Recovery From Schizophrenia: Psychiatry And Political Economy

More documents

Recommendations

Info

WHAT IS SCHIZOPHRENIA? 19Figure 1.3 The average risk of developing schizophrenia for relatives of a person with theillness; compiled from family and twin studies conducted in Europe between 1920 and1987Source: Reprinted by permission of the author. <strong>From</strong> Gottesman, I.I., <strong>Schizophrenia</strong> Genesis:The Origins of Madness, New York: W.H.Freeman, 1991, p. 96, © 1991 IrvingI.Gottesman.psychosis, the chances of the other twin developing schizophrenia are very muchlower—around 25 per cent. 36 This observation suggests that the geneticvulnerability influences both the onset and the course of the illness. The identicaltwins of people with schizophrenia, furthermore, if they do not developschizophrenia, run an increased risk of developing other psychiatric disorders—alcoholism, neurosis or personality problems. 37 What is inherited is, perhaps, notspecifically a vulnerability to schizophrenia but, instead, an underlying
20 BACKGROUNDbiochemical and functional disturbance that may express itself in somewhatdifferent ways under the influence of environmental stresses.Recent genetic linkage studies have led to the identification of severalsuspected gene locations each associated with a proportion of the risk ofdeveloping schizophrenia; a single major gene locus has not emerged. Geneticsusceptibility regions have been detected on chromosomes 5, 6, 8, 15 and 22, andeach region could harbor one or more relevant genes. Genetic researchers suspectthat susceptibility genes are present in a large proportion, perhaps seven to ten percent, of the general population, and that the interaction of multiple genes andadditional environmental factors are necessary to produce the illness. 38Just what is the deficit that might be inherited?Brain chemistryEmotions and thought processes are regulated by the complex interaction ofsystems of nerve cells throughout the brain. Each nerve cell (or neuron) exerts itseffect by the release of a chemical mediator at the synapse—the point of contactwith another neuron. Biochemical theories attempting to explain the appearanceof symptoms of schizophrenia have focused on abnormalities in the action ofsome of these chemical neurotransmitters.A prominent biochemical theory of schizophrenia—the dopamine hypothesis—suggests that the underlying abnormality may be a relative overactivity of tracts ofneurons in which dopamine is the chemical mediator. Acute stress, leading tosudden increases in dopamine turnover, could thus precipitate an episode ofpsychosis in a vulnerable individual. 39 It is likely, however, that the disturbance ofdopamine function is a consequence other abnormalities elsewhere in the brainwhich have not yet been clearly identified. Attention has been focused, forexample, on whether an abnormality in the functioning of the inhibitoryinterneurons, which release gamma-amino butyric acid (GABA), is responsible forproducing changes in the dopamine-releasing neurons. 40 Inhibitory interneuronsdamp down the action of primary neurons and prevent the brain beingoverwhelmed by sensory input. GABA release is decreased in the brains of peoplewith schizophrenia, suggesting that they may be at greater risk of brain overloadfrom environmental stimuli.The dopamine hypothesis (which will be dealt with in detail in Chapter 10) issupported in large part by the observation that the standard antipsychotic drugsachieve their effect by blocking the dopamine-2 receptor. With the introductionof the modern “atypical” or “novel” antipsychotic drugs in the past decade,however, researchers have begun to realize that many more receptors areimplicated in the illness. Besides the dopamine-2 receptor, the atypicalantipsychotic drugs (like clozapine and olanzapine) block the action of a numberof other neurotransmitters, such as serotonin, 5-HT 2 , NMDA and otherdopamine receptors, suggesting that these neurochemicals also play a role inschizophrenia. 41
