Guze, Samuel Barry

   (pronounced [Goo-ZAY])

   (1923–2000)

   Born in New York City, in 1945 Guze earned his M.D. at Washington University in St. Louis. He trained in internal medicine at Barnes Hospital (one of the teaching hospitals of Washington University) and at a Veterans Administration hospital in Connecticut. It was at Barnes that he became interested in psychiatry while working in the consultation-liaison service; there he encountered staff psychiatrist George Saslow (1906–), who was very hostile to psychoanalysis.

   In 1951, Guze joined the psychiatry department at Washington University as an instructor, ultimately succeeding Eli Robins in 1975 as head of psychiatry; he retired from the post in 1989. As one of the founders of the St. Louis school, Guze like Robins was convinced that psychiatry must again become part of medicine; he rejected the "biopsychosocial" model of psychiatry propagated by University of Rochester internist and psychiatrist George L. Engel and argued for the medical model in his 1992 book, Why Psychiatry is a Branch of Medicine. Guze is particularly known for his 1962 work on chronic hysteria, later called somatization disorder, in which he linked a family history of hysteria on the female side of a family tree to sociopathic behavior on the male side; it was published in the New England Journal of Medicine, with Guze’s resident Michael Perley (1936–) generously listed as the main author. (Perley went on to have a career as endocrinologist and nephrologist.) In 1970, Guze baptized chronic hysteria "Briquet’s syndrome," after the French psychiatrist Pierre Briquet (1796–1881), whose 1859 book, Traité clinique et thérapeutique de l’hystérie, was one of the first quantitative studies of the disorder. (Yet, it was in 1881 that Briquet enunciated his concept of hysteria as a chronic familial illness.) (See HYSTERIA: "Briquet’s Syndrome" [1881].) Guze was a coauthor, with resident John Feighner, of a 1972 paper on psychiatric diagnosis published in the Archives of General Psychiatry that introduced operational criteria for making diagnoses. In 1974, Guze and Donald Goodwin (1931–1999), another member of the St. Louis school, wrote a book on Psychiatric Diagnosis that has been described as "the manifesto" of the St. Louis school. In that year, Guze was offered the chair of psychiatry at Johns Hopkins University but decided to stay at Washington University and "look after Eli." Robins and Guze stressed the concept of "validation" of psychiatric diagnoses. Guze in particular insisted on "external" validation. This led to a falling out between the St. Louis school and Robert Spitzer and the DSM-III drafters, who sought "reliability," meaning agreement among users.