When Ifirst read this manuscript, Iexclaimed to a colleague: "This is
the most important and clinically relevant book on schizophrenia since
Bleuler!" Time has not altered my initial enthusiastic evaluation. Drs.
Strauss and Carpenter are among the most distinguished researchers in
the field ofschizophrenia, butthey are also clinicians ofgreat
experience, breadth, sensitivity, and flexibility. It is from this
expertise, as well as theirwide familiarity with the world literature,
thattheyhavebeenable to distill the essence of an exceedingly practical
and comprehensive approach to the understanding, evaluation, diagnosis,
and treatment of schizophrenia. They begin by unequivocally stating the
inadequacy and futility of approaching schizophrenia via a single model.
Standingalone, neither a biomedical, a social, nor a psychological model
can adequately account for the complexities of this illness with regard
to etiology, phenomenol- ogy, course, or optimum treatment. While the
advent of psychophar- macologicalinterventionhas made a profound impact
on both individual treatment and the responsive support systems, and is
an important aspect ofmosttreatmentplans, to view schizophrenia as a
phenothiazine deficiency disease is not only bad science but bad
therapeutics. Their conceptualization of an "interactive developmental
systems model" provides a framework upon which to build a broad medical
approach to schizophrenia. This model relates variables drawn from
different systems, interactive with one another, and contributing to a
pathogenetic process across time. Within this bio-social-psychological
matrix, one can then organize information relative to vulnerability, the
manifest illness per se, the course of the disorder, and the
multiplicity of factors relative to treatment planning.
