Schizophrenia: A Very Short Introduction

Very Short Introductions #089

by Chris Frith, Christopher D. Frith, Eve C. Johnstone

The schizophrenic patient presented to the public in sensational press reports and lurid films bears little resemblance to reality of the illness. This book describes what schizophrenia is really like, how the illness progresses, and the treatments that have been applied. It also summarizes the most up-to-date knowledge available about the biological bases of this disorder. Finally it attempts to give some idea of what it is like to have schizophrenia and what this disorder tells us about the relationship between mind and brain.

Genres: Psychology, Nonfiction, Science, Mental Health, Medicine, Biology, Neuroscience

208 pages, Paperback

First published April 22, 2003

About the author

Author writes under Christopher D. Frith as well.

Chris Frith is Emeritus Professor of Neuropsychology at the Wellcome Centre for Human Neuroimaging at University College London and Honorary Research Fellow at the Institute of Philosophy, University of London. He has contributed many papers to scientific journals and is the author of The Cognitive Neuropsychology of Schizophrenia and Making up the Mind: How the Brain Creates our Mental World. He is a Fellow of the Royal Society and the British Academy.

After several years trying to understand schizophrenia, Chris pioneered the application of brain imaging to the study of mental processes such a consciousness and free will. He has become increasingly interested in social interactions (how we make decisions together, why we cooperate) and in the role of culture in consciousness and free will. In 2014 he was awarded the Jean Nicod Prize (jointly with Uta Frith) for philosophical oriented work in cognitive science. Together, Chris & Uta developed the idea for Two heads a graphic exploration of how our brains work with other brains.

You can learn more about Chris and Uta and read their blog on http://frithmind.org/

Reviews

[Zidane Abdollahi · Rating 3 out of 5]

کتابی خلاصه و جمع و جور در رابطه با اسکیزوفرنی، بیماری ای که نرخ شیوعی برابر با آرتریت روماتوئید (التهاب مفاصل روماتیسمی) دارد: از هر صد نفر جمعیت، یکی.
نویسندگان محترم در هشت فصل تاریخچۂ بیماری، تعریف دقیق آن، علل آن، نحوۂ درمان و مشکلات درمان را بررسی می کنند.
حداقل چیزی که از کتاب فرا گرفته می شود، ورای اطلاعاتی در رابطه با چگونگی ایجاد بیماری و درمان و اینها، درک این نکته است که تصور عامۂ مردم دربارۂ این بیماری از واقعیت آن بسیار دور است. خوشبختانه در کتاب، اینکه اسکیزوفرن ها به چشم جانیانی بدون کنترل بر وضع خودشان، در جامعه دیده می شوند و خطری بالقوه برای مردم به اصطلاح «سالم» به حساب می آیند، به باد انتقاد گرفته شده و دلایل محکمی برای نادرست بودن این تصور ارائه شده است.
دوست داشتنی ترین قسمت های کتاب، یکی گزارشات قرار گرفته شده در آن از افراد مبتلا به این بیماری و دیگری فصلی در رابطه با تلاش نویسندگان برای درک ویژگی های بیماری اسکیزوفرنی مثل توهم و هذیان است؛ نحوۂ توضیح فرایند های ذهنی، برای افراد علاقه مند بسی دلنشین است و اینکه برای مخاطبی که تجربۂ چنین بیماری هایی را نداشته، توضیح می دهد که از دید افراد بیمار، جهان چگونه تغییر می کند جزء هیجان انگیزترین قسمت های کتاب است.
ترجمۂ کتاب نیز خوشبختانه روان است و مشکلی برای درک مطلب ایجاد نمی کند.
قطعا برای کسانی چون من که علاقه به شناخت چنین بیماری هایی دارند (چه از لحاظ عصب شناختی و چه از لحاظ مشکلات درمانی و اجتماعی)، کتاب مناسبی است و مختصرا دیدی کلی از مطلب می دهد.

