Obsessive Compulsive Disorder. Current Science and Clinical Practice, by Joseph Zohar (Ed.) Chichester, United Kingdom: Wiley-Blackwell, 2012, 339 Pages (ISBN 978-0-470-97432-2, US $100.00, Hardcover)Reviewed by K1ERON O'CONNORDOl: 10.l037/a003227IThis book is part of the World Psychiatric Association Current Science and Clinical Practice Series. It is unsurprisingly heavily biased toward a medical model of obsessive-compulsive disorder (OCD). Indeed, the author claims in the introduction that the book is a celebration of the second revolution in OCD, the building blocks of which are neurocognitive endophenotypes, brain imaging, genetics, and venturing beyond the serotonin hypothesis; the first revolution apparently having dispelled notions of OCD's psychological origins.The editor is a distinguished psychiatrist (Joseph Zohar) who has published widely in psychiatric journals, and the other 12 chapters are mostly written by eminent clinician-researchers. The book is divided into three sections. Section 1 highlights assessment and treatments with a first chapter on assessment by J. Menchon; followed by a chapter on pharmacotherapy (E. Decloedt and D. Stein); a third chapter on cognitive behaviour therapy (CBT) (M. Franklin, A. Goss, and J. March); a fourth chapter on electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS) (R. Blom, M. Figee, N. Vulink, and D. Denys); and a fifth chapter on treatment resistance (S. Pallanti, G. Grassi, and A. Cantisani). Section 2 on clinical spotlights contains a chapter of subtype and spectrum issues (E. Hollander, S. Poskar, and A. Gerard) and paediatric OCD (D. Geller, A. Faro, A. Brown, and H. Levy). The section on research spotlights contains a chapter on methodological issues for treatment trials (S. Reghumandanan and N. Fineberg), neurotransmitters (A. Abudy, A. Juven-Wetzler, R. Sonnino, and J. Zohar), brain imaging (D. Rosenberg, P. Easter, and G. Michalopoulou), genetics (D. Pauls), and neurocognition (S. Chamberlain and L. Menzies).The strongest chapters of the book are certainly on somatic treatment, genetics, and the search for endophenotypes and pharmacology. One of the most informative chapters from a technical viewpoint describes the experimental use of ECT, TMS, and DBS in treatment-resistant OCD. Other chapters discuss newer hypotheses concerning the search for endotypes in family members of OCD and genetic risk factors. There is an informative discussion on the efficacy of serotonin reuptake inhibitors and newer hypotheses about the involvement of other neurotransmitter (e.g., dopaminergic) systems. However, despite the impressive array of studies reviewed, the above chapters end by concluding that findings are contradictory and puzzling and that future work is necessary to be conclusive. In other words, despite increased knowledge, the somatic and genetic keys to evaluating and treating OCD remain experimental and elusive. On the other hand, in the brain imaging chapter, the authors conclude that the clinical phenomenology, nosology, and treatment of OCD have been well established, so exciting times lie ahead (p. 267) for research focused on neuroimaging and genetic laboratory interactions seeking biomarkers.I would argue our understanding of clinical phenomenology, nosology, and optimal treatment are far from satisfactory, and missing from this book is any clear recognition of the importance of the psychological components in clinical phenomenology. After all, OCD is diagnosed on the basis of disordered thinking and behaving. Ironically, improving the clinical phenomenology through knowledge of its psychological form and content is likely to prove essential to unravel genetic markers because it will better define the phenotype. Likewise, a critical look at current nosology (DSM) and symptom subtyping would have been refreshing. Instead, the spectrum chapter considers OCD and associated disorders along a symptom dimension in which the core phenomenological features are repetitive behaviours. …