I haven't read the book, yet, but here's my take on the movie...
But first a little bit of Roger Ebert's take:
All of the murders are equally real or unreal, and that isn't the point: The function of the murders is to make visible the frenzy of the territorial male when his will is frustrated. The movie gives shape and form to road rage, golf course rage, family abuse and some of the scarier behavior patterns of sports fans.
I think that while Ebert is right that an important point of the murder frenzy is to take to the extreme the various rage scenarios that we might see in everyday life, I believe that attempting to determine what's real or unreal is also an important point. One of the key aspects of the movie is that it leaves the true extent of Bateman's crimes ambiguous. I think it's important for the viewer to try to figure out where the line of reality falls, and I'd be surprised if the director (Mary Harron) did not expect that.
I consider the movie to be outstanding (but it's definitely not something for everyone). I particularly like the scenes with Dafoe and the shootout with the cops. Bateman's reaction when the car explodes is worth the price of admission alone.