from British Journal of Psychiatry, Vol. 174, May 1999, pp. 461-462.

Early Psychosis

Richard Gosden

The June 1998 Supplement of the British Journal of Psychiatry was devoted to a discussion of early psychosis. Patrick McGorry, the Guest Editor, introduced the subject with an extract from a 1938 article by D. Ewen Cameron. McGorry credits Cameron with originally fore-shadowing this form of preventive intervention and he was apparently using Cameron as a source of authority. It is uncertain whether McGorry is ignorant, indifferent or in admiration of Cameron's unsavoury reputation as a CIA-funded unethical experimenter. Cameron attempted to erase his patients' self-identities using ECT and deep sleep. McGorry's judgement in openly citing Cameron as a source of authority is certainly unsound.

Perhaps McGorry has not actually read the Discussion which follows Cameron's 1938 article. Harry Stack Sullivan's adverse comments about Cameron's thinking and the general idea of pre-psychotic detection and intervention do not accord with McGorry's beliefs. Sullivan wrote:

I would be very deeply disturbed if, as is implied by the last speaker [Cameron], people who show signs of personality disorders, early mental disorder of an indeterminate kind, were to be rushed through treatment with insulin, metrazol and camphor on the chance that they might otherwise have developed schizophrenia. I privately have a suspicion that might have a distinctly unfavourable effect on the general intelligence level and so on of the community.

What does it mean that a person will have schizophrenia which can be detected by the intelligent layman months to years before the schizophrenia appears? In seven and half years of exclusive preoccupation with the schizophrenia problem I was unable to put my finger on anything sufficiently simple and obvious to service this purpose.

Was Sullivan right to nip this scheme in the bud in the late 1930s? Cameron proved to have many very bad ideas yet McGorry is apparently so naive he draws on Cameron as a source of authority. Should we allow McGorry to persuade us that amongst all Cameron's bad ideas, this one is an exception?

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