As the book jacket proclaims, Adrian, Patrick J. Schnerch's first novel, seeks to be "dark, graphic, and grim." It weaves the horror and mystery of a serial rapist and killer in New York City with an insider's knowledge of mental illness. The main character "evolved from the author's acknowledged experiences" with "severe mental and emotional problems" and "bipolar depression."

The story's first mystery lies in uncovering who is responsible for the "murderous rampage": is it the title character, Adrian, who suffers from a combination of what appears to be bipolar affective disorder and a childhood trauma-based dissociative disorder, modified by substantial quantities of alcohol? Is it his long-estranged brother, who has basically the same maladies? We are teased with the interspersed journal of a megalomaniacal psychopath, "Madman," who alternately philosophizes on the ills of society, exhorts parents on how to better raise their children, and seethes with hatred and revenge for the police who are tracking him down. This mystery is resolved by the tenth of 24 chapters.

The second—and more impenetrable—mystery lies in trying to comprehend the story's characters. Schnerch manages to make the title character both disturbing and likeable, despite the improbability of his actions and feats. This character starts out unemployed and winds his way from strip joint voyeur to, by discovery of birthright, mob member to chief of a commando-like raid on a warring mob family to owner of all the strip clubs and head of the entire mobster organization. He drinks heavily and dissociates regularly, often to his advantage and apparently with some degree of purpose and intent. He is wracked with guilt and despair yet is capable of ruthless murder, with few apparent ill effects.

This book suffers mightily from a lack of editing. There are critical spelling errors, awkward syntax, and misdirected or out-of-place metaphors. And if the repetitions were cleaned up the length of the book would be reduced by a welcome percentage.

The dialogue has a curiously formal and stiff quality, and almost all the characters are given to crass comments and abrupt and profane explosions, followed quickly by inexplicable reconciliations. They seem to operate in a primitive, black-and-white mode, and their ethical frameworks shift widely and at times rapidly. Given the author's and the protagonist's repeated concern with morality, the choices that are made are perplexing to the reader. Schnerch explores but oversimplifies the notion of "not guilty by reason of insanity."

It seems that, as likeable as Adrian may be, he succumbs in the end to the mob family loyalty, greed, and lust for power he has so criticized and feared. The sources of literary tension shift and strangely dissipate, leaving the novel with something of a picaresque "Adventures of Adrian" quality. The conclusion of part 1 could really be the end of the book, perhaps leaving part 2 for a "Further Adventures" sequel.

Nevertheless, Schnerch makes meaningful observations about society, loyalty, parenting, mental illness, and the criminal mind. I liked his advice to alcoholics: "find something to do that alcohol affects the enjoyment of that activity. Then a choice has to be made … you have to find things that you would rather do than drink." He is ultimately optimistic about the effects of treatment for both mental illness and substance abuse.

The author's notes state that writing for the author "became therapeutic and increased his well being." To that extent, Adrian can be considered a success. As a novel, it should be considered, like life itself, as a work in progress.

Dr. Backlund is a psychiatrist with Compass Health and is also in private practice in Mount Vernon, Washington.