پ.ن:
تنها مشکلم با کتاب این بود که کسی که دست آخر کتاب رو فرستاده واسه چاپ، چرا زحمت نکشیده که اندازۂ سطرها رو برابر کنه! حداقلش ده صفحه کاغذ کمتر مصرف میشد!

[Mohsen Abootalebi · Rating 3 out of 5]

خوب و اطلاع افزا.

[Aurélien Thomas · Rating 4 out of 5]

Psychosis, apathy, withdrawal... Schizophrenia strikes at the core of what it is to grapple with reality, including one's social surroundings. As such, it's not only a baffling and startling illness but also a scary one. Deluded, irrational, out-of-touch: are its sufferers dangerous then? Of all mental illnesses, there's no denying that schizophrenia scores high in being misunderstood, prejudiced, stigmatised. Just think about how hysterical (and ignorant) the mass medias delight in systematically mis-portraying it each time a violent crime is committed by a schizophrenic person! And yet...

'It's easy to understand why accounts of the illness elicit fears, but, rather, they should elicit sympathy.'

The authors, a Professor of Neuropsychology and a Professor of Psychiatry (it takes two to tackle such an elusive condition!) are interesting, because, having worked in the field for the past four decades they not only witnessed incredible medical advances (eg neuro-imaging, genetics…) but, also, deinstitutionalisation that is, the massive social shift in how we deal with the mentally ill (the closing down of the asylums, and patients being released into the community).

Here's what is supposed to be an 'introduction'. Well, tighten up because it's quite dense! They spare nothing, and from the difficulties to define it, let alone diagnose it, up to how society perceive schizophrenics, here's a remarkable crash course. Its debatable features, speculative causes (both biological and environmental), the drugs available to treat some of its symptoms... They dedicate whole chapters to each topic, offering thus an insightful picture of an elusive disorder.

It's intense, but fascinating. Indeed, as it turns out, understanding schizophrenia, because it goes right at the core of how we cope with our surrounding reality, is to better understand human nature. There is no other illness demonstrating how plainly that 'the boundary between normality and psychosis is not clear-cut'. As such, affected or not by it, this in-depth introduction therefore talks to us all.

A highly recommended read... Even if it's just to stay clear from the mediatic idiocies we are all too familiar with!

[Puri Kencana Putri · Rating 5 out of 5]

It took time for me to read until the end of the book. Yet, the book is one of the foremost readings in 2017.

The book is quite short and concise, but the process to digested all forms of treatments, to define schizofrenia as part of illness, all the medication, techniques that has been used in order to improve the treatments were really consuming my time. Nevertheless, it's all worth to go process as for me, a beginner reader in science department and caregiver should understand about this kind of illness.

The book covers many things that is strongly related to the preliminary establishment of schizofrenia institutions in Europe. Some treatments were in fact dreary; especially when the medical team used coma therapy toward the patients, located them in longterm sanatorium wouldn't change anything. While the authors strongly agree that the drug treatment is one of the optimum ways to improve the schizofrenia conditions.

I personally learned that "the existence of madness reminds us how fragile this certainty is. The idea of madness is frightening because it reminds us that our minds are essentially alone in an uncertain world."

Surely I would like to revisit this book in the future.

[Heilika · Rating 4 out of 5]

Це дійсно a very short introduction. Думаю, до книжок з цієї серії варто буде повернутися.

[Ashley Owens · Rating 3 out of 5]

Very good overview focused on the medical approaches and biology of schizophrenia. I wanted more on the history of its treatment but the authors provided decent references for that section so I can check out more books on that specific topic. However there was one sentence I found strange in the section discussing the societal or environmental factors regarding schizophrenia: “It is possible that women only appear to do better then men because society because society expects less from them, but it is hard to see how social expectations could affect age of onset.” ?? Is this meant to imply that society expects less from women? Because that’s incorrect.

