Schizophrenia: Its Origins and Need-Adapted Treatment PDF
Preview Schizophrenia: Its Origins and Need-Adapted Treatment
YRJO O. A L A N EN S C H I Z O P H R E N IA Its Origins and Need-Adapted Treatment Foreword by Introduction by STEPHEN FLECK MURRAY JACKSON KARNAC BOOKS SCHIZOPHRENIA Yrjo O. Alanen S C H I Z O P H R E N IA Its Origins and Need-Adapted Treatment Yrjo O. Alanen Foreword Introduction Stephen Fleck Murray Jackson translated by Sirkka-Liisa Leinonen London KARNAC BOOKS First published in English in 1997 by H. Karnac (Books) Ltd, 118 Finchley Road, London NW3 5HT Copyright © 1997 Yrjo O. Alanen The rights of Yrjo O. Alanen to be identified as the author of this work have been asserted in accordance with §§ 77 and 78 of the Copyright Design and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. British Library Cataloguing in Publication Data A CLP. record for this book is available from the British Library ISBN 978 1 85575 156 9 Edited, designed, and produced by Communication Crafts Printed in Great Britain by BPC Wheatons Ltd, Exeter 10987654321 my co-workers CONTENTS PREFACE AND ACKNOWLEDGEMENTS xi FOREWORD by Stephen Fleck xv INTRODUCTION by Murray Jackson xvii CHAPTER ONE Three patients 1 Sarah, my first patient 3 Eric, significance of individual psychotherapy 8 Paula and family therapy 15 CHAPTER TWO General notes on schizophrenia 25 Symptoms 25 Subgroups 30 vii Vlii CONTENTS On DS M diagnostics 32 Schizophrenia from a public health perspective 33 Prognosis 36 Illness models 39 CHAPTER THREE The origins of schizophrenia: an attempt at synthesis 45 Starting-point: necessity of an integrative approach 45 Studies on predisposition to schizophrenia: role of biological factors 47 Studies on predisposition to schizophrenia: role of psychosocial factors 58 An attempt at integration 73 Prepsychotic personality development 89 Factors precipitating the onset of psychosis 95 The onset of psychosis 101 Is schizophrenia a uniform illness? Integrating remarks 104 CHAPTER FOUR Contemporary ways of treating schizophrenia and psychotherapy research 111 Introductory remarks 111 Psychopharmacological treatment 114 Individual psychotherapy 118 Family therapy 125 Groups and communities 130 Community psychiatric developments 134 CONTENTS ix CHAPTER FIVE Need-adapted treatment of schizophrenic psychoses: development, principles, and results 139 The Turku Schizophrenia Project 140 The Finnish National Schizophrenia Project 159 The Inter-Scandinavian NIPS Project 167 Concept and principles of need-adapted treatment 170 Conclusions 187 CHAPTER SIX . Therapeutic experiences 191 Experiences of applying the different modes of treatment 191 Need-adapted treatment: case excerpts [with Irene Aalto and Jyrki Heikkila] 214 CHAPTER SEVEN Treatment of schizophrenia and society 237 Political factors affecting the treatment of schizophrenia 238 It is worth while to develop treatment 239 Development of the treatment organization 241 Is it possible to prevent schizophrenia? 252 What does the future look like? 254 REFERENCES AND BIBLIOGRAPHY 259 INDEX 297
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