Customer Reviews

Schizophrenia Revealed: From Neurons to Social Interactions

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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.

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.

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.

Schizophrenia Revealed was an enjoyable and informative book to read except for a couple chapters in the middle of the book that were a bit confusing. Overall, Dr. Michael Green did an excellent job of explaining schizophrenia. The book is basically divided into chronological order of the progression of disease starting with prenatal conditions and ending with treatment and recovery. The book starts out by stating some addressing some common beliefs and misconceptions about schizophrenia. Schizophrenia has always been a mysterious disease and people either "stigmatize the illness or they romanticize it." (pg 1) The author explains how the understandings of the disease have changed since the early 20th century. In this book, Dr. Green attempts to explain schizophrenia to remove the shroud of mystery that has always encompassed the disease. He states that once people understand the disease, they will no longer be afraid of it.

The three main symptoms of schizophrenia are explained in the first chapter and are divided into three categories: positive psychotic symptoms, negative symptoms, and disorganized symptoms. The positive psychotic symptoms are the most noticeable symptoms of schizophrenia and include hallucinations (both visual and auditory) and delusions. Negative symptoms are the disappearance of normal human qualities such as emotions and motivation. Disorganized symptoms are manifested by the inability of the patient to form coherent sentences and ideas. Dr. Green does a very good job of explaining each symptom and how each is used in diagnosing clinical schizophrenia. He compares several examples of patients with to patients without schizophrenia. This helps the reader understand the difference between schizophrenia and other diseases. He also explains how one of the main criteria for being diagnosed is functional impairment. He says "If a person functions as well as ever, without deterioration in work, school, family, and peer relationships, then that person does not have schizophrenia, no matter how many times he or she hears voices." (pg 19) Schizophrenia is a serious illness and so it is diagnosed conservatively.

The next couple chapters explain possible reasons for schizophrenia such as genetic predispositions, environmental conditions, or disturbances in early development. Dr. Green discusses past and current studies that have been done on schizophrenia patients and families to find possible triggers of the disease. If schizophrenia could be found earlier, then it might be possible to prevent the onset of symptoms. Possible examples of clues could be any early behavioral abnormalities of the person visible in home videos. Dr. Green explains that the occurrence of schizophrenia in twins is very helpful in uncovering the genetics of the disease. Oftentimes one identical twin will have the disease whereas the other will not. This leads to the conclusion that schizophrenia is a complicated disease based on many different factors.

Dr. Green also explains the biological and neurological differences in patients with schizophrenia. Using MRI and PET scans, variations in brain shapes and brain functions are noticed. Some of the differences explained in the book are larger ventricles and a smaller hippocampus in patients with schizophrenia. This leads scientists to believe that cortisol and dopamine are involved in the disease. These discoveries have led to the development of treatment drugs. In the chapter, "Interventions for Schizophrenia," Dr. Green discusses the benefits and weakness of the different drugs. The older drugs developed in the 1940s treated the psychotic symptoms of schizophrenia without addressing the negative symptoms. The newer drugs from the 1990s treat the psychotic and negative symptoms but have some serious side effects. Because schizophrenia is a very complicated disease with many causes and effects, the success in treatment of schizophrenia is highly variable. Some patients make a full recovery and are able to live normal lives whereas others never fully recover and spend the rest of the lives plagues by hallucinations and delusions. Despite the difficulty in treating schizophrenia, a lot of discoveries have been made on "the world's most enigmatic disorder" (pg 168) and so the future shows hope of improvement in its diagnosis and treatment.

Overall I think this book does a good job in educating the reader about schizophrenia. It uses clear examples and simple language to describe the symptoms, possible causes, and treatments of the disease. What I enjoyed most about this book were the first few chapters about what criteria are used in diagnosing schizophrenia. Examples of patients are used and the reader must choose which patients have schizophrenia and which patients do not. One interesting example was a 21 year-old subject who was convicted of robbery but pleaded insanity. A psychiatrist was asked to evaluate the subject and after questioning the subject was diagnosed normal because "The person reports a large number of unrelated delusions, but does so in an usually coherent manner." (pg 24) The only parts in the book where I had some difficulty in following along were the chapters on genetics and neuroimaging. The material in these chapters was more complicated than the other chapters and not as many real examples were used.

I would recommend this book to readers who are interested in learning about the causes and treatments of schizophrenia. Although it can be a little complex at times, one does not have to understand everything to comprehend the overall purpose of the book. It is a very interesting read.

This book was an excellent review of schizophrenia and I recommend it to anyone interested in gaining general knowledge about this severe mental disorder.

I would recommend this book if you want a scientific understanding of schizophrenia and want to learn about the myriad studies conducted on neurocognitive functions of schizophrenics. But don't buy this book if you want a practical application to coping with schizophrenia because you or your loved ones suffer from this illness. But even from a scientific perspective, I found the book incomplete. For example, the book attributes 50% of schizophrenia to genetics (based on identical twin studies) and 50% to environmental; yet the book fails to discuss what these environmental factors are and what triggers the onset of the illness. It also says little about social interactions of schizophrenics. It also fails to discuss fully the conclusions reached in many of the studies so the reader is left wondering "So what? Why did he even mention this study?" This book felt like a nutshell text book one would use to cram for a psychopathology class exam.

Schizoprenia Revealed is a well-written and informative book about this often misunderstood illness. Michael Foster Green gives us some insight into some possible causes, what's physically going on at the neuronal level, the social and functional issues, the various treatments over the last century and much more. The content flows well and should be able to be understood by laypersons and professionals alike. It is not filled with incomprehensible jargon but is descriptive enough to convey the science behind the illness, it's research and treatments etc. I recommend this book to anyone who suffers from Schizoprenia, patient's families and anyone who is interested in learning more about the illness.

I was just looking for a layman's book on schizophrenia. This one is just too technical for me.

it is a good book for the new person who want to start to get know more about Schizophrenia.

Green is in an expert in the area of neurocognition, a concept that he explains with clarity and humor in this wonderfully written book. For instance he describes one neurocognitive test (startle blink or PPI: p. 116) as a procedure that "can be used aross an entire mammalian spectrum from mice to rats to college sophomores". He goes on to explain why this test is an important research tool for schizophrenia.

Green presents a well reasoned argument that underlying neurocognitive deficits are the key factor causing disability (functional impairment) in schizophrenia due to their links to poor social skills for example. He advocates both for new drugs to address the neurocognitve deficits and training and therapy to address neurocognitive deficits, social skills, and functional impairment. Green is optimistic that combining these approaches will lead to better lives for those living with schizophrenia. While he is primarily a neuroscientist, Green uses excellent examples ranging from the biblical Nebuchadrezzar to long-term psychiatric case studies to illustrate the important social aspects of good outcomes for schizophrenia.

In conclusion (p 167) he states: "Fundamentally, schizophrenia is an illness of disrupted neural connections and these problems in connections lead to neurocognitive deficits. The neurocognitive deficits, among other factors lead to functional impairment and its striking disability. In addition the illness has characteristic symptoms (psychotic, negative, and disorganized) during the active phase that are the focus of treatment. Though the scope of the explanation is sweeping ranging from neurons to social interactions, there is nothing particularly mysterious about this formulation."

The discussion of technical details of neurocognitive tests such as functional MRI and PET brain imaging veers into the highly technical; this will be challenging though informative for readers with less medical-technical background. Overall, you should read this book for the breadth of insight and balanced approach to treatment that Green presents here.