Medications & Psychiatry
Resources

 email page    print page

All Topic Reviews
Psychiatry Under the InfluenceAlternatives Beyond PsychiatryAmerican MadnessAmerican PsychosisAn Unquiet MindAntipsychiatryBad PharmaBefore ProzacBetter Than ProzacBiological PsychiatryBipolar, Not So MuchBlack Man in a White CoatBlaming the BrainBrain Science and Psychological DisordersBrainwashedClinical Psychopharmacology Made Ridiculously SimpleComfortably NumbCompassion and Healing in Medicine and SocietyComplete Mental HealthConcise Guide to PsychopharmacologyCrackedCultural FormulationDeconstructing PsychosisDemystifying PsychiatryDiagnosing the Diagnostic and Statistical Manual of Mental DisordersDiagnosis: SchizophreniaDiagnostic Issues in Depression and Generalized Anxiety DisorderDimensional Models of Personality DisordersDisordered Personalities and CrimeDoctoring the MindDoctors of DeceptionDruggedDrugs for LifeEmpirical Ethics in PsychiatryEssential PsychopharmacologyEssential Psychopharmacology of Depression and Bipolar DisorderEssentials of Psychiatric DiagnosisEsssential Philosophy of PsychiatryEthics in PsychiatryEvidence-Based Treatment of Personality DysfunctionFinding the Right Psychiatrist:Forces of HabitHandbook of Clinical Psychopharmacology for TherapistsHappy Pills in AmericaHealing the Soul in the Age of the BrainHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHerbs for the MindHigh PriceHippocrates CriedHistory of Psychiatry and Medical PsychologyHookedHuman TrialsInfectious MadnessInspired SleepIntoxicating MindsIs It Me or My Meds?Let Them Eat ProzacLife-Threatening Effects of Antipsychotic DrugsLitLiving with Bipolar DisorderMad in AmericaMad ScienceMalignant SadnessMedicating ChildrenMedicating Modern AmericaMental Health in Asia and the PacificMoments of EngagementMommy I'm Still in HereNatural Healing for DepressionNo One Cares About Crazy PeopleNot CrazyOrdinarily WellOur Daily MedsOverdosed AmericaPathologist of the MindPediatric PsychopharmacologyPediatric PsychopharmacologyPediatric PsychopharmacologyPharmacracyPharmageddonPharmageddonPoets on ProzacPower HerbsPowerful MedicinesPrescriptions for the MindProfits Before People?Prozac and the New AntidepressantsProzac As a Way of LifeProzac BacklashProzac DiaryProzac on the CouchPsychiatric DiagnosisPsychiatric HegemonyPsychiatrists and Traditional HealersPsychiatry and EmpirePsychiatry and the Business of MadnessPsychiatry as Cognitive NeurosciencePsychiatry at a GlancePsychiatry in PrisonsPsychiatry ReconsideredPsychopathyPsychopharmacology Problem SolvingPsychotropic Drug Prescriber's Survival GuidePsychotropic Drugs And Popular CulturePsychotropic Drugs: Fast FactsRaising Generation RxRe-Visioning PsychiatryRecovery from SchizophreniaReligious and Spiritual Issues in Psychiatric DiagnosisRitalin NationRunning on RitalinRutter's Child and Adolescent PsychiatrySaving NormalSchizophreniaShock TherapyShock TherapyShould I Medicate My Child?ShrinksSide EffectsSometimes Amazing Things HappenStraight Talk about Psychiatric Medications for KidsSuccessful PsychopharmacologySuffer the ChildrenTaking America Off DrugsTalking Back to ProzacTextbook of Cultural PsychiatryThe $800 Million PillThe Age of AnxietyThe Anti-Depressant Fact BookThe Antidepressant EraThe Antidepressant SolutionThe Antidepressant Survival ProgramThe Big FixThe Book of WoeThe Complete Guide to Herbal MedicinesThe Conceptual Evolution of DSM-5The CorrectionsThe Creation of PsychopharmacologyThe Cult of PharmacologyThe Dream DrugstoreThe Emperor's New DrugsThe Essential Guide to Prescription Drugs 2005The Essential Guide to Prescription Drugs 2006The Making of DSM-III®The Medicated ChildThe Medication QuestionThe Merck DruggernautThe Mind/Mood Pill BookThe Natural Pharmacist : Natural Health Bible from the Most Trusted Alternative Health Site in the World The Pill BookThe Pill Book Guide to Natural MedicinesThe PlaceboThe Rise and Fall of the Biopsychosocial ModelThe Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Truth About the Drug CompaniesThe Use and Misuse of Psychiatric DrugsThe World of CaffeineThomas S. SzaszToxic PsychiatryTrouble in MindTry to RememberTry to RememberTwilight of American SanityUnderstanding Physician-Pharmaceutical Industry InteractionsUnhingedVoluntary MadnessWarning: Psychiatry Can Be Hazardous to Your Mental HealthWhat Is Mental Illness?What Psychiatry Left Out of the DSM-5What Works for Whom?Will@epicqwest.comWomen, Madness and MedicineYour Drug May Be Your Problem

Related Topics
Recovery from SchizophreniaReview - Recovery from Schizophrenia
Psychiatry and Political Economy
by Richard Warner
Routledge, 2004
Review by Christian Perring
Jul 14th 2008 (Volume 12, Issue 29)