[Daniel Wright · Rating 3 out of 5]

Chapter 1: The experience of schizophrenia
Chapter 2: The concept of schizophrenia
Chapter 3: Intellectual functioning of schizophrenia
Chapter 4: Schizophrenia and drugs
Chapter 5: Biological factors
Chapter 6: Environmental factors
Chapter 7: Understanding the symptoms of schizophrenia
Chapter 8: The importance of schizophrenia

[Ozan · Rating 3 out of 5]

Şizofreniyle ilgili temel bir şeyleri kaçırmamak için bu kitabı okudum. Bilmediğim çok az şey öğrendim, unuttuğum bazı şeyleri hatırladım. Jung ve James Joyce anekdotu güzeldi. Kitapta bana kalsa "olmasa daha iyi olacak" birçok bölüm var ve bazı bölümler(Özellikle pozitif ve negatif belirtilerle ilgili bölümler) daha geniş olabilirmiş. Ancak bir giriş kitabı olma iddiasından ötürü bunlara göz yumuyorum.

[Kelly · Rating 3 out of 5]

Informative and enlightening

[Natalia · Rating 4 out of 5]

"What makes us so sure that the world we are experiencing is not simply the creation of our own disordered minds?"

'A Very Short Introduction' is definitely what it claims to be and delivers on its promise; free of excessive jargon, easy to read, and to-the-point - it explains what schizophrenia is, the history of its understanding and treatment, possible causes, and how it can be managed. The book also touches upon the philosophical and sociological questions that naturally arise from the discussion of symptoms and their origins. The chapters are short, but do not feel incomplete or rushed. Case studies are sprinkled in very judiciously to illustrate points, without being distracting from theme/topic being illustrated.

The language and tone remain neutral, on the side of empathetic and hopeful; which as a healthcare professional, I definitely appreciate. The book acknowledges the amount of struggles, suffering, and social stigma people with schizophrenia and their loved ones may experience in our reality, as well as the potential for successful symptom management and to lead a relatively normal life (thanks to modern medicine.)

It was really satisfying to read about how theories and treatments progressed throughout time - especially on the development of the dopamine theory and how a disorder of dopamine can simultaneously cause hallucinations and mania as well as a depression-like stupor, and how on a hormonal level, schizophrenia may be the "opposite" of Parkinson's disease. And yet, the dopamine theory still does not fully explain the pathophysiology of schizophrenia, as newer antipsychotics have little if any effect on the dopamine system, and only address the "positive" symptoms (not the depressive-like states, reduced functioning, social withdrawal, etc.)

The fantastically thorough discussions of symptoms certainly provide an insight as to why schizophrenia may present in certain ways, as perhaps a sometimes reasonable reaction to a very abnormal experience of reality. It was a delight to read about theories of how delusions of control may arise (including some experiments such as how if we manually make our eye move, the world appears to shift in a way that does not occur when we move our eyes normally - how the perception of autonomy of movement makes us perceive the experience of it differently. Or how auditory hallucinations may be caused by a neurological misperception of the lack of autonomy over our own inner voice - and how engaging that inner voice somehow can indeed reduce auditory hallucinations. But not always - there is such a variety of presentations that one does wonder if indeed there is no such thing as one schizophrenia, but rather a multitude of conditions categorised together under a blanket term.)

Next time I go for a run, perhaps I may consider how I can be so sure that it is definitely me running, and ponder how it may feel to not be in charge of myself - to know that my legs are the legs that are moving and that it is my body that is running, but not feeling like I have any say in this happening. How distracting it would be to hear a voice narrating my actions constantly, only to switch to telling me terrifying things, or to see a person nobody else does in a room. Or if I 'knew' that the water in my tap was poisoned - but people around me would dismiss my fear, telling me that my reality isn't real, and I should drink poisoned water, and that the person I can see and talk to is not actually there. How ridiculous would that be. Indeed, it isn't surprising that trust can be a difficult thing to build with people experiencing severe psychosis, especially in the context of a care/medical setting. Especially if they have been met with a lack of empathy and understanding before. How difficult it may be for my patient to trust me, if we clearly do not share the same reality - and they have to take my word for it when I say my reality is more real than theirs. Furthermore, that I actually may want to do something that would in a sense pull them out of their reality into mine (e.g. when I offer them medications to stop their hallucinations.) How scary would it be for someone to try to convince me that what I experience so vividly is not real and to find that others do not experience the world quite like I do - and to not be sure what is real (although one does not need to suffer from psychosis nessecarily to find themselves not being sure what is true/real, or with a sensation that the world around them isn't real, as e.g. in a state of dissociation)

