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The author asks why some psychopathological reactions stop at the level of the neurosis and others progress to psychosis. In some cases it is a matter of underlying personality factors. In others, it depends on a defect in the method of handling disturbing experiences related to early instinctual life. The author postulates that there is a third group consisting of patients with
fairly stable personality organizations who under numerous stresses and strains resort first to a neurosis and subsequently to schizophrenia. In such cases the reaction is frequently reversible. To illustrate his thesis the author gives three cases. Unfortunately the cases do not illustrate very clearly the reason why the psychotic reaction developed as and when it did.
There is a rich literature on this subject which the author, outside of a dutiful reference to Adolf Meyer, has not even attempted to review. It is unfortunate that the author is not familiar with the article by Sullivan on Onset of Schizophrenia in which the same subject is treated with much deeper understanding and penetration.