Monthly Archives: January 2013

Social Deprivation, Inequality, and the Neighborhood-Level Incidence of Psychotic Syndromes in East London

This article (freely available and published online in advance of press) may be a fairly technical and difficult article to follow for the lay reader, but snippets provide some insights into its findings and implications. The authors have looked at data which showed higher prevalence of non-affective psychoses (as opposed to bipolar-type psychoses) in some parts of London and:

“…sought to investigate whether the incidence of psychotic disorders varied between neighborhoods in East London, after adjustment for individual-level age, sex, ethnicity, and social class. We tested whether such variation was associated with several neighborhood-level environmental factors, including absolute (deprivation, social fragmentation, social cohesion, and population density) and relative (inequality, ethnic density, and ethnic separation) measures.”

Principal Findings
We identified marked spatial variation in the relative risk of nonaffective psychotic disorder in East London, not explained by individual-level factors including age, sex, ethnicity, and social class. Together with our observation that the incidence of affective psychoses showed no such spatial variation, our data replicate previous studies to have found such differences with respect to the environment.3–5 Our study extends these findings, however, by using appropriate spatial multilevel models to demonstrate that the incidence of nonaffective psychosis was independently associated with increased deprivation, income inequality, and population density. When we studied the influence of socioenvironmental factors in specific ethnic groups, we observed that ethnic separation and ethnic density were associated with nonaffective psychosis risk for people of black Caribbean and black African, respectively.

The authors make several conclusions make from the results, two of which are:

“…living in more deprived neighborhoods may expose people to a range of stressful experiences, resultant from lower social and economic investment, including higher rates of crime and antisocial behavior, poorer educational, leisure and health facilities, and more physical health problems, all of which may induce stress with further consequences for mental health.57 Individuals who lack sufficient social or financial capital to offset exposure to these stressful events, either by drawing upon social support or by moving to less-deprived neighborhoods,55 may face chronic exposure to such threats over the life course; several studies have observed an association between lower social support and psychosis risk.”

“Our findings suggest that inequality, absolute deprivation, and the experience of living in dense, urban environments in adulthood may contribute to psychosis risk. Continued efforts to integrate social neuroscience with social epidemiology should help reveal how and when environmental exposures over the life course have critical effects on brain processes that increase psychosis risk.”

What Happened After a Nation Methodically Murdered Its Schizophrenics? Rethinking Mental Illness and Genetics

What Happened After a Nation Methodically Murdered Its Schizophrenics? Rethinking Mental Illness and Genetics.

Very interesting article, by a well rspected psychologist/comentator,  which seems to systematically and successfully de-bunk the idea that psychotic illnesses are heritable…

“Schizophrenia Bulletin in 2010 (“Psychiatric Genocide: Nazi Attempts to Eradicate Schizophrenia“) reported that an estimated 73 percent to 100 percent of individuals with schizophrenia living in Nazi Germany were sterilized or killed. This psychiatric genocide obviously resulted in a lower prevalence of schizophrenia in Germany immediately after 1945, but not for long….”

Cannabis use predicts psychosis vulnerability in adolescents and vice versa

An interesting prospective study from Holland has been published in the journal Addiction, which seems to show that the simple idea that cannabis causes psychosis (schizophrenia) is not supported by their results.

This prospective study (looking at adolescents who later develop psychosis) indicated that there are bi-directional actions at work, so that some cannabis use can be seen as attempts at self-medication.

As many people with psychosis have told me, they see cannabis as their medication of choice.

You can download this report here

Psychoanalytic Treatment of Psychoses

Three recent issues of The American Psychoanalyst are devoted to the treatment of psychosis, and are freely downloadable. They include topics such as:

Psychotic Disorders: From DNA to Neighborhood

Establishing Empathy by Analyzing Psychosis

Working at the Limits of Human Experience

The Hearing Voices Movement: Beyond Critiquing the Status Quo

Jacqui Dillon is chair of the Hearing Voices Network in the UK, teacher, advocate, voice hearer, and a survivor of childhood abuse and the psychiatric system.

She is an inspirational speaker and a great friend.

This is her first post on the Mad in America web site.

She also sent this email update, which outlines some of her plans for this year:

I am feeling very optimistic about positive changes in mental health in 2013. My 2012 ended with a bang with a talk at Critical Perspectives and Creative Responses to Experiences of Trauma and Distress Conference at University College Cork, Ireland. Here is a link to my presentation which was filmed:

I also gave talks at the Institute of Psychiatry about the work of the Hearing Voices Movement which was very well received and at the Division of Clinical Psychology Annual Conference at University of Oxford with Professor Mary Boyle, Eleanor Longden and Dr Lucy Johnstone on Beyond DSM: What are the Alternatives. This work part of an on-going collaboration.

I also have a number of upcoming events. I will be delivering training on Hearing Voices Group Facilitation & Network Development at Durham University in February. This training is free and supported by: Applications close this Friday, 18th February 2013.