Page 2 and 3: Recovery from SchizophreniaRecovery
Page 4 and 5: First edition published 1985by Rout
Page 6 and 7: ContentsAcknowledgments viIntroduct
Page 8 and 9: devotion to excellence in creating
Page 10 and 11: ixA NOTE ON THEORYThe materialist t
Page 12 and 13: Part IBackground
Page 14 and 15: WHAT IS SCHIZOPHRENIA? 3WHAT IS SCH
Page 16 and 17: WHAT IS SCHIZOPHRENIA? 5syphilis, n
Page 18 and 19: WHAT IS SCHIZOPHRENIA? 7Table 1.1-c
Page 20 and 21: WHAT IS SCHIZOPHRENIA? 9complete sy
Page 22 and 23: WHAT IS SCHIZOPHRENIA? 11patients w
Page 24 and 25: WHAT IS SCHIZOPHRENIA? 13publicatio
Page 26 and 27: WHAT IS SCHIZOPHRENIA? 15Figure 1.1
Page 28 and 29: WHAT IS SCHIZOPHRENIA? 17intrusiven
Page 32 and 33: WHAT IS SCHIZOPHRENIA? 21Brain stru
Page 34 and 35: WHAT IS SCHIZOPHRENIA? 23system. Th
Page 36 and 37: WHAT IS SCHIZOPHRENIA? 25One thing
Page 38 and 39: WHAT IS SCHIZOPHRENIA? 27of worth,
Page 40 and 41: Chapter 2Health, illness and the ec
Page 42 and 43: HEALTH, ILLNESS AND THE ECONOMY 31a
Page 44 and 45: HEALTH, ILLNESS AND THE ECONOMY 33i
Page 46 and 47: HEALTH, ILLNESS AND THE ECONOMY 35B
Page 48 and 49: HEALTH, ILLNESS AND THE ECONOMY 37s
Page 50 and 51: HEALTH, ILLNESS AND THE ECONOMY 39d
Page 52 and 53: HEALTH, ILLNESS AND THE ECONOMY 41F
Page 54 and 55: HEALTH, ILLNESS AND THE ECONOMY 43o
Page 56 and 57: HEALTH, ILLNESS AND THE ECONOMY 45T
Page 58 and 59: HEALTH, ILLNESS AND THE ECONOMY 47b
Page 60 and 61: HEALTH, ILLNESS AND THE ECONOMY 49F
Page 62 and 63: HEALTH, ILLNESS AND THE ECONOMY 51A
Page 64 and 65: Part IIThe political economy of sch
Page 66 and 67: RECOVERY FROM SCHIZOPHRENIA 55impro
Page 68 and 69: RECOVERY FROM SCHIZOPHRENIA 57categ
Page 70 and 71: RECOVERY FROM SCHIZOPHRENIA 59Table
Page 72 and 73: RECOVERY FROM SCHIZOPHRENIA 61Table
Page 74 and 75: Table 3.1 -continuedRECOVERY FROM S
Page 80 and 81:
Table 3.1 -continuedRECOVERY FROM S
Page 82 and 83:
RECOVERY FROM SCHIZOPHRENIA 71Table
Page 84 and 85:
RECOVERY FROM SCHIZOPHRENIA 73Figur
Page 86 and 87:
Table 3.3 Recovery rates in the USA
Page 88 and 89:
RECOVERY FROM SCHIZOPHRENIA 77the l
Page 90 and 91:
RECOVERY FROM SCHIZOPHRENIA 79Table
Page 92 and 93:
THE POLITICAL ECONOMY OF SCHIZOPHRE
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102 and 103:
Page 104 and 105:
Page 106 and 107:
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
MADNESS AND THE INDUSTRIAL REVOLUTI
Page 116 and 117:
Page 118 and 119:
Page 120 and 121:
Page 122 and 123:
25 patients, and on the more distur
Page 124 and 125:
Page 126 and 127:
Page 128 and 129:
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 136 and 137:
Page 138 and 139:
Chapter 6Labor, poverty and schizop
Page 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Page 164 and 165:
Page 166 and 167:
Page 168 and 169:
Page 170 and 171:
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
THE PERSON WITH SCHIZOPHRENIA IN WE
Page 186 and 187:
Page 188 and 189:
Page 190 and 191:
Page 192 and 193:
Page 194 and 195:
Page 196 and 197:
Page 198 and 199:
Page 200 and 201:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
Chapter 9The incidence of schizophr
Page 208 and 209:
Page 210 and 211:
Page 212 and 213:
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Part IIITreatment
Page 232 and 233:
ANTIPSYCHOTIC DRUGS: USE, ABUSE AND
Page 234 and 235:
Page 236 and 237:
Page 238 and 239:
Page 240 and 241:
Page 242 and 243:
Page 244 and 245:
Page 246 and 247:
Page 248 and 249:
Page 250 and 251:
Page 252 and 253:
Page 254 and 255:
Page 256 and 257:
Page 258 and 259:
TREATMENT 247indicated, unemploymen
Page 260 and 261:
TREATMENT 249success, for the lodge
Page 262 and 263:
TREATMENT 251vocational programming
Page 264 and 265:
TREATMENT 253the job is permanent.
Page 266 and 267:
TREATMENT 255Social enterprises in
