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In a comprehensive review of the research on and theories about schizophrenia, Alanen makes the point that family environment is an important pathogenic factor and that family treatment is a necessary aspect of therapy. Twin studies, biological findings, epidemiologic and psychopharmacologic studies are judiciously criticized in terms of their limitations and inherent prejudices. He stresses
the need for careful scrutiny of child-parent interactions, particularly from the point of view of pathological narcissism, to determine their etiological significance.