Schizophrenia: Concepts and Clinical Management

From our regular book review column.

Eve Johnstone, Head of Psychiatry at the University of Edinburgh, together with her departmental colleagues, has put Scotland on the map with this comprehensive and critical review of the phenomenology, etiology, pathophysiology, and treatment of schizophrenia. From brain imaging to community services, Johnstone and her coauthors have cut a wide swath through current knowledge about the most devastating of the mental diseases. While there has been a veritable avalanche of research and cumulative clinical experience with this disorder during the past 2 decades, the authors aptly point out that we are still "in the dark" about most of the important questions regarding schizophrenia, waiting for improved assessment and treatment technology to bring the "light of dawn." Researchers in
schizophrenia tend to behave very much like the proverbial drunk who has lost his keys and when asked why he was searching for them under the street lamp, replied, "Because I can see in the light." Similarly, we depend on prevailing tools for understanding and treating schizophrenia. The authors of this book make it clear that it is highly likely that in another 50 years, we’ ll look back to current concepts and clinical management of schizophrenia at the end of the 20th century as simplistic and wrongminded. By standing on the shoulders of Johnstone and her colleagues, and using the perspectives in their book, we will be making a good first step toward that more enlightened future.