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The authors of this book argue that psychiatric diagnosis is both possible and necessary. They discuss psychiatric diagnosis, long-term prognosis,
treatment indications, and therapeutic response. Each section deals with a specific diagnostic subgroup and uses extensive definitions and illustrative case histories, much of the data derived from studies conducted at Hillside Hospital in Glen Oaks, N.Y. No review can do justice to these valuable, detailed clinical case histories. As Jonathan Cole writes in the foreword, they “relate past history, present illness and ongoing treatment attempts to treatment response and eventual outcome.”
There are excellent discussions of thought-process disorders, the use of ECT in psychotic patients refractory to phenothiazines, obsessive-compulsive reactions, various types of depression, the need to rediagnose in the face of continued therapeutic failure, the ysteroid dysphoric character, the premorbid personality, the “myth that phenothiazines usually exacerbate depression,” the “unsubstantiated bland assumption … that psychotherapy is … incompatible with … medication,” akathisia versus anxiety, and “pseudo-schizophrenic neurosis.”
Many fascinating ideas are presented, such as that “thorazine has a markedly activating value for retarded, perplexed schizo-affectives” and that “panic attacks leading to phobic dependent manipulations often occur in a context of recent, severe endocrine fluctuations, and … can be terminated by Tofranil.” The authors discuss the value of giving medication in one dose at night, hysterical characters who develop a pseudoschizophrenia refractory to somatic treatment, and the importance of adequate medication dosages and time course.
Naturally a few questions crossed my mind, but the authors have written an instructive book that will be valuable to psychiatrists, psychiatric residents training in psychopharmacology, and nonmedical psychotherapists who work with patients on medication in hospitals or outside th