Chance: a major factor in the causation of mental illness.

This paper questions the adequacy of traditional models of human behaviour, including models of functional mental illness. It is proposed that random (chance) variation is an invariable rule of nature which must apply to neurophysiological processes. Because of this, internal chance (random variation in neurophysiological processes) must be an important factor in determining the course and onset of mental illness. It is proposed that external chance--fortuitous changes in the complex pattern of interaction between physical and functional factors influencing behaviour--is also an important determinant of mental illness. It is proposed that many of the key characteristics of mental illness are explicable in terms of the properties of complex interactional systems.     

Socioeconomic status and mental illness: tests of the social causation and selection hypotheses

This study tests several hypotheses about the underlying causal structure of the inverse correlation between socioeconomic status (SES) and mental illness. It does this through the analysis of a longitudinal statewide database on acute psychiatric hospitalization in Massachusetts for the fiscal years 1994-2000 as well as supplemental census data. The modeling strategy used techniques of structural equation modeling and found that SES impacted directly on rates of mental illness as well as indirectly through the impact of economic hardship on low and middle income groups.     

Mind-body concepts and mental illness: a study of Japanese values.

This paper examines Japanese mind-body concepts and attempts to tease out some of the ways this philosophical orientation influences the Japanese view of mental illness. An analysis of key Japanese words will demonstrate that traditionally the Japanese have viewed the mind and body as inextricably intertwined and that this interconnectedness extends to the Japanese self conceptualization. It is argued that this Japanese value orientation sheds light on the stigma associated with mental illness and equally helps to explain the Japanese tendency to somatisize psychological distress. Because "mental" illness is perceived as a character weakness, "somatic talk" becomes a culturally coded idiom of distress providing the Japanese with a culturally acceptable way to influence the behavior of others while at the same time avoiding being labeled with a psychiatric disorder. Somatization in Japan, then, can be understood as an inherently ethical event that has more to do with morals than medicine.     

The mental illness spectrum

There exists a growing argument in favour of a more dimensional approach to the diagnosis and treatment of psychiatric patients. This encompasses first the idea of a spectrum of symptoms correlating to severity within a single disorder, and secondly, the idea of spectra of different disorders sharing overlapping collections of symptoms. Here we consider the issue in light of specific clinical examples we have observed, which support the idea of a 'mental illness spectrum', both with symptoms within a single disorder, and between different mental disorders.     

Some myths about "mental illness".

Radical psychiatrists and others assert that mental illness is a myth. The opening and closing portions of the article deal with the impact such an argument has had in law and psychiatry. The body of the article discusses the five following versions of the myth argument prevalent in radical psychiatry: (1) that there is no such thing as mental illness; (2) that those called "mentally ill" are really as rational as everyone else, only with different aims, that the only reasons anyone ever thought differently was (3) because of unsophisticated category mistakes or (4) because of an adherence to the epistemology of a sick society; and (5) that the phrase "mental illness" is used to mask value judgments about others' behavior in pseudoscientific respectability. Reasons are given for rejecting each of these versions of the argument that mental illness is a myth.     

"Home treatment" for mental illness. Concept definition and effectiveness

A number of projects have used home treatment (HT) for severely mentally ill people in recent years. This paper intends to define HT and show the main differences between it and other forms of psychiatric community service, present the existing evidence for HT, and discuss eligibility criteria. Studies about HT's efficacy in treating severely mentally ill adults were identified by electronic (MEDLINE, PsycLIT) and manual search. Six studies met these inclusion criteria. Compared to inpatient treatment, HT was equally or more efficacious in respect to reduction of symptom distress, social (re-)integration, and patient and carer satisfaction. Furthermore, direct costs for HT were often lower than for inpatient care. However, the number of relevant studies is limited and knowledge on the long-term effects of HT is sparse.     

Parental mental illness and psychiatric disorders in "at risk" children

Data are reported from psychiatric evaluations of a large group of communication disordered children and their parents who presented to a community speech clinic. Systematic psychiatric evaluations involving the use of standardized interviews, questionnaires, and DSM-III diagnostic criteria reveal that approximately 50% of the children have definable DSM-III psychiatric disorders and approximately the same percentage of children have at least one psychiatrically ill parent. Comparisons of children with psychiatrically ill parents and children with psychiatrically well parents show that parental psychiatric disorder is associated with increased psychopathology in the children. However, other factors, particularly psychosocial stress, are more strongly correlated with the presence of childhood psychopathology. There are few correlations between the types of parental psychiatric disorders and the types of childhood disorders.