My only small nit-pick would be its brief discussion on responsibility over one's own actions and right to make decisions in the context of someone 'not of sound mind.' There are a few thought provoking questions asked, however, the small extra half-mile could had been walked to answer at least some of them; at least in the UK, mental capacity is assessed on case by case basis (a single case being a decision to be made - that is, e.g. the mental capacity to be able to make a decision regarding whether or not to have medical treatment.) The way that capacity is assessed is by examining a person's ability to understand information relevant to the decision that has to be made, retain the information long enough to make the decision in question, evaluate the advantages and disadvantages of their decision, and be able to communicate it (even if not verbally.) Capacity always is - and should be - assessed in such a way that facilitates each of the aforementioned competencies (e.g. writing key points down to facilitate information retention, using simple language to facilitate understanding, allowing the person to communicate in whatever way they prefer, etc.) As the book correctly identifies, it's easy to assume someone lacks capacity simply because we perceive them as insane - and indeed, they may lack capacity to make many decisions (and take responsibility for them), but they may have capacity to make some decisions (and take responsibility for them.) But of course, in the context of criminal law, I can see how abstract it may sound to consider 'does one have the mental capacity to hurt someone?' for example.

Although the term 'lacks mental capacity' should apply to individual scenarios and questions, it is too often applied as a blanket term to everything. This has implications on restrictions that can be placed upon someone, but also on - especially where the mental health support systems have failed someone - the degree of responsibility, or lack thereof, that can be placed on someone who has committed a crime, or hurt someone, if they are deemed to 'lack capacity - in general.' Nevertheless, I do see how the discussion here shouldn't necessarily be about who is to take blame, but how to manage situations where mental health teams do 'fail' someone, and what would it take to have an 'adequate' mental health care system in place - and what would that entail? Indeed, as the book points out - it's impossible to have a perfect system, and there is always a degree of risk that will exist. And the question remains: what degree of risk is acceptable, if it may involve risk to someone's life or wellbeing (even if small and unlikely)?

Definitely a great read for anyone interested in schizophrenia from a technical angle. For those seeking practical advice on supporting their loved ones struggling with psychosis, this book is not the guide they may need.

For those seeking more reassurance and guidance, a good supplementary read may be Schizophrenia: Understanding Symptoms Diagnosis & Treatment

[Thomas Brown · Rating 4 out of 5]

I haven't always gotten on with the Very Short Introductions series. It's a great series of 100 page introductions to different subjects, but they always choose a noted academic to write about the subject in question. Which makes sense, get someone incredibly knowledgeable and respected to write a brief intro to something he's spent most of his adult life learning about. Ronseal job.

But some academics are terrible writers, which can kill some incredibly interesting subjects dead. But the Schizophrenia guide is very well written, concise and informative without being patronising. Really interesting because I did psychology as an a-level from 1999 to 2001, and the amount of progress that psychologists have made since then is phenomenal.

Favourite chapter was about genius and madness, looking at the incidence of mental illness in brilliant people. Conclusion seems to be that manic or depressive people can be brilliant, and that their brilliance may be partially because of their illness, but if you're properly schizophrenic you can't focus on anything enough to write a novel or whatever.

James Joyce's daughter suffered from severe schizophrenia, and Joyce (a manic depressive) took her to see Carl Jung, convinced that she was gifted like him: "Jung concluded that father and daughter were like two people going to the bottom of the sea, 'one falling and one diving'. Joyce was in control of his ideas and could use them creatively; Lucia's ideas were out of control and could not be used. Lucia spent most of her life in mental hospitals."

