Society and Psychosis aims to discuss the social aspects of psychosis and to contribute an agenda for future research. At present, there is a wealth of texts that deal with the biological and psychological aspects of mental illness but not many that focus on the social aspects. This book counterbalances this inequality and fills a gap in the market. It is aimed at a broad audience of all mental health professionals along with researchers dealing with psychosis.
The book has an impressive line up of contributors from both sides of the Atlantic. It is divided into four parts covering various aspects of society and psychosis: theory, onset and outcome of illness, cognitive models of psychosis and future directions for research. Each chapter is well organized and well referenced. Throughout the book, there has been good use of textboxes, tables and figures to illustrate or highlight important points.
After an engaging introduction, Part 1 attempts to explain the theoretical and conceptual basis for the relationship between society and psychosis. It considers the social processes relevant to psychosis such as migration, urbanization, etc. Authors propose that these individual-level risk factors must be considered within the wider social context to understand their aetiological role. The final chapter in this section gives an excellent overview of the gene environment interplay which is essential to understanding the social determinants of mental health.
Part 2 considers the social factors with regard to the onset of psychosis. Authors discuss both ecological and individual-level risk factors such as urbanization, family environment, adverse childhood and adult experiences. Finally, this section reviews the findings on migration and schizophrenia to show how social experience may be important in the causation of psychosis. However, there was no mention of how these factors may relate to psychosis in older people or to affective-psychosis.
Social responses to psychosis and their effect are considered in Part 3. This book presents a balanced overview of the social factors that can have both a positive and negative effect on the course and outcome of psychosis. However, the chapter on the international findings was disappointing. The author fails to give a coherent overview of the rich body of literature on psychosis in the developing world.
The final section aims to review the cognitive models of psychosis and offers suggestions for future research. In chapter 14 Bebbington et al. explain how a cognitive model can provide a further explanatory link between social adversity and psychosis. However, a large part of the chapter is actually taken up justifying a symptom-based approach to psychosis research rather than discussing the cognitive models in detail including their limitations.
Overall, Society and Psychosis is an excellent attempt to summarize the current understanding of the social aspects of schizophrenia with regard to its aetiology, course and outcome. It acts as a useful reminder that it is artificial to distinguish social from biological research particularly in relation to aetiology. It offers a different perspective to broaden our knowledge, and would be a valuable resource for clinicians and researchers alike.
