Madness Explained

by Richard P. Bental

  81. K. Popper (1961) The Poverty of Historicism. London: Routledge.

  Chapter 19 Madness and Society

  1. Quoted in N. Zierold (1991) The Moguls. New York: Silman-James.

  2. E. Kraepelin (1899/1990) Psychiatry: A Textbook for Students and Physicians, Vol. 1: General Psychiatry. Canton, MA: Watson Publishing International.

  3. W. Mayer-Gross, E. Slater and M. Roth (1975) Clinical Psychiatry. London: Cassell.

  4. A. Lewis (1934) ‘The psychopathology of insight’, British Journal of Medical Psychology, 14: 332–48.

  5. X. F. Amador and H. Kronengold (1998) ‘The description and meaning of insight in psychosis’, in X. F. Amador and A. S. David (eds.), Insight and Psychosis. Oxford: Oxford University Press, pp. 15–32.

  6. World Health Organization (1973) International Pilot Study of Schizophrenia. Geneva: WHO; X. F. Amador, M. Flaum, N. C. Andreasen, D. H. Strauss, S. A. Yale, S. C. Clark and J. M. Gorman (1994) ‘Awareness of illness in schizophrenia and schizoaffective and mood disorders’, Archives of General Psychiatry, 51: 826–36; M. A. Weiler, M. H. Fleisher and D. McArthur-Campbell (2000) ‘Insight and symptom change in schizophrenia’, Schizophrenia Research, 45: 29–36.

  7. A. S. David (1998) ‘The clinical importance of insight’, in Amador and David (eds.), Insight and Psychosis, op. cit., pp. 332–51; A. S. David (1999) ‘“To see ourselves as others see us” ’, British Journal of Psychiatry, 175: 210–16.

  8. For a study of recent historical trends in the use of coercion in Britain see M. Hotopf, S. Wall, A. Buchanan, S. Wessely and R. Churchill (2000) ‘Changing patterns in the use of the Mental Health Act 1983 in England, 1984–1996’, British Journal of Psychiatry, 176: 479–84.

  For evidence from Finland, see H. R. Kaltiala, J. Korkeila, C. Tuohimaeki, T. Tuori and V. Lehtinen (2000) ‘Coercion and restrictions in psychiatric inpatient treatment’, European Psychiatry, 15: 213–19.

  For evidence from the USA, see S. K. Hoge, C. W. Lidz, M. Eisenberg and W. Gardner (1997) ‘Perceptions of coercion in the admission of voluntary and involuntary psychiatric patients’, International Journal of Law and Psychiatry, 20: 167–81.

  For evidence from New Zealand, see B. G. McKenna, A. I. F. Simpson and T. M. Laidlaw (1999) ‘Patient perception of coercion on admission to acute psychiatric services: the New Zealand experience’, International Journal of Law and Psychiatry, 22: 143–53.

  Finally, for evidence that patients’ perceptions that they are being coerced are often accurate, see C. W. Lidz, E. P. Mulvey, S. K. Hoge, B. L. Kirsch, J. Monahan, M. Eisenberg, W. Gardner and L. H. Roth (1998) ‘Factual sources of psychiatric patients’ perceptions of coercion in the hospital admission process’, American Journal of Psychiatry, 155: 1254–60.

  9. V. W. Swayze (1995) ‘Frontal leukotomy and related psychosurgical procedures in the era before antipsychotics (1935–1954): a historical overview’, American Journal of Psychiatry, 152: 505–15.

  10. P. Breggin (1993) Toxic Psychiatry. London: Fontana.

  11. J.-E. Meyer (1988) ‘The fate of the mentally ill in Germany during the Third Reich’, Psychological Medicine, 18: 575–81.

