Reviewer: Michael Schrift, DO (University of Washington School of Medicine)
Description: Schizophrenia is often conceptualized and studied as if it is a single disease. The DSM categories suggest schizophrenia is a discrete disorder, but schizophrenia is actually a syndrome or spectrum disorder containing multiple diseases and etiologies, analogous to intellectual disability, epilepsy, and dementia, with multiple pathophysiologies and with multiple outcomes. Lastly, the genetic predispositions for schizophrenia and affective illness are well known to overlap. The current concept of schizophrenia can no longer be considered a unitary entity and clinical recommendations that do not take this heterogeneity seriously have, in my opinion, outlived their usefulness. This book does, for the most part, incorporate the heterogeneity although many of the chapters retain the unitary concept.
Purpose: The purpose, according to the editors, is to "provide an overview of current conceptualizations of, and treatments for, schizophrenia spectrum disorders." The editors note that the psychological treatments for schizophrenia are often neglected in graduate medical training, even though there is evidence of their effectiveness and comparable to that of pharmacological treatments.
Audience: The targeted audience includes graduate students in psychology, psychiatry residents in training, psychologists, psychiatrists, and any mental health workers involved in the treatment of patients diagnosed with schizophrenia.
Features: This small book is divided into eight sections that include case vignettes, further readings, references, and an appendix with useful tools and resources. The first section focuses on the terminology involved with the concept as well as a mental health policy construct, the dimensions of schizophrenia spectrum, the medical model, psychiatric rehabilitation and recovery, evidence-based practice, outcomes, differential diagnosis and comorbidities, and diagnostic and other assessment procedures. Theories and models of schizophrenia spectrum are reviewed in section 2 and it also addresses issues of vulnerability, genetics, theories of etiology, neuroanatomy and physiology, neurodevelopmental factors, cognitive factors, social learning, and environmental factors. Section 3 covers diagnosis and treatment implications with a focus on assessment, treatment planning, and the multimodal functional model. Treatment issues are reviewed in section 4 with a description of treatment modalities, rehabilitation counseling and related modalities, collaborative psychopharmacology, neurocognitive therapy, contingent management, individual psychotherapy and social skills training, family therapy, treatment of co-occurring substance abuse, supported housing, mental health policy and economics, and multicultural issues. The reference section contains timely and pertinent citations of the relevant scientific literature. The further reading section is very helpful. There is no index.
Assessment: This is a useful book on schizophrenia spectrum disorders and important treatment modalities. Anyone who is involved in the care of patients with chronic psychosis would benefit from this excellent book. I highly recommend it. This edition, written and edited by internationally recognized clinician-researchers in the field, remains a valuable contribution to the psychiatric literature.