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In Search of Madness: Schizophrenia and Neuroscience. By R. W. Heinrichs. (Pp. 358; £27.50.) Oxford University Press: Oxford. 2001.

Studies of schizophrenia from the so-called neurosciences have increased dramatically in the past two decades. R. Walter Heinrichs takes a lucid, critical and comprehensive look at the question: Has this resulted in a better understanding of the aetiology of schizophrenia? In Search of Madness provides an unparalleled examination of the neuroscientific evidence in schizophrenia. It begins with a balanced account of the book’s approach and scope, which is critical and wide. The following six chapters then examine the evidence regarding various domains (symptoms, behavioural and biological markers, frontal–executive and temporal–semantic functions, neurochemistry, biological and behavioural antecedents). Effect size analyses are used in order to evaluate the extent to which various factors and variables are specifically associated with schizophrenia, in addition to distanced and sound methodological and theoretical criticisms. This is followed by a chapter that presents and evaluates three models of schizophrenia (Meehl, 1962; Weinberger, 1987; Walker & Difornio, 1997). The book then concludes with an overview, synthesis and three-pronged future for schizophrenia research. Briefly, the reader is confrontedwith inadequate evidence that schizophrenia is a neuroscientific disorder, as effect size analyses reveal few variables that successfully distinguish a normal healthy person from a schizophrenic. The models, being at least partly dependent upon this evidence, are similarly criticized and seen as inadequate in providing a full understanding of this complex disorder. Each chapter begins with a presentation of pertinent background information in clear and concise terms, and each chapter is finalized in true scholarly fashion where few aspects are left uncriticized. Due to the book’s wide scope, and in order to provide a more detailed analysis of the book, I will mainly concentrate on the chapter that examines symptoms, and the final chapter. In ‘The Nature of Symptoms’, studies that examine delusions, hallucinations and thought disorders are presented. For delusions, studies are grouped according to those related to premature decision-making, and those related to negative cognitive bias. Research on hallucinations is divided into studies of externalizing attributions, and inaccurate speech tracking and monitoring. Finally, thought disorder is then examined in terms of those studies looking at either defective monitoring, semantic hyperpriming or impaired theory of mind. Although this chapter is clearly written, interesting and grasps the main issues (as is in general the case for all the chapters), there are certain limits. Despite the recent explosion of studies looking at relations between externalizing attributions and hallucinations, only three such studies are included. Although it may be that the missing studies did not report findings that are amenable to effect sizes (e.g. nonparametric statistics), it is unlikely that this is the case for all the missing studies. Also, a number of important studies looking at relations between positive symptomatology and externalizing attributions should also have been included. Comparisons of positive versus negative symptoms tend to be simplistic. Negative symptoms are suggested to be more related to a person’s attempt to cope with the illness, compared to positive symptoms. However, since hallucinations many times relate to specific, often highly personal themes, they may be considered as a form of self-defence emerging to ensure that memories are kept at bay, that is, that the voices emerge instead of the memory. Also, hallucinations may be regarded as a reaction to overwhelming social problems and personal interactions with which the person has not been able to cope (Romme & Escher, 2000). Furthermore, Heinrichs states that positive symptoms seem