Book Reviews

sion of reviews of books for people or family mem- bers of those facing chronic or acute illnesses such as cancer, diabetes, schizophrenia, or AIDS. The emphasis in this guide is on interpersonal and per- sonal growth topics, rather than physical health or illness.

JANE LORD ANDREWS, M.S.W., L.I.C.S.W.

Cambridge, Massachuseffs

SSDI 0163-8343(94)00101-I

Why Psychiatry is a Branch of Medicine. By Samuel B. Guze. New York, Oxford University Press, 1992 ($24.95), 157 pp.

For Samuel Guze, psychiatry has been and re- mains a fundamental branch of medicine. Along with several colleagues at Washington University School of Medicine (St. Louis), Guze has main- tained this position consistently for over 30 years. While American Psychiatry as a whole has oscil- lated in its practices and attitudes towards its med- ical roots, the Washington University group has served as a national medical anchor for the field.

This thin volume is indeed a jewel; its clarity and conciseness in dealing with fundamental episte- mological questions are superb. Guze deals with enormously complex issues with a unique blend of rationality, lucidity, and common sense. For exam- ple, he raises basic epistemological questions about the meaning of illness and states . . . “The major difference here is between those who are committed to natural science strategies and those who deny that this is the only or even the best approach to understanding human behavior” (p. 106). While some focus on “understanding,” Guze’s emphasis on “prediction” and “control” inextricably tie him to medical science.

Guze reiterates that psychiatry will succeed only if it follows “the paths trod so successfully by the rest of medicine” (p. 129).

He emphasizes systematic approaches to clinical description and to methods of examination; he also maintains the centrality of etiology, diagnosis, ep- idemiology, pathogenesis, natural history, re- sponse to interventions, and prognosis.

One of the most important features of this book is Guze’s immersion into philosophical questions. In contrast to the overwhelming majority of his

academic and research colleagues, Guze is consis- tently aware of the epistemological underpinnings of each question he asks. What is most impressive, however, is his capacity to present these questions and their answers clearly; a novice to philosophy of science can comprehend the issues and follow Guze’s positions. We are living in a time when logical positivism is dominant in American psychi- atry and, unfortunately, the interest in philosophy is weak. In my judgment this disinterest in theory has profound disadvantages and could erode longer-term scientific progress. Guze is a major ex- ception to the trend; in this book he discusses fun- damental philosophical and theoretical questions (free will, consciousness, and so forth) while plac- ing psychiatry squarely into a medical model.

Guze and his colleagues have helped American psychiatry to “remedicalize,” as is reflected in the DSM-IV, the practice guidelines, and the rebirth of scientific epidemiology and prevention. This book is a concise credo of why psychiatry must remain in medicine. Scientific and economic fac- tors do reinforce this direction. Whether the “re- medical-ization” includes some rigidities and lim- itations that may not be optimal, remains an open question for the next generation to determine. For current American psychiatry, Guze has done a great service by presenting a medical model of wis- dom and clarity. This book should be widely read and quoted.

MELVIN SABSHIN, M.D.

Washington, D. C.

SSDI 0163-8343(94)00102-J

Child and Adolescent Psychiatry for the Specialty Board Review. By R. L. Hendren. New York, Brunner Maze1 Publishers, 1994 ($21.95), 128 pp.

Taking and passing the certification boards in one’s specialty has become a rite of passage for physicians who have recently completed their training. According to the American Board of Psy- chiatry and Neurology, 62% of child psychiatrists who took the certification exams in 1992 passed the test [l]. In comparison, the percentages of those passing the general psychiatry boards for the same year were 59% for the written [2] and 61% for the oral examination [ 11.

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