The Etiology of Schizophrenia

Psychiatry has been called the art of practising a science which does not exist. This is true at least in part because, although many excellent psychiatric studies are published, the literature is generally not reviewed and synthesized. Psychiatry has no review journal. This book fulfills a specific need, in that it critically reviews the literature on the etiology of schizophrenia. Book discusses the genetic aspects of schizophrenia, and Abood and Heath argue for a chemical approach to mental disease. Balanced against this is a brilliant critical review of the literature on the genetics of schizophrenia by Jackson. He questions "the assumption that seems to be widely made that there is overwhelming factual evidence for a strong genetic component in the etiology of schizophrenia." Although he concludes, "it seems likely that hereditary factors do play a part in at least some of the schizophrenias," he shows that the genetic evidence is neither overwhelming nor factual and that, indeed, much remains to be done in this important area. Kety critically reviews the evidence for some of the biochemical theories, showing many of the sources of error and artifact. Winder provides an interesting, thorough review of the psychological studies on schizophrenia, and Clousen reports some interesting work on the sociology of schizophrenia. These four papers are particularly important because of their discussion of methodology. Bowen reports a study in which "the family unit is regarded as a single organism and the patient is seen as that part of the family organism through which the overt symptoms of psychosis are expressed." Bowen showed that some families of schizophrenics who were crazy enough to allow themselves to be hospitalized with their schizophrenic child did indeed show significant psychopathology. That is, parents who allow themselves to be hospitalized with their children for a relatively long period of time may not be a representative sample of schizophrenic parents. Litz reports an intensive naturalistic study of schizophrenics and their families. Boatman and his group advance the hypothesis that "the etiology of the psychotic disease of children is entirely psychogenic," and therefore report their experience in the treatment of one hundred pre-adolescent schizophrenic children by psychotherapy. They feel that twenty of these children showed improvement in the course of psychotherapeutic work. McReynolds proposes "that the primary cause of schizophrenia is an excessively high level of unassimilated precepts." Weakland proposes a communication theory of schizophrenia. Certainly schizophrenics, like most people, have two arms and two legs, some unassimilated precepts, and receive contradictory communications. That is to say, schizophrenics are human. To show that any psychological factor causes schizophrenia, one