Book Review: Schizophrenia: A Scientific Delusion?

This is the kind of book which restores my faith in clinical psychologists and encourages me to admit to my own allegiance to this particular breed of 'clinicians'.

Dr. Boyle does credit to her profession in the scholarly manner in which she approaches a very controversial subject as she challenges the concept of schizophrenia by arguing that it has been developed and used in a way which bears little resemblance to the methods of construct formation used in medicine and other empirical sciences.

Dr. Boyle's methodological rigour and understanding of the philosophy of science underpin a careful review of the evidence put forward in favour of the concept of schizophrenia. The book examines in some detail the original work of Kraeplin, Bleuler and Schneider and concludes that there is no evidence in their work that could justify inferring the concept.

The question of the validity of schizophrenia rests on the demonstration that it is derived from a reliably observed pattern, an above chance co-occurrence of phenomena. However, Dr Boyle's analysis of the literature exposes the lack of evidence to support that the latter has indeed been demonstrated.

The book also reviews the genetic research highlighting severe methodological and conceptual weaknesses in many of the adoption and twin studies cited in support of an hereditary factor in schizophrenia.

Finally, Dr. Boyle examines some of the reasons as to why we have retained the concept, showing how it serves a number of functions both for psychiatrists and the general public. Dr. Boyle does not deny the existence of the behaviours and experiences from which the concept of schizophrenia has been inferred. Rather, she contests the interpretation of these behaviours and in the final chapter of the book she examines social and psychological analyses of bizarre behaviour in an attempt to offer alternative interpretations and to suggest avenues for further research.

This is a thoroughly well researched book whose findings and suggestions should be taken extremely seriously by anyone involved in the mental health professions. I can but highly recommend it and having had the opportunity to hear Dr Boyle speak I would also recommend attending one of her lectures.

Alessandra Lemma