Schizophrenia Revealed: From Neurons to Social Interactions [Hardcover]

Michael Foster Green (Author)

Book Description

ISBN-10: 0393703347 | ISBN-13: 978-0393703344 | Publication Date: June 15, 2001 | Edition: 1

For many years, schizophrenia was considered to be a mystery beyond the reach of science, but since 1990, developments in scientific research have changed the way it is viewed. Michael Green presents an integrated overview of schizophrenia and discusses findings from brain imaging, medications, cognitive remediation and determinants of functional outcome.

Editorial Reviews

From The New England Journal of Medicine

According to the latest World Health Organization figures, 24 million people have schizophrenia, a disorder that is often serious, disabling, and relapsing. Perplexing yet intriguing, it beckons experts of an authorial bent to provide enlightenment and guide readers through a thicket of confusions, complexities, and misunderstandings. The uncommon skill needed to succeed in such a task is reflected by the fact that recently there have been very few good books about this illness for a broad readership. Michael Foster Green's excellent Schizophrenia Revealed is written in an engaging and uncomplicated manner that ensures ready accessibility. It, as well as Nancy C. Andreasen's recently published and more general Brave New Brain: Conquering Mental Illness in the Era of the Genome (New York, Oxford University Press, 2001), has lifted the bar in this realm of explanatory neuroscience-based psychiatry to a height that could well deter most would-be authors in the field of psychosis for at least a couple of years.

The book's integrated style and clear sense of direction are an advertisement for the virtues of single authorship in an era in which teams of chapter contributors are in favor. The book is of an agreeable size: it is long enough to cover most topics but brief enough to not be intimidating. With a stated focus on the developments of the past decade, the contents are impressively up to date. Not only has Green ensured that recent findings are included; he has also selected those likely to be of enduring importance. One example is his reference to recent work in which both in vitro studies and positron-emission tomography revealed the brevity of action of certain antipsychotic drugs at the dopamine D2 receptor -- specifically, those with favorable neurologic side-effect profiles.

Any general book about schizophrenia is likely to include -- as this one does -- a core of standard fare. Thus, there is coverage of both the positive symptoms (including hallucinations and delusions) and the negative symptoms (such as loss of motivation and reduced emotional expression) associated with the disorder; the strong evidence supporting a substantial genetic contribution to the cause of schizophrenia; a description and discussion of the most consistent neuroradiologic findings in the disorder, such as enlargement of the cerebral ventricles; improvements in treatment with nontraditional antipsychotic drugs such as clozapine, risperidone, olanzapine, and quetiapine; and innovations in community care and training in social skills. It is hard for a book to address these core issues in any more than a satisfactory way, but Schizophrenia Revealed exceeds expectations because it is enlivened by evocative analogies, experiments for the reader, brief case histories, quips, quotations, and literary allusions.

Interwoven with this material are valuable reminders about how much there is yet to learn about the disorder, despite the onward march of scientific discovery. For example, Green makes the important point that because the diagnosis of schizophrenia is based arbitrarily on a constellation of symptoms and since the choice of one constellation over a similar one is essentially a matter of expert opinion, current ``official'' definitions of the disorder are works in evolution and are unlikely to map to specific biologic entities. Thus, the failure to validate the schizophrenia phenotype with the use of objective measures (such as the plaques and tangles of Alzheimer's disease), together with the likelihood that schizophrenia is a polygenic disorder, explains the frustrating lack of progress in the identification of genes that predispose people to the disorder.

If you require a special reason to read this book, you will find it in the crystal-clear sections relating to Green's own area of expertise, neurocognition. He groups and describes the neurocognitive deficits in schizophrenia that have been identified by many research groups, including impairments in problem solving and in sustained attention and deficits in working memory, sensory gating, and the perception of emotion. He then thoughtfully considers how these deficits might be used to construct phenotypes that are alternatives to those that are purely symptom-based for purposes of studying the neurobiology and genetics of the disorder. In addition, he explains how the investigation of these deficits can help us understand the disabilities and functional impairments that affect persons with schizophrenia, such as social awkwardness and difficulties in carrying out the normal tasks of daily living. Remediation and rehabilitation strategies can be based on an understanding of this nexus.

The book is not flawless. There is insufficient emphasis on progress in the neurochemistry and molecular biology of the disorder. There is also uncritical support of both the early developmental hypothesis of schizophrenia and the proposition that the disorder involves specific abnormal neuronal connections. Competing ideas about which circuits, neurons, and synaptic elements are primarily involved and the conflicting and generally inconsistent findings in this area of research make these attractive hypotheses very difficult to confirm.