  12. R. N. Proctor (1988) Racial Hygiene: Medicine under the Nazis. Cambridge, MA: Harvard University Press.

  13. J. Le Fanu (1999) The Rise and Fall of Modern Medicine. London: Little, Brown & Co.

  14. See, for example, recent systematic reviews published electronically (and available at academic libraries) by the international ‘Cochrane’ collaborative network of researchers, which provides evidence on the effectiveness of treatments for the British National Health Service and other health care providers: B. Thornley, C. E. Adams and G. Award (2001) ‘Chlorpromazine versus placebo for schizophrenia (Cochrane Review)’, The Cochrane Library, 3. Oxford: Update Software; C. B. Joy, C. E. Adams and S. M. Lawrie (2001) ‘Haloperidol versus placebo for schizophrenia (Cochrane Review)’, The Cochrane Library, 3. Oxford: Update Software.

  15. R. Warner (1985) Recovery from Schizophrenia: Psychiatry and Political Economy. New York: Routledge & Kegan Paul.

  16. W. A. Brown and L. R. Herz (1989) ‘Response to neuroleptic drugs as a device for classifying schizophrenia’, Schizophrenia Bulletin, 15: 123–8.

  17. B. J. Kinon, J. M. Kane, C. Johns, R. Perovich, M. Ismi, A. Koreen and P. Weiden (1993) ‘Treatment of neuroleptic resistant relapse’, Psychopharmacology Bulletin, 29: 309–14.

  18. P. F. Kennedy, H. I. Hershon and R. J. McGuire (1971) ‘Extrapyramidal disorders after prolonged phenothiazine therapy’, British Journal of Psychiatry, 118: 509–18.

  19. G. Sullivan and D. Lukoff (1990) ‘Sexual side effects of anti-psychotic medication: evaluation and interventions’, Hospital and Community Psychiatry, 41: 1238–41.

  20. J. Day, P. Kinderman and R. P. Bentall (1997) ‘Discordant views of neuroleptic side effects: a potential source of conflict between patients and professionals’, Acta Psychiatrica Scandinavica, 97: 93–7.

  21. R. Robinson, P. McHugh and M. Follstein (1975) ‘Measurement of appetite disturbance in severe psychiatric disorders’, Journal of Psychiatric Research, 12: 59–68.

  22. D. B. Allison, J. L. Mentore, M. Heo, L. P. Chandler, J. C. Cappelleri, M. C. Infante and P. Weiden (1999) ‘Antipsychotic-induced weight gain: a comprehensive research synthesis’, American Journal of Psychiatry, 156: 1686–96.

  23. T. van Putten and P. R. May (1978) ‘Subjective response as a predictor of outcome in pharmacotherapy’, Archives of General Psychiatry, 35: 477–80; T. van Putten, P.R. May, S.R. Marder and L.A. Wittman (1981) ‘Subjective response to antipsychotic drugs’, Archives of General Psychiatry, 38: 187–90.

  24. M. Harrow, C. A. Yonan, J. R. Sands and J. Marengo (1994) ‘Depression in schizophrenia: are neuroleptics, akinesia or anhedonia involved?’, Schizophrenia Bulletin, 20: 327–38.

  25. T. Lewander (1994) ‘Neuroleptics and the neuroleptic-induced deficit syndrome’, Acta Psychiatrica Scandinavica, 89: 8–13; N. R. Schooler (1994) ‘Deficit symptoms in schizophrenia: negative symptoms versus neuroleptic-induced deficits’, Acta Psychiatrica Scandinavica, 89: 21–6.

  26. T. J. Crow, J. F. MacMillan, A. L. Johnson and E. C. Johnstone (1986) ‘The Northwick Park study of first episodes of schizophrenia. II: A randomised controlled trial of prophylactic neuroleptic treatment’, British Journal of Psychiatry, 148: 120–7.

  27. N. Thorogood, P. Cowen, J. Mann, M. Murphy and M. Vessey (1992) ‘Fatal myocardial infarction and use of psychotropic drugs in young women’, Lancet, 340: 1067–8; W. A. Ray, S. Meredith, P. B. Thapa, K. G. Meador, K. Hall and K. T. Murray (2001) ‘Antipsychotics and the risk of sudden death’, Archives of General Psychiatry, 58: 1161–7; W. A. Ray and K. G. Meador (2002) ‘Antipsy-chotics and sudden death: is thoridazine the only bad actor?’, British Journal of Psychiatry, 180: 483–4.