One of the major empirical and conceptual controversies for the whole history of psychiatry concerns the possibility of recovery from schizophrenia.  Kraepelin was one of the main theorists to posit the disorder as a discrete entity, and in naming it dementia praecox (premature dementia) he expressed his judgment that it is a permanent condition.   Since the end of the nineteenth century, there have been related debates about how best to define schizophrenia and whether it is possible to recover from it partially or completely.  In 12-Step Plans, people talk about being "in recovery" but also describe addiction as a life long condition, so the notion of recovery itself has shown flexibility, since it used to be that recovery from a disease meant that it was gone.  In recent years, ideas of the recovery movement have spread to rehabilitation, and even people with serious mental illnesses will describe themselves as being in recovery. 

Richard Warner places himself firmly in the camp supporting the idea of recovery from schizophrenia in his book Recovery from Schizophrenia; the notion of recovery is basically sufficient reduction of symptoms for a person to be able to return to the workforce, although he does not define the term narrowly in this way.  His main contention is that changing economic conditions and especially doing productive work can improve the recovery rate for people with schizophrenia.  His book, first published in 1985, is now in its third edition.  It is a comprehensive survey of the theories about schizophrenia, the different treatments for the disorder now and in the past, approaches to treating schizophrenia in the Third World, the experience of living as a person with schizophrenia in the west, the importance of work for recovery, and ways to improve rehabilitation services.  It is written very clearly, and each chapter has a summary of the main points at the end. 

Warner accepts that schizophrenia is fundamentally a biological condition, but as with many other biological conditions, the course of the disorder is fundamentally affected by the economic conditions.  When jobs are easier to find, more people recover from schizophrenia, and when jobs are harder to find, recovery rates decline.  Even when it is possible to produce correlations, it is hard to prove causation, but Warner makes a strong case that these phenomena are at least intimately tied.  He quotes many studies and literature reviews, sometimes at length, to make his case.  He uses data from the USA, the UK and Ireland, and many other countries.  Often he returns to the theme of the Tuke Retreat in the late 18th and early 19th centuries, which used "moral treatment'" this had many aspects, but especially important to Warner is that patients were put to work performing useful tasks, and the recovery rates were impressive.  Warner accepts that medication is often a very helpful treatment, but he points out that it may not always be the best treatment, and it should not be used as a substitute for other psychosocial approaches.  He shows that despite our advances in treatment in the last century, recovery rates have not significantly improved.  He also points out that there are many abuses of people with schizophrenia, and that stigma is a major factor in the problems for helping people with severe mental disorders.  Warner draws on information from his home state of Colorado regarding the rehabilitation services there as a model for how to improve treatment outcomes.

The chapter on schizophrenia in the Third World is maybe the most philosophically interesting because it raises major questions of how to conceptualize mental illness in different cultures, or whether schizophrenia is a universal concept that can be applied equally in all cultures.  Similar issues arise in applying the concept of schizophrenia to previous centuries, in rather less urgent form.  Warner does not press these issues philosophically, and keeps the conceptual discussion to the minimum necessary for his main purposes.  The chapter on the Third World attempts to cover a huge area in relatively few pages, and could easily be expanded to a book of its own.  Nevertheless, philosophers and medical anthropologists will find his discussion here fascinating, and it could serve as a starting place for a sustained investigation of the cultural variation in the understanding of schizophrenia.

As a philosopher, I don't have the expertise in the wide range of empirical literature, from Western economic history, through non-Western medical anthropology, the history of psychiatry, modern clinical studies, to modern psychopharmacology and genetics to judge the adequacy of Warner's survey of the field or his interpretation.  Indeed, one wonders how many people would be competent to assess the whole range of claims in the book.  Nevertheless, it has stood up to the criticism of previous editions and is up to date with recent information.  It is careful and nuanced, as well as reasonably thorough in its argument.  For anyone who is interested in the debate over the best policy for treating schizophrenia, and the economic factors relevant to mental health treatment, Recovery from Schizophrenia is essential reading. 

© 2008 Christian Perring

Christian Perring, Associate Professor of Philosophy, Dowling College, New York.


Share

Welcome to MHN's unique book review site Metapsychology. We feature over 7900 in-depth reviews of a wide range of books and DVDs written by our reviewers from many backgrounds and perspectives. We update our front page weekly and add more than thirty new reviews each month. Our editor is Christian Perring, PhD. To contact him, use one of the forms available here.

Can't remember our URL? Access our reviews directly via 'metapsychology.net'


Metapsychology Online reviewers normally receive gratis review copies of the items they review.
Metapsychology Online receives a commission from Amazon.com for purchases through this site, which helps us send review copies to reviewers. Please support us by making your Amazon.com purchases through our Amazon links. We thank you for your support!


Join our e-mail list!: Metapsychology New Review Announcements: Sent out monthly, these announcements list our recent reviews. To subscribe, click here.

Interested in becoming a book reviewer for Metapsychology? Currently, we especially need thoughtful reviewers for books in fiction, self-help and popular psychology. To apply, write to our editor.

Metapsychology Online Reviews

Promote your Page too

Metapsychology Online Reviews
ISSN 1931-5716