Page 268 and 269:
TREATMENT 257pharmacy technicians a
Page 270 and 271:
TREATMENT 259The situation seems to
Page 272 and 273:
TREATMENT 261Though these results a
Page 274 and 275:
TREATMENT 263• raise the minimum
Page 276 and 277:
TREATMENT 265• Social policy inno
Page 278 and 279:
TREATMENT 267Table 12.1 Living situ
Page 280 and 281:
TREATMENT 269A JAIL DIVERSION PROGR
Page 282 and 283:
TREATMENT 271the office work and th
Page 284 and 285:
TREATMENT 273One might imagine that
Page 286 and 287:
TREATMENT 275studies may be the res
Page 288 and 289:
TREATMENT 277established for some o
Page 290 and 291:
TREATMENT 279Another residential pr
Page 292 and 293:
TREATMENT 281interest loans and gra
Page 294 and 295:
TREATMENT 283individual’s goals s
Page 296 and 297:
TREATMENT 285Cognitive therapy, it
Page 298 and 299:
TREATMENT 287Table 12.2 Facts about
Page 300 and 301:
TREATMENT 289consumers and professi
Page 302 and 303:
TREATMENT 291definitively not part
Page 304 and 305:
FIGHTING STIGMAAlthough the mentall
Page 306 and 307:
TREATMENT 295The National Alliance
Page 308 and 309:
TREATMENT 297other medical disorder
Page 310 and 311:
TREATMENT 299when a psychiatrist an
Page 312 and 313:
NotesINTRODUCTION1 Harris, M., Cult
Page 314 and 315:
NOTES 30333 Heston, L.L., “Psychi
Page 316 and 317:
NOTES 30557 Sham, P.C., O’Callagh
Page 318 and 319:
87 Dohrenwend, B. and Egri, G., “
Page 320 and 321:
NOTES 30929 Srole, L., Langner, R.S
Page 322 and 323:
NOTES 311unemployment cause the dea
Page 324 and 325:
NOTES 313107 Warr, P., “Studies o
Page 326 and 327:
138 Dear, M., Clark, G. and Clark,
Page 328 and 329:
NOTES 3178 Epstein, L.J., Morgan, R
Page 330 and 331:
NOTES 31943 Quirk, A. and Lelliott,
Page 332 and 333:
Page 334 and 335:
NOTES 32349 Walton, “Pauper lunat
Page 336 and 337:
105 Bockoven, J.S., Moral Treatment
Page 338 and 339:
NOTES 32729 For positive evaluation
Page 340 and 341:
66 Barker, D., “Moscow mayor has
Page 342 and 343:
NOTES 33133 World Health Organizati
Page 344 and 345:
NOTES 33380 Eliade, M., Shamanism:
Page 346 and 347:
NOTES 335homelessness a mental heal
Page 348 and 349:
NOTES 337Academic Press, 1978; Faul
Page 350 and 351:
NOTES 339Washington, DC: House of R
Page 352 and 353:
NOTES 34194 Read, J. and Baker, S.,
Page 354 and 355:
132 Robinson, J.R and Shaver, P.R.,
Page 356 and 357:
NOTES 345“Schizophrenia is not di
Page 358 and 359:
NOTES 34748 Bagley, C., “The soci
Page 360 and 361:
NOTES 34979 ni Nuallain, M., O’Ha
Page 362 and 363:
NOTES 3514 Kapur, S. and Seeman, P.
Page 364 and 365:
NOTES 35327 Pasamanick, B., Scarpet
Page 366 and 367:
NOTES 355Archives of General Psychi
Page 368 and 369:
NOTES 357“Prognostic factors in r
Page 370 and 371:
NOTES 359Chandler, D., Meisel, J.,
Page 372 and 373:
30, 1978; Moffit, R., “The econom
Page 374 and 375:
NOTES 36312 Stein, L.I. and Test, M
Page 376 and 377:
NOTES 36547 Personal communication,
Page 378 and 379:
NOTES 367European Psychiatry, 15:26
Page 380 and 381:
BibliographySTUDIES OF THE OUTCOME
Page 382 and 383:
BIBLIOGRAPHY 371Horowitz, W.A. and
Page 384 and 385:
BIBLIOGRAPHY 373Salokangas, R.K.R.,
Page 386 and 387:
AUTHOR INDEX 375Dunham, Warren 31Du
Page 388 and 389:
AUTHOR INDEX 377Urquhart, M.C. 129n
Page 390 and 391:
SUBJECT INDEX 379atypical 20;compan
Page 392 and 393:
SUBJECT INDEX 381CESP see Carer Edu
Page 394 and 395:
SUBJECT INDEX 383disability pension
Page 396 and 397:
SUBJECT INDEX 385diagnosis of 148;d
Page 398 and 399:
SUBJECT INDEX 387Isle of Wight 33is
Page 400 and 401:
SUBJECT INDEX 389Middlesex, Hanwell
Page 402 and 403:
SUBJECT INDEX 391PACE see Personal
Page 404 and 405:
SUBJECT INDEX 393economic condition
Page 406 and 407:
SUBJECT INDEX 395self-employment 15
Page 408 and 409:
SUBJECT INDEX 397symbolic thinking
Page 410:
SUBJECT INDEX 399volition disturban
show all

Recovery From Schizophrenia: Psychiatry And Political Economy

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?