If you wish to read an enjoyable and instructive primer on what we know about schizophrenia at the beginning of the 21st century, or wish to recommend such a book to your patients or their families, you could do no better than to choose Schizophrenia Revealed. If you read it, you will understand why those of us in the area of schizophrenia research share Green's optimism about better outcomes for our patients, even though we work in a discipline in which our advances are characterized by steady increments rather than spectacular breakthroughs.

David Copolov, M.B., B.S., Ph.D.
Copyright © 2001 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review

The costs of schizophrenia....can be dramatically reduced by acting on the insights contained in this book. -- Metapsychology, Mental Health Net's Online Bookstore Reviews

Well-written and will be a useful additional to both personal and institutional libraries. -- International Review of Psychiatry, Dinesh Bhugra, 1 August 2003 --This text refers to the Paperback edition.

See all Editorial Reviews

Product Details

• Hardcover: 207 pages
• Publisher: W W Norton & Co Inc; 1 edition (June 15, 2001)
• Language: English
• ISBN-10: 0393703347
• ISBN-13: 978-0393703344
• Product Dimensions: 8.6 x 5.8 x 0.9 inches
• Shipping Weight: 15.7 ounces (View shipping rates and policies)
• Average Customer Review: 4.5 out of 5 stars  See all reviews (11 customer reviews)
• Amazon Best Sellers Rank: #807,173 in Books (See Top 100 in Books)

More About the Author

Discover books, learn about writers, read author blogs, and more.

Customer Reviews

Most Helpful Customer Reviews

18 of 19 people found the following review helpful:

5.0 out of 5 stars Cramming has never been so interesting, April 2, 2005

By 

Brigitte (New York, USA) - See all my reviews

This review is from: Schizophrenia Revealed: From Neurons to Social Interactions (Paperback)

I was recently forced to stay in on a Friday night to read this entire book in preparation for an upcoming exam. Pretty non-ideal circumstances, confounded by my expectation that this would be a heavy read, filled with scientific jargon that I don't have the background to understand. I was pleasantly surprised to discover that this book was nothing like what I expected. The author provided an easy-to-follow overview of the differences in the transmission of neurochemical impulses in individuals with schizophrenia (as compared with individuals in a normal sample). Throughout the book, the author interspersed findings of studies leading to what we know about the brains of individuals suffering from schizophrenia (including research conducted on alternative phenotype individuals - i.e., individuals with the genotype for schizophrenia who do not manifest symptoms necessary to be diagnosed with the full-blown disorder). These studies are fascinating- it is really remarkable how far the field has come- and they were very helpful in providing a background for the advances researchers are making in the field today. It was really a pleasure to finally read a book that caters to "non-scientists" who are interested in learning about the processes underlying this terrible disease. As a senior who would normally have greatly preferred a night out at the bars to a night catching up on class reading, I think it says a lot that I was not only able to get through this book, but was also engaged from cover to cover.

23 of 26 people found the following review helpful:

5.0 out of 5 stars "Schizophrenia Revealed" is an excellent up-to-date summary, August 18, 2001

By 

Harry L. Green "Harry L. Green, M.D." (Los Angeles, CA, USA) - See all my reviews
(REAL NAME)   

This review is from: Schizophrenia Revealed: From Neurons to Social Interactions (Hardcover)

Michael Foster Green is a Ph.D. in the UCLA Dept. of Psychiatry and is
the sole author of this book (as well as innumerable papers on this
subject in the scientific literature). While his prior book on
schizophrenia was clearly aimed at a professional audience, this
current one is eminently suitable for both lay and medical audiences.
It is up-to-the-minute in explaining this complex disease in cause,
diagnostic testing, and treatment. Physicians will find many useful
clues in making this difficult diagnosis and in how to structure
therapy. Of even greater value, this is the first down-to-earth, very
readable (and humorous) book to explain to families why this has
happened to loved ones. It is a very good book, and very well
written.

10 of 11 people found the following review helpful:

5.0 out of 5 stars UNTITLED, March 12, 2006

By 

Aizel Zarek - See all my reviews

Amazon Verified Purchase

This review is from: Schizophrenia Revealed: From Neurons to Social Interactions (Paperback)

This book presents neurodevelopmental, genetic, neurocognitive, and brain imaging insights in recent schizophrenia research. Evidence suggests that schizophrenics may have smaller brains and larger cavities in their brains. Also they experience neurocognive deficits particularly in social situations, which partially explains the finding that they have trouble maintaining continuous employment.