I will also be speaking at conferences in Nottingham,LondonSweden and Dundee. Due to high demand, Eleanor Longden and I will running our training course, Abuse, Trauma & Dissociation: Understanding & Working Towards Recovery, in London. We regularly deliver this highly successful course in-house; if this is something you would like to discuss in more detail, please do get in touch.

Social Isolation Kills, But How and Why?

This editorial in the Journal Psychosomatic Medicine is freely available at, as is the Brummett et al article he is editorialising (

While Professor House supposes that we do not really know why social isolation leads to more severe disease (in biomechanical terms), the Dialogical Practices approach takes the absence of social engagement as the pathogenic state for the human being.

Open Dialogue has proceeded from the work of Russian literary theorist, whose study of the great Russian novels, especially Dostoevsky, led to to assert that:

“For a human being there is nothing more terrible than a lack of response” – Mikhail Bakhthin

This is approach is important as it has provided a framework for an experiment in early intervention in psychosis with outstanding success, although this was in the unique environment of sub-Arctic Finland.

Quality of life is predictive of relapse in schizophrenia

This report from a French group looked at relapse data for more than 1000 people in three countries, and found that quality of life measures correlate with relapse (53% in the 24 month period they followed) better than other factors – like age, functioning or compliance.

The authors conclude that:

“QoL, as assessed by the SF36, is an independent predictor of relapse at a 24-month follow-up in schizophrenia. This finding may have implications for future use of the QoL in psychiatry. Moreover, our findings may support the development and monitoring of complementary therapeutic approaches, such as ‘recovery-oriented’ combined with traditional mental health cares to prevent relapse.”

This article is freely available from Biomed Central – BMC Psychiatry at

Psychosis resources from Northumberland, Tyne & Wear NHS (UK)

Schizophrenia and Psychosis

The publication of a report by the Schizophrenia Commission is being covered widely in the media today (Page last updated on Wednesday 14th November 2012, 12:15 pm) which underlines the importance of early intervention in the early stages of the illness, which can reduce the likelihood of patients needing acute care. Here are some key facts and information on where you can get help if you live in Northumberland, Tyne and Wear.

They also have an extensive range of “Self Help” resources – 25 topics related to mental health, covered in video, male or female audio, or for print:

Self Help Top 10

  1. Anxiety
  2. Depression and low mood
  3. Sleeping Problems
  4. Depression
  5. Panic
  6. Stress
  7. Controlling Anger
  8. Shyness and Social Anxiety
  9. Obsessions and Compulsions
  10. Bereavement

Psychosis as a Personal Crisis

A new book has been added to the the ISPS book series (published by Routledge) late in 2012

Edited by Professor Marius Romme and Dr Sandra Escher, “Psychosis as a Personal Crisis” describes an approach which is fundamentally about the person, and finding traditional medical approaches at best providing band-aid treatment for these crises, this book seems to provide a framework for this personalised response to  distressing symptoms, like voices (auditory hallucinations) and beliefs (delusions).

A sample chapter, “Psychiatry at the crossroads: The limitations of contemporary psychiatry in validating subjective experiences “, by Dr Brain Martindale, is available for download here.

Dr Martindale has written extensively on psychosis – two of his freely available papers are here:

Psychodynamic contributions to early intervention in psychosis

The rehabilitation of psychanalysis and the family in psychosis: Recovering from blaming

Interesting (and free) online articles on resilience and recovery, in ‘Studies in Social Justice’

Vol 6, No 1 (2012): The Politics of Resilience and Recovery in Mental Health Care

Guest Editors: Jijian Voronka and Alison Howell

Table of Contents


Introduction: The Politics of Resilience and Recovery in Mental Health Care PDF
Jijian Voronka, Alison Howell 1-7


Uncovering Recovery: The Resistible Rise of Recovery and Resilience PDF
David Harper, Ewen Speed 9-26
Towards a Social Justice Framework of Mental Health Recovery PDF
Marina Morrow, Julia Weisser 27-43
Power and Participation: An Examination of the Dynamics of Mental Health Service-User Involvement in Ireland PDF
Liz Brosnan 45-66
The New Vocabulary of Resilience and the Governance of University Student Life PDF
Katie Aubrecht 67-83
“Recovering our Stories”: A Small Act of Resistance PDF
Lucy Costa, Jijian Voronka, Danielle Landry, Jenna Reid, Becky Mcfarlane, David Reville, Kathryn Church 85-101

Other Articles

Homelessness in the Suburbs: Engulfment in the Grotto of Poverty PDF
Isolde Daiski, Nancy Viva Davis Halifax, Gail J. Mitchell, Andre Lyn 103-123
The Aesthetic Post-Communist Subject and the Differend of Rosia Montana PDF
Irina Velicu 125-141

Book Reviews

Review of Global Child Poverty and Well-Being: Measurement, Concepts, Policy and Action PDF
Laura Camfield 143-146
Review of Becoming Biosubjects: Bodies, Systems, Technologies PDF
Audrey L’Espérance 147-149