Schizophrenia: A Very Short Introduction, by Christopher Frith &
Eve Johnstone
This was one of the best VSI books I've read: a very clear, detailed and
well-written description of the condition of schizophrenia, how it's been
viewed and treated, and what the current thinking is on its causes and how we
should deal with it. I think I learned a lot. Stuff I marked:
- Psychosis is "any severe form of mental disorder in which the patient has
lost touch with reality" (p24)
- The term schizophrenia (split mind) is "intended to describe a
loosening of the associations between the different functions of the
mind...coordination between emotional, cognitive and volitional processes
[becomes] weaker" (p30). I.e. not having multiple personalities.
- There are "positive" and "negative" aspects of schizophrenia: negative
being characterised by a "withdrawal from the world and from self" (p2);
positive being the more stereotypical hallucinations and delusions
- Different schools of thought developed about what constituted the
condition, leading to variation in what classes as "schizophrenia". In 1972,
"62% of patients were given a hospital diagnosis of schizophrenia...[in
London] the proportion was only 34%" (p32). There has to date been no
evidence produced of any physical marker (in the brain) which correlates with
the condition
- There is some correlation between incidence of schizophrenia and lower
than average IQ, but it's not entirely clear whether this is a causal link,
or whether it may even be a result of the treatment schizophrenics
receive
- "There does seem to be some truth in the romantic idea that there is a
relationship between madness and genius...but the majority of people with
schizophrenia can cain little of value from their psychotic experiences..."
(p71)
- Amphetamines are generally held capable of inducing psychosis; cannabis
also appears to increase the risk of developing schizophrenia.
Anti-psychotic drugs can be helpful in reducing symptoms of psychosis. So
there does appear to be evidence that the condition has a physiological
basis, i.e. to do with brain chemistry.
- Genetic factors have some influence on whether you'll develop the
condition
- People born in winter are more likely to develop it, reason unknown
- The idea of corollary discharge is that the brain, in addition to
sending signals to your body to do something (e.g. move your head), sends a
corollary message to cancel out the effect on your perception (e.g. stops you
thinking the world is spinning round). Plenty of evidence that this happens,
and the suggestion is that in schizophrenia, the corollary discharge
mechanism is broken. So in a normal person, the movement of a hand is
cancelled out by the CD which says "your hand is about to feel motion". But
in a schizophrenic, the cancelling out doesn't work, and so it feels as the
your hand is being controlled by something else. May explain why they often
feel their thoughts are being intercepted/controlled, as the hand is doing
what they want it to, although they don't feel in control of it.
- CBT has been shown to be effective in some cases, e.g. in the cases of
patients hearing threatening voices, "patients were encouraged to test these
threats and prove to themselves that nothing terrible happened when they
refused to obey the voices" (p144)
Completed : 30-May-2004
Links
- Oxford University press has a web page for this book.
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