  28. S. N. Caroff (1980) ‘The neuroleptic malignant syndrome’, Journal of Clinical Psychiatry, 41: 79–83.

  29. M. N. G. Dukes (ed.) (1992) Meyler’s Side Effects of Drugs. Amsterdam: Elsevier.

  30. I am grateful to Professor Simon Wessely of the Institute of Psychiatry in London, who first drew my attention to this risk associated with neuroleptics.

  31. E. C. Atbasoglu, S. K. Schultz and N. C. Andreasen (2001) ‘The relationship of akathisia with suicidality and depersonalization among patients with schizophrenia’, Journal of Neuropsychiatry and Clinical Neurosciences, 13: 336–41; H. Lars (2001) ‘A critical review of akathisia and its possible association with suicidal behaviour’, Human Psychopharmacology: Clinical and Experimental, 16: 495– 505; M.Z. Azhar and S. L. Varama (1992) ‘Akathisia-induced suicidal behaviour’, European Psychiatry, 7: 239–41; J. L. Schulte (1985) ‘Homicide and suicide associated with akathisia and haloperidol’, American Journal of Forensic Psychiatry, 6: 3–7.

  32. T. van Putten, S. R. Marder and J. Mintz (1990) ‘A controlled dose comparison of haloperidol in newly admitted schizophrenic patients’, Archives of General Psychiatry, 47: 754–8; J. P. McEvoy,
G. E. Hogarty and S. Steingard (1991) ‘Optimal dose of neuroleptic in acute schizophrenia: a controlled study of the neuroleptic threshold and higher haloperidol dose’, Archives of General Psychiatry, 48: 739–45; A. Rifkind, S. Doddi, B. Karagigi, M. Bornstein and M. Wachspress (1991) ‘Dosage of haloperidol for schizophrenia’, Archives of General Psychiatry, 48: 166–70.

  33. P. Bollini, S. Pampallona, M. J. Orza, M. E. Adams and T. C. Chalmers (1994) ‘Antipsychotic drugs: is more worse? A meta analysis of the published randomized controlled trials’, Psychological Medicine, 24: 307–16.

  34. Royal College of Psychiatrists (1993) Consensus Statement on the Use of High Dose Antipsychotic Medication (CR26). Royal College of Psychiatrists.

  35. A. F. Lehman, D. M. Steinwachs, L. B. Dixon, H. H. Goldman, F. Osher, L. Postrado, J. E. Scott, J. W. Thompson, M. Fahey, P. Fisher, J. A. Kasper, A. Lyles, E. A. Skinner, R. Buchanan, W. T. Carpenter, J. Levine, E. A. McGlynn, R. Rosenheck and J. Zito (1998) ‘Translating research into practice: the Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations’, Schizophrenia Bulletin, 24: 1–10.

  36. L.M. Flynn (1998) ‘Patterns of usual care for schizophrenia: initial results from the Schizophrenia Patient Outcomes Research Team (PORT) Client Survey’, Schizophrenia Bulletin, 24: 30–2; D. Cohen (1997) ‘A critique of the use of neuroleptic drugs in psychiatry’, in S. Fisher and R. P. Greenberg (eds.), From Placebo to Panacea: Putting Psychiatric Drugs to the Test. New York: Wiley, pp. 173–228.

  In an as yet unpublished study carried out by myself and Jennie Day, in which we collected data on neuroleptic treatment from 212 patients on psychiatric wards in the North West of England and North Wales between 1995 and 1998, we found that the median dose of medication received by the patients was equivalent to 600 milligrams of chlorpromazine a day and approximately a quarter of the patients were on doses equivalent to 1 gram of chlorpromazine or more.

  37. H. Hippius and D. Healy (1996) ‘The founding of the CNIP and the discovery of clozapine (interview)’, in D. Healy (ed.), The Psychopharmacologists. London: Chapman & Hall, pp. 187–213.

  38. J. Kane, G. Honigfeld, J. Singer and H. Meltzer (1988) ‘Clozapine for the treatment-resistant schizophrenic’, Archives of General Psychiatry, 45: 789–96.

