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The author describes a group of patients with relatively stable personalities who, under repeated assaults upon their attempts at meeting life, retreat gradually more and more, first becoming maladjusted, then showing pronounced neurotic symptoms and finally breaking down into a schizophrenic state. Reference is made to studies by Freud, Adolf Meyer, Zilboorg and Myerson. A
few detailed histories accompany the paper, one especially interesting because the patient had shown neurotic symptoms for about sixteen years prior to the schizophrenic episode. The author discusses the question of whether this group of patients was schizophrenic from the beginning, but feels that the prepsychotic phase has to be considered as neurotic in nature. The schizophrenic reactions were a further step in the effort of the personality to find a balance between inner driving forces and the demands of reality. 'The final psychotic reaction labeled schizophrenia may be reached in a variety of ways. One of those ways, we have found, appears repeatedly in certain patients not exhibiting the schizophrenic or shut-in type of personality, and this is through the route of neuroses.'