NZ Herald
March 10, 2004
Critics' attack beats the book
by Martin Johnston, health reporter
A book which
suggests schizophrenia is the result of trauma rather than a genetically linked
biological illness has come under attack even before it is published.
Models of Madness, containing contributions from six
But Dr Ian Goodwin, of the Australian and New Zealand College of Psychiatrists,
says ideas in it fly in the face of all scientific evidence.
One of the book's editors, Dr John Read, director of clinical psychology at
He and colleagues say in the book that this model, promoted by "biological
psychiatry" and the drug industry, has produced a destructive pessimism
about the chances of recovery.
Anti-psychotic drugs worked for only a third of patients, he said, and their
potential side-effects - including tremors from the old ones and diabetes from
the new - had often been glossed over.
"About half of patients throw away these drugs because of the
side-effects. That's why we have to offer a range of things like people to talk
to and psychotherapy.
"There are studies showing people who don't get anti-psychotic medication
from the outset do at least as well as those who do. People who are offered
basic human support do just as well in terms of symptoms as people on
medication.
"They do better on quality of life measures like number of friends,
likelihood of having a job and so on. These studies get buried."
Dr Read's research suggests that childhood abuse is often a factor in causing
schizophrenia.
He cites a Dutch study of more than 4000 people that found the risk of serious
psychosis was nine times greater in those abused as children.
Dr Goodwin, a psychiatrist at
"It's potentially dangerous to start putting out the message that people
with serious mental illnesses can get by without medication.
"This stuff just flies in the face of all the scientific evidence. It's
time we stopped being nice about it.
"There is incontrovertible evidence that anti-psychotics work for vastly
more than 30 per cent of people. It's 70 to 80 per cent now, particularly with
modern drugs."
Side-effects did not occur in all patients, and could "generally be worked
through".
While drugs were important, his patients also received psychotherapy and other
therapies. This mix was standard practice for psychiatrists.
A Mental Health Commissioner, Mary O'Hagan, said the new book would be a
welcome addition to analysis and evidence on alternatives to the medical model.
Many mental health service "consumers" were concerned at the medical
model's dominance, but it should not be rejected, said Ms O'Hagan.