  39. H. Meltzer and D. Healy (1996) ‘A career in biological psychiatry (interview)’, in Healy (ed.), The Psychopharmacologists, op. cit., pp. 483–507.

  40. T. Van Putten, B. D. Marshall, R. Liberman and J. Mintz (1993) ‘Systematic dosage reduction in treatment-resistant schizophrenic patients’, Psychopharmacology Bulletin, 29: 315–20.

  41. J. Geddes, N. Freemantle, P. Harrison and P. Bebbington (2000) ‘Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis’, British Medical Journal, 321: 1371–6.

  42. American psychiatrist Peter Breggin takes this kind of position. See Breggin, Toxic Psychiatry, op. cit.

  43. L. R. Mosher and A. Z. Menn (1978) ‘Community residential treatment for schizophrenia: two-year follow-up’, Hospital and Community Psychiatry, 29: 715–23; L. R. Mosher, R. Vallone and A. Menn (1995) ‘The treatment of acute psychosis without neuroleptics: six-week psychopathology outcome data from the Soteria project’, International Journal of Social Psychiatry, 41: 157–73.

  44. H. S. Sullivan (1962) Schizophrenia as a Human Process. New York: Norton.

  45. F. B. Evans (1996) Harry Stack Sullivan: Interpersonal Theory and Psychotherapy. London: Routledge.

  46. K. T. Mueser and H. Berenbaum (1990) ‘Psychodynamic treatment of schizophrenia: is there a future?’, Psychological Medicine, 20: 253–62.

  47. A. H. Stanton, J. G. Gunderson, P. H. Knapp, A. F. Frank, M. L. Vannicelli, R. Schnitzer and R. Rosenthal (1984) ‘Effects of psychotherapy in schizophrenia: I. Design and implementation of a controlled study’, Schizophrenia Bulletin, 10: 520–63; J. G. Gunderson, A. F. Frank, H. M. Katz, M. L. Vannicelli, J. P. Frosch and P. H. Knapp (1984) ‘Effects of psychotherapy in schizophrenia: II. Comparative outcome of two forms of treatment’, Schizophrenia Bulletin, 10: 564–98.

  48. T. H. McGlashan (1984) ‘The Chestnut Lodge follow-up study I: Follow-up methodology and study sample’, Archives of General Psychiatry, 41: 575–85; T. H. McGlashan (1984) ‘The Chestnut Lodge follow-up study II: Long-term outcome ofschizophrenia and affective disorders’, Archives of General Psychiatry, 41: 586–601; M. H. Stone (1986) ‘Exploratory psychotherapy in schizophrenia-spectrum patients’, Bulletin of the Menninger Clinic, 50: 287–306.

  49. J. P. Leff, L. Kuipers, R. Berkowitz, R. Eberlein-Fries and D. Sturgeon (1982) ‘A controlled trial of intervention with families of schizophrenic patients’, British Journal of Psychiatry, 141: 121–34.

  50. J. P. Leff, L. Kuipers, R. Berkowitz and D. Sturgeon (1985) ‘A controlled trial of social intervention in the families of schizophrenic patients’, British Journal of Psychiatry, 146: 594–600.

  51. I. R. H. Falloon, J. L. Boyd, C. W. McGill, M. Williamson, J. Razani, H. B. Moss, A. M. Gilderman and G. M. Simpson (1985) ‘Family management in the prevention of morbidity of schizophrenia: clinical outcome of a two-year longitudinal study’, Archives of General Psychiatry, 42: 887–96.

  52. G. E. Hogarty, C. M. Anderson, D. J. Reiss, S. J. Kornblith, D. P. Greenwald, R. F. Ulrich and M. Carter (1991) ‘Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare treatment of schizophrenia. II: Two year effects of a controlled study on relapse and adjustment’, Archives of General Psychiatry, 48: 340–7.

