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Psychosis In The Inner City - The Camberwell First Episode Study (Hardcover)
Loot Price: R1,619
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Psychosis In The Inner City - The Camberwell First Episode Study (Hardcover)
Series: Maudsley Series
Expected to ship within 12 - 17 working days
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The "epigenetic puzzle" which is schizophrenia, forms the focus of
this Monograph, but the authors do not sit comfortably with the
notion that this is an entity. Rather, they approach the
non-affective psychoses on a broad epidemiological base,
ascertaining cases of so-called "functional" psychosis over a
quarter of a century. They examine admission policies, showing that
patients are admitted to hospital on the grounds of their
particular presentation, rather than their diagnosis. They explore
differences between males and females with psychotic disorders, and
show that gender is a more powerful influence than diagnosis. They
investigate trends over time, and find that demography is the major
influence. Looking at criminality, they show that the factors
predicting criminal behavior in individuals with psychotic illness
are much the same in those without psychotic illness. And they
trace the longitudinal course of illness, putting paid to the
schizophrenia/manic depression dichotomy. Their powerful message
isthat diagnostic criteria are spurious, complacent constructs,
which lull us into a false sense of security, and which should be
challenged. They suggest that it is epidemiology which can place
the current vogue for diagnostic conformity in its correct
perspective.
Epidemiology has a vital role to play by exploring the attributes
of the clinical concept of schizophrenia and their correlates in
relation to the population base from which cases are drawn. While
many clinical and biological studies still operate with truncated
distributions of such attributes because of unsystematic or
opportunity sampling, an epidemiological sample is less likely to
be affected by such bias andmore likely to be representative of the
entire spectrum of manifestations of the notional disease. The
study of epidemiologically defined samples of schizophrenia cases
should therefore lead to more precise questions about syndrome
boundaries, clinical heterogeneity, and associations with possible
risk factors.
To mention some of the highlights of the monograph, the analyses of
crime and schizophrenia, and of the comparative incidence of
disorders in Afro-Caribbean and African immigrants, are
methodologically ingenious and lead to well supported conclusions.
The description of the clinical profile of late onset schizophrenia
is a timely contribution to a topic which attracts less attention
in the current literature than is warranted by its critical
importance for any aetiological theories about the disorder.
This monograph is an excellent overview of the ideas and many of
the findings generated by a highly productive group of researchers.
It has a good chance to become one of the standard references on
several of the key aspects of schizophrenia.
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