Schizophrenia : the facts, 3rd edition

This book provides a detailed understanding of a much misunderstood
mental illness. It is one of the Oxford University Press ‘true facts’
series, targeted at the layman, a series that claims to offer
“practical advice … in a clear and accessible style”

For large parts of the book, however, the 3 professor authors write as
if the audience were their academic colleagues, and not the friends
and family of schizophrenic sufferers that the preface claims to
target. By way of example, on page 43, they write ‘In contrast to
linkage analysis, which uses random DNA markers as proxies for nearby
risk genes …” and on page 79 “Phencyclidine acts by binding to a site
on the N-methyl-D-aspartate receptor that blocks the influx of calcium
and other cations through the ion channel …”

As if in deference to peers who might critique the book, they also
feel compelled to qualify most statements with copious research
findings, along with a statistical analysis. So I found myself skim
reading past intense technical paragraphs to hopefully find the
summary at the end of each.

This is a great shame, as the book is full of interesting information
about this multi-faceted condition. It covers the principle delusional
and hallucinatory aspects, along with the expressive (positive) and
withdrawal (negative) axes of schizophrenia, whilst describing, in
detail, the spectrum nature of the condition. By doing so, it provides
a strong argument for careful diagnosis since schizophrenia overlaps
many other conditions, which would require different treatment
schedules. It covers current understanding of the genetic and
environmental causes of the condition, along with the range of
medical, psychological and behavioural treatments to help tame this
Unfortunately, it is targeted at the wrong audience in the middle
third of the book. The final third of the book redeems itself,
however, offering sound, practical advice to those burdened with
caring for a schizophrenic person. For example, that initial
hospitalisation is often essential for accurate assessment and
treatment, but should not be prolonged since research shows that the
subject is likely to slip into a passive, subordinate state,
aggravating their condition.
In summary, the book has a great deal to offer, but buries much inside
lengthy technical narratives. The middle few chapters of the read like
a set of research notes that need massaging into a palatable form. It
is evident from the nature of schizophrenia that the sufferers can
engage in behaviours that will frustrate and defeat the best
intentions of supporters, but much of the guidance will be missed by
many who fail to get past the first few chapters.

Neil Moffatt, 15th August 2011

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