Psychiatry in Transition—The British and Italian Experience: Edited by Shulamit Ramon with Maria Grazia Giannichedda. London: Pluto Press. 1988.

Since 1980 Italian psychiatric hospitals have ceased taking new patients and this has necessitated enormous changes in the provision of care for both chronic and acute patients within the community.

But this new 'Italian reform menu' which looks good à la carte, should it be taken with a pinch of salt?

When faced with the difficulty in understanding 'the Italian experience', the main point to bear in mind is that it cannot be divorced from the political, economical and cultural context of each Italian region which explains the variations and discrepancies in the Italian psychiatric provisions found in various studies.

Therefore I would have thought that a comparison among the Italian regions, let alone between Italian and British psychiatric services would have been extremely complicated, if not impossible.

However Ramon with her contributors in this book have done just this by drawing a comparison of the English and Italian psychiatric systems almost ten years after this momentous Italian reform.

The book layout consists of two parts: 'The Experience of Psychiatry in Transition', and 'Policy, Power and Changing Roles'. Each individual chapter has an Italian and a British contribution.

It starts with an introduction based on a rather hasty, though appealing, socio-political historical analysis of each country.

Since the two editors are both sociologists with a strong anti-medical bias which sets the scene behind the philosophy of the book, it was hardly surprising that the overall picture came over as an apotheosis of socio-psychiatry purported in the name of 'radical reformism' (Preface XV).

The authors, devoid of any self-doubt, strongly believe that the only solution to mental distress, as they put it, is psychiatric community care as the outcome of 'de-hospitalization, de-institutionalization and normalization'. They categorically deny the existence of the unconscious as well as the biological determinations of mental disorder.

Some rather worrying bald statements, li