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After having published an extensive ten-year survey of dementia præcox, Dr. Bellak and his co-workers have undertaken another tremendous task of compiling the literature and bringing order to the many problematic concepts centering about the manic-depressive psychoses.
The basic approach to the subject is a 'multiple factor psychosomatic theory'. The etiological factors of the syndrome 'may range from a hypothetically almost completely psychogenic nature to a hypothetically almost completely organic nature'. The anatomical, biochemical, endocrine, genetic, infectious, neurophysiological, and psychological factors are stressed. The various newer and older forms of therapy 'ranging from lobotomies to the injection of distilled water' are extensively described.
In the author's opinion shock treatments are still without rational basis. He ventures to suggest that shock treatment produces at least a transitory change in or a damage to the brain cells, perhaps only in the way of influencing the enzyme metabolism: 'At any rate', he states, 'I believe that it is the direct brain damage by the shock treatment and its influence on the id, ego and superego balance that accounts for its beneficial effects'.
Bellak comes to the conclusion that 'a definition of manic-depressive psychosis is an achievement yet to be attained'.
There is an extensive summary of the analytic literature with references to the work of Abraham, Fenichel, Lewin, Rado, Gerö, Edith Jacobson, Melanie Klein, René Spitz (to whom the book is dedicated), and others.