The chapters on ECT are divided into five parts. Part one is devoted to the scientific and experimental basis of ECT and contains eight well-written, extensively referenced chapters on neurochemical and hormonal effects, mechanism of action, and brain imaging as well as evidence for efficacy in mood disorders, catatonia, and psychoses. It is a luxury to have this large and diverse body of research reviewed comprehensively in one volume. Part two has very interesting chapters on nonclinical issues, including a concise but excellent history of ECT written by Edward Shorter, the foremost historian of this treatment. Other chapters review ECT's often prejudicial depiction in books, movies, legislation, and within the healthcare system. The tone of these chapters is objective and fair, but they do not mince words about the irrational stigma that has been the burden of ECT for decades and the harm that this does to patients who need the treatment. Part three consists of chapters on international perspectives of this treatment, including discussions of ECT in the United States, the United Kingdom, Scandinavia, Western Europe, Asia, Russia, and Latin America. I was surprised to find this in an ECT text, but once I got into them, I found these chapters fascinating. They are a great addition, and even psychiatrists who never practice ECT will find them interesting. Parts four and five cover administrative issues and the clinical practice of ECT, and as such they should be required reading for anyone embarking on the practice this treatment. The clinical chapters are clearly written and thoroughly referenced and address all relevant issues, including patient selection, consent, treatment technique, anesthesia and medical risk, cognitive side effects, and long-term follow-up. The chapter on ECT in children and adolescents was especially timely, since children with mood disorders often derive great benefit from this treatment and tolerate it well but rarely have access to it because of prejudice and daunting legislative and administrative obstacles.