Suiting Therapeutic Intervention to the Scientific Models of Aetiology

Since descriptive psychiatry offers only the surface exploration of psychopathology we must turn to aetiology for the deeper understanding of our problems. It has become quite clear during the last few decades that the factors in the aetiology of schizophrenia are less established than those in the efficacy of therapeutic intervention. The former are still highly theoretical scientific models whose tenability is often difficult to establish, while the latter can be tested more objectively through clinical trials. In this manner, the efficacy of neuroleptic therapy and of the various behavioural and psychosocial therapeutic interventions has been examined and some found to be wanting (e.g. renal dialysis). Nevertheless, the therapeutic clinical trials probably arose as a result of some aetiological considerations and for new therapeutic approaches we need to turn again to our aetiological models. However, the connection between aetiological models and therapeutic intervention has never been examined. As a result we have elaborate aetiology on the one hand and specific therapies on the other but the two pass each other by. The purpose of this paper is to weave the threads of practice into the web of theory.