  53. N. Tarrier, C. Barrowclough, C. E. Vaughn, J. S. Bamrah, K. Porceddu, S. Watts and H. Freeman (1988) ‘The community management of schizophrenia: a controlled trial of a behavioural intervention with families to reduce relapse’, British Journal of Psychiatry, 153: 532–42; N. Tarrier, C. Barrowclough, C. E. Vaughn, J. S. Bamrah, K. Porceddu, S. Watts and H. Freeman (1989) ‘The community management of schizophrenia: a controlled trial of a behavioural intervention with families to reduce relapse: a two-year follow-up’, British Journal of Psychiatry, 154: 625–8.

  54. W. G. Pitschel, S. Leucht, J. Baeumil, W. Kissling and R. R. Engel (2001) ‘The effects of family interventions on relapse and rehospitalisation in schizophrenia: a meta-analysis’, Schizophrenia Bulletin, 27: 73–92.

  55. N. Tarrier, C. Barrowclough, K. Porceddu and E. Fitzpatrick (1994) ‘The Salford family intervention project: relapse rates of schizophrenia at five and eight years’, British Journal of Psychiatry, 165: 829–32.

  56. D. J. Miklowitz, T. L. Simoneau, E. L. George, J. A. Richards, A. Kalbag, N. Sachs-Ericsson and R. Suddath (2000) ‘Family focused treatment of bipolar disorder: 1-year effects of a psychoeducational program in conjunction with pharmacotherapy’, Biological Psychiatry, 48: 582–92.

  57. A. T. Beck, A. J. Rush, B. F. Shaw and G. Emery (1979) Cognitive Therapy of Depression. New York: Guilford.

  58. P. Chadwick and C. F. Lowe (1990) ‘The measurement and modification of delusional beliefs’, Journal of Consulting and Clinical Psychology, 58: 225–32.

  59. G. Haddock, R. P. Bentall and P. D. Slade (1993) ‘Psychological treatment of chronic auditory hallucinations: two case studies’, Behavioural and Cognitive Psychotherapy, 21: 335–46.

  60.P. Chadwick and M. Birchwood (1994)‘The omnipotence of voices: acognitive approach to auditory hallucinations’, British Journal of Psychiatry, 164: 190–201.

  61. D. G. Kingdon and D. Turkington (1994) Cognitive-Behavioural Therapy of Schizophrenia. Hove: Lawrence Erlbaum.

  62. L. Yusupoff and N. Tarrier (1996) ‘Coping strategy enhancement for persistent hallucinations and delusions’, in G. Haddock and P. D. Slade (eds.), Cognitive-Behavioural Interventions with Psychotic Disorders. London: Routledge, pp. 71–85.

  63. N. Tarrier, R. Beckett, S. Harwood, A. Baker, L. Yusupoff and I. Ugarteburu (1993) ‘A trial of two cognitive-behavioural methods of treating drug-resistant residual psychotic symptoms in schizophrenic patients. I: Outcome’, Britis
h Journal of Psychiatry, 162: 524–32.

  64. P. A. Garety, L. Kuipers, D. Fowler, F. Chamberlain and G. Dunn (1994) ‘Cognitive behavioural therapy for drug-resistant psychosis’, British Journal of Medical Psychology, 67: 259–71.

  65. T. Sensky, D. Turkington, D. Kingdon, J. L. Scott, J. Scott, R. Siddle, M. O’Carrol and T. R. E. Barnes (2000) ‘A randomized controlled trial of cognitive-behaviour therapy for persistent symptoms in schizophrenia resistant to medication’, Archives of General Psychiatry, 57: 165–72.

  66. E. Kuipers, P. Garety, D. Fowler, G. Dunn, P. Bebbington, D. Freeman and C. Hadley (1997) ‘The London–East Anglia randomised controlled trial of cognitive-behavioural therapy for psychosis. I: Effects of the treatment phase’, British Journal of Psychiatry, 171: 319–27; E. Kuipers, D. Fowler, P. Garety, D. Chizholm, D. Freeman, G. Dunn, P. Bebbington and C. Hadley (1998) ‘London– East Anglia randomised controlled trial of cognitive-behavioural therapy for psychosis. III: Follow-up and economic considerations’, British Journal of Psychiatry, 173: 61–8.