Schizophrenia: Its Origins and Need-Adapted Treatment

335 Pages·1997·9.52 MB·English

by  Yrjo O. Alanen

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