Other noteworthy chapters deal with the role of traditional healers, the toxic effect of cities, and the effects of cultural factors in schizophrenia. There is also a clear critical message for American mental health professionals when Leff talks about diagnostic practices that are formulated under political pressure or attain wide endorsement due to the power of commercial forces and health reimbursement dollars. The most evident shortcomings in this book are the examples given of biological findings. Most are outdated and at times incorrect. A good example is on page 38, where Leff talks about newer antipsychotics having "little or no blocking action against dopamine." If he refers here to the atypical antipsychotics, he is obviously wrong. He uses this argument to challenge the dopamine theory of schizophrenia, stating that this theory "as yet has not been replaced by an alternative theory." However, one significant alternative theory, which has been extensively explored, is the N-methyl-d-aspartic acid theory of schizophrenia (1). Another example of incomplete data use is on page 145, where the author reports on findings from longitudinal cohort studies investigating precursors of later schizophrenia. While the author mentions that lower sociability is found in children who later develop schizophrenia as adults, he does not mention other, more recent findings, such as later development of speech and other cognitive deficits (2), which all contribute to lower sociability and may be more biologically rooted.