66 To link to this article:

Published online: 13 Sep 2010.

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that coronary heart disease, mortality and/or morbidity, is reduced by daily moderate consumption of wine compared with abstention or heavy drinking. There is some evidence for a protective effect of wine on the incidence of other forms of vascular disease, particularly stroke. They support red wine from Merlot and Pinot Noir grapes. The contributors to this volume include physicians, scientists and wine specialists. It is essential reading for all clinicians, scientists, and interested members of the community. Department of Psychiatry Austin Health Austin Hospital, Heidelberg, Victoria 3084, Australia E-mail: [email protected]

Professor Graham D. Burrows

DOI: 10.1080/13651500310003831

MCQs in Psychiatry David McNamara Gaskell Press, 2003. ISBN: 1 901242897. £18.00 MCQ books are notoriously difficult to write. One must attempt to be an expert in every field whilst at the same time setting questions that are of appropriate difficulty and of clinical relevance. Whatsmore, any MCQ book immediately enters an extremely competitive market of at least 20 competing texts. For this reason, any new book must offer something that others do not. Perhaps the biggest selling point of this new MCQ book from Gaskell is that it is derived from the nine books in the College Seminar Series. McNamara has had the unenviable job of extracting 584 MCQs from these texts and adding chapters on Child and Adolescent Psychiatry, Psychiatric Genetics and Basic Neurosciences. Based on the number of questions alone, this is one of the best value MCQ books on the market. A further credit to the author, is that he has provided not just answers, but explanations for at least 50% of stems, a factor that will prove useful to those engaged in last minute revision. Unfortunately, the big disadvantage of following the seminar series is that the content bears little relationship with the underlying Part II syllabus. For example there is little or nothing on the topics of psychotherapy; epidemiology, statistics and research methods / all of which appear in the college syllabus guidelines. Indeed there is one chapter that is not in the college syllabus (although perhaps it should be), namely, psychosexual disorders. Similarly, the length of the chapters does not accurately reflect the weight given to each topic in the exam, according to the college. For example, nearly 40% of questions in this book cover neurosciences and psychopharmacology, but this topic only accounts for 17% of the Part II exam. Looking closely at the content of the questions, I am painfully reminded how MCQs are poor a test of deep

learning. Although there are many fair questions, there are also many examples of questions that are impossibly difficult even with good knowledge of the subject area. More irritatingly, there are a handful of ambiguously worded questions and a small number that are simply incorrect (e.g. q110, page 159). Also of concern is a large number of off-topic questions that appear in the wrong chapters (the worst offender being 14 questions unrelated to psychopharmacology in Chapter 2). Overall, this book may be a nice companion to those who revise heavily from the college seminar series but it cannot be relied on alone. I am perplexed why a college-endorsed MCQ book remains in the conventional MCQ format of one question, followed by five stems. Most readers will be aware that both Part I and Part II moved over to individual statement questions in October 2001, and the extended matching items format has recently been introduced into Part I, with Part II scheduled to follow from Autumn 2003. Consultant in Liaison Psychiatry, Leicester General Hospital, UK

Alex Mitchell

DOI: 10.1080/13651500310003859

Presumed Curable: An Illustrated Casebook of Victorian Psychiatric Patients in Bethlem Hospital Edited by Colin Gale and Robert Howard. Wrightson Biomedical Publ. Ltd. 2003, £14.50 ISBN: 1-871816-48-3 One of the more unique features of late 19th century asylum patients was the likelihood of their being photographed. The reasons for this are not entirely clear, but can probably be understood as part of both identification (in case they ran away) and in order to teach medical students the basics of diagnostic practice. This belief that ‘‘melancholia’’ or ‘‘mania’’ or ‘‘general paralysis of the insane’’ (GPI) could be distinguished at a glance was part of psychiatry’s attempt to share in the diagnostic advances of Victorian medicine and surgery. Making a diagnosis from the end of the bed was very much the coup de the´aˆtre of the brilliant professor, the ‘‘elementary’’ expositions of Sherlock Holmes (himself created by a doctor) being the apogee of the art. Other influences on this process were the dominance of phrenology and physiognomy, for example the work of Professor Lombroso around ‘‘criminal anthropology’’ (i.e. identifying criminals by their head shapes) and the work of Charles Darwin and Francis Galton in their studies on evolution and eugenics. Such pictures have largely remained hidden in asylum archives, thus the very welcome publication of Presumed Curable , using 61 patients’ photographs from the Bethlem Hospital records between 1885 and 1900. This collection also provides succinct summaries of how patients fared in the asylum, so it really is a unique addition to our understanding of the asylum inmate. Previous historical studies of Victorian

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