Commentary on McGlashan/Nayfack and Money/Lobato case studies.

In this initial discussion for Psychiatry's series of case studies, I will be emphasizing two special contributions that can be made by single case and small sample reports, which are exemplified by the McGlashan/Nayfack paper and by the Money/Lobato study that appeared in the February 1988 issue of Psychiatry. The first contribution provides a unique perspective on the significance of therapist orientation in influencing the course of a patient's disorder and life. The second illustrates the use of a small sample study for understanding complex processes determining the onset and evolution of disorder. The McGlashan/Nayfack report is one of those rare case histories in which we have the opportunity to see the completion of a life, extending our vision far beyond the usual therapeutic frame. The Money report exemplifies the way in which small sample reports can provide a powerful approach to making the detailed comparisons needed to clarify multidetermined processes.