[Tanvi · Rating 4 out of 5]

This book was great. It provides an extremely in-depth look at schizophrenia, laying strong foundations for those who want to pursue it for research or just sheer curiosity.

It discusses the history of Schizophrenia, and how over the years we've come to the understanding that we have today. Moreover, it also includes some other chapters that I found particularly interesting which was the 'presenting symptoms' as well as its relationship with creativity and intelligence.
It provides reasonable amount of knowledge about the medications, & the development over the years with regard to the same.

I had initially picked it up to see, if I could recommend it to client's with schizophrenia or their friends & family, however, this book would be too heavy & is more suited for students & professionals in psychiatry or psychology.

[Mahsa · Rating 4 out of 5]

“Most of the time we have no doubt that what we experience is real, and that we are in control of our actions. The existence of madness reminds us how fragile this certainty is. The idea of madness is frightening, because it reminds us that our minds are essentially alone in an uncertain world.”

This was one of the most well written and easy to read volumes that I have read from the Very Short Introductions series. However, it was published 20 years ago, so I think the information needs to be updated.

[Bab · Rating 3 out of 5]

Informative but dispersive and quite partial, not very thorough at all, in my most humble opinion. Not bad for an introduction and perhaps it was my bad, that I was expecting much more. Also possibly because there's soooo much we don't know yet about this disease. And also maybe because we've come to put a little bit too much trust on this whole OUP series -always blame someone else whenever possible ;)

[Spencer Knafelc · Rating 4 out of 5]

Nice introduction. It covers some history, provides a little insight into the experience of those with schizophrenia, and provides short summaries of hypotheses and findings guiding research. It is a bit outdated at this point by nearly 20 years, but as someone who was looking for a short but informative introduction, I found it worth the read.

[M. Ashraf · Rating 4 out of 5]

Schizophrenia
A Very Short Introduction #89
Chris Frith

I really liked the organization of this book, it discussed an important hard topic in a simple Q&A with multiple cases and explanations.
History of mental disorder and Schizophrenia, early diagnosis, symptoms, medication, and studies.
One of the best introductions in the series.
A good and informative read.

[Ryan]

Abnormalities of blood flow to the dorsolateral prefrontal cortex affecting executive functioning is presented in this neurodevelopmental conditional that arises early in life. These individuals are unable to make rapid error corrections of self monitoring; they cannot monitor their movements in the normal way.

[Suanne · Rating 3 out of 5]

Written in an engaging style and in a lucid manner, I was entranced and fascinated (by its writing).
Whilst it serves as an excellent introduction to this highly tricky and challenging topic, it does not explain the illness comprehensively.

To me, further reading is a requisite.

[ERIN · Rating 4 out of 5]

Good introduction/general overhaul of the condition. Everything clearly presented and portrayed in an interesting manner. I’d love to see an updated version of this book with the most recent research.

[Giovani Oliani · Rating 5 out of 5]

One of the best nonfiction books I've read.

[Mrigank · Rating 4 out of 5]

Another excellent vsi. Does justice to the topic. Explains every facet from history to neurophysiology extensively.

[Wan Lin Tee · Rating 2 out of 5]

Very boring

[Fer Lis · Rating 3 out of 5]

Instructive introduction to the subject.

[Brian Hayden · Rating 4 out of 5]

Needs a second, updated, edition.

[Nilakshi Pathak · Rating 5 out of 5]

Provides you with a good overview of Schizophrenia. Picked this book out of curiosity and it managed to answer the questions that I had.

[gala · Rating 4 out of 5]

decent and comprehensive

[Cal Davie · Rating 2 out of 5]

Adequate overview.

[João Bastos · Rating 3 out of 5]

The lack of commas in this book is scary.

It's an otherwise good overall introduction.

[Charlotte]

DNF at 63%. I got what I needed from what I read of this, and will look to more current sources for more.

[Hoß · Rating 4 out of 5]

به یاد جنگ‌دیده‌هایی که راوی متفاوتی بودند و انگ سایکوز خوردند.