In Search of Madness —— Schizophrenia and Neuroscience

----- 寻找疯狂：精神分裂症和神经科学

ISBN: 9780195122190 出版年：2009 页码：358 Heinrichs, R Walter Oxford University Press

R. WALTER HEINRICHSNew York: Oxford University Press, 2001, 368 pages(ISBN 0-1951-2219-4, US$39.95 Hardcover)Reviewed by GILLIAN O'DRISCOLLThe goal of this book is to review the burgeoning and disparate research literatures in schizophrenia to identify findings that are both strong and reliable. This is not a small task as, according to the author's review, papers produced each year in the field number almost two thousand. It is a credit to Dr. Heinrichs that he includes almost every major topic in schizophrenia, and also provides an introduction to relatively new hypotheses and domains of research (genetics is specifically excluded.) The book is well-written, and Dr. Heinrichs describes the various technical literatures in a way that a relative novice (who has some knowledge of neuroanatomy) can understand. From the point of view of a graduate text, the book provides an excellent model for how literature should be considered, with clear explanations of effect sizes, confidence intervals, and the relationship between the question asked and the effect size desired. However, the best audience for this book may be medical students or psychiatry residents, as it presumes more knowledge of neuroanatomy and less of statistics than might be found in a typical clinical psychology graduate student.The first three areas reviewed are cognitive theories of schizophrenia, the frontal hypothesis of schizophrenia, and temporal lobe hypotheses of schizophrenia. These reviews are fairly exhaustive and are probably the best in the book in terms of interest for both established researchers and students. They provide clear, interesting introductions to the rationale behind research in these areas and detailed summaries of different subliteratures (e.g., neuropsychological studies, MRI studies, and functional neuroimaging studies). They then provide in tabular form the average effect size and the confidence limits around the effect for each subfield. For the purposes of comparison, they also provide effect sizes one would find in a neurological population. This is highly useful for readers who want a general picture of the field with a minimum of rhetoric. Further, these analyses provide some surprising conclusions, such as the fact that frontal neuropsychological tests are as good at identifying schizophrenic patients as they are at identifying patients with frontal lobe lesions.The chapter on neurochemical hypotheses (including dopamine, serotonin, and glutamate), provides a similar summary but is written at the level of the advanced lay reader or new graduate student, providing an introduction that can be the basis for more advanced reading that is done elsewhere.A chapter on current theories of schizophrenia is also provided. This chapter presents Meehl's older, but still relevant, schizotaxia hypothesis, Weinberger's neurodevelopmental hypothesis of compromised frontotemporal connectivity, and the more recent hypothesis of Walker and Diforio implicating the HPA axis in schizophrenia. In the final chapter, research findings in all areas are compared. Robust and replicable findings in schizophrenia include abnormalities in the P50 wave, deficits in verbal memory, abnormal eye tracking, abnormal D2 receptor density, and reduced frontal activation in functional neuroimaging studies.Two chapters that are relatively weaker than those above concern markers and high-risk populations. The notion of "endophenotype," which is fundamental to understanding current marker research, is not explained in any detail. Instead, the quest for markers is presented as a quest to find a cognitive or psychophysical abnormality that occurs whenever the clinical disorder is observed and not when it is not. However, most marker research is aimed at identifying gene carriers, whether or not they develop the illness. This conceptual weakness affects the literature review of high-risk populations as well, since only the literature on "preschizophrenic" children is considered thoroughly. …