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Book Forum: Schizophrenia   |    
Schizophrenia Revealed: From Neurons to Social Interactions
JAMES A. WILCOX, D.O., PH.D.
Am J Psychiatry 2002;159:1450-1451. doi:10.1176/appi.ajp.159.8.1450
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By Michael Foster Green. New York, W.W. Norton & Co., 2001, 207 pp., $32.00.

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This is a very interesting little book. The title seems to call for a huge, multiple-volume opus, ad tedium. I was pleasantly surprised by the compact and highly readable nature of this work. It contains a fairly large amount of information on schizophrenia in the 207 pages. It may seem difficult to imagine a text on schizophrenia as an exciting "page turner," but this book is actually enjoyable and hard to put down. Many clinicians may find it pleasant to spend a Saturday afternoon on this excellent summary.

The book covers descriptive pathology from Kraepelin and Bleuler to the current topics of DSM subcommittees. It moves along with the increasing knowledge of psychiatric illness through time and discusses treatments and new discoveries. There are several color plates that are quite good. More illustrations of this kind would have been helpful. The author takes an open approach that draws heavily from the medical literature. This is refreshing, as many general texts seem tethered to a psychosocial model. Dr. Green, a psychologist, is remarkably supportive of biological treatments and cites appropriate papers to support his remarks.

The sections of the book are well organized and demonstrate a well-thought-out approach to this multifaceted illness. The description of symptoms is excellent and quite clear. The discussion of neurodevelopmental risks is a good addition to this book. The association of the risk factors is, however, left unclear. A detailed review of exposure and outcome in an odds ratio format would have been a helpful contribution. The author covers genetics reasonably well, although more space could be given to Meehl’s concept of schizotaxia and the important implications of this concept. The genetics section is also very limited in scope, possibly an artifact of being a generally brief text, but there is a wealth of evidence supporting a genetic transmission for many cases of schizophrenia. A very interesting discussion of neurocognitive deficits follows the genetics section and includes an interesting clinical vignette. The chapter on neuroimaging is composed of odd combinations of material. The information is factually correct but seems uneven. For example, I found it odd that that the author mentions historical footnotes like pneumoencephalograms while virtually ignoring the single photon emission tomography literature. The discussion of treatment is well balanced and avoids the trap of condemning early practitioners’ attempts and failures in the care of this enigmatic psychosis.

In all, the author avoids jargon and assembles the basic history of schizophrenia for us. Schizophrenia Revealed is a good book, but it falls short of being a major contribution to the literature. Many psychiatrists will enjoy it. People in academia might find it very relaxing reading, like a favorite novel. The book is not technical and should be very useful to the layperson who wants to learn more about schizophrenia than might be gleaned from the newspapers. Students will benefit from the concise nature of Green’s work and the accuracy of his information. This book is pleasant to read, but not essential for one’s library.

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