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In 1948 Leopold Bellak published a review of the prior decade's literature on schizophrenia. He has repeated the feat decennially, the present volume being the fourth in the series. This latest overview contains seventeen chapters, by twenty-three authors, devoted to such topics as the epidemiology, biochemistry, genetics, psychology, familial aspects, diagnosis, somatic treatment, psychotherapy, and prognosis of schizophrenia. Among them, these chapters contain 2,875 references to the literature, primarily of the last ten years. Each chapter represents a compact statement of our current understanding in a particular domain and also estimates and evaluates current trends in that domain.
The major events of the last decade in this field have been the increased documentation of the role of genetic factors and the growing doubts with regard to the dopamine hypothesis in its present form. The genetic studies are well reviewed by Robert Cancro, who includes a particularly sophisticated subessay on the theory of diagnosis. Cancro concludes that "the genetic studies do not rule out social interventions … the knowledge of the value of psychotherapy for certain patients derives from experience and cannot be refuted by a theoretical notion" (p. 149).
This defensive note with regard to dynamic treatment is, of course, a reference to the bias, which grew rapidly in American psychiatry of the sixties and seventies, that psychotherapy in any form is ineffective in the treatment of schizophrenia and therefore could not rationally be included in a treatment program. John Gunderson, in his chapter on psychotherapy, examines the evidence for this pessimism and finds it wanting. Nonetheless, he notes that "the psychotherapy of schizophrenia is at an impasse"; the acceptance of psychotherapy as a useful modality "which grew modestly but consistently from 1930 to 1960" has not continued to expand.
The entire volume, under Bellak's aegis, maintains an attitude consistent with Freud'