Living and Working with Schizophrenia, 2nd ed.
J.J. Jeffries, E. Plummer, M.V. Seeman and J.F. Thornton. 148 pp.
University of Toronto Press, Toronto. 1990
ISBN 0-8020-6781 -6
This is a short, informative manual written for schizophrenic patients and their relatives, friends, employers and teachers. The authors are based in Toronto, so the material presented is especially relevant to the Canadian scene.
The authors have shrewdly gleaned major issues of concern from their own clinical experience. Some of the issues are academic; for example, what is the risk of passing schizophrenia to an offspring? Others are more mundane but equally important; for example, which team member should the family contact when a patient is admitted to hospital? The chapter on inpatient treatment is particularly useful. It walks the reader through the admission process, describing in detail the roles of the various professionals the patient is likely to encounter and the nature of tests and other common procedures. Also outstanding is the chapter outlining how the family can help. This chapter addresses such thorny topics as overprotectiveness and appropriate responses to treatment noncompliance.
This book “tells it like it is”; therefore, physicians who still feel that patients should be protected from any knowledge of their diagnosis will find it unsuitable. The authors make no apology for taking a medical perspective; they describe the illness in biologic terms and identify the psychiatrist as the appropriate leader of both acute treatment and rehabilitation efforts. Although they repeatedly encourage patients to follow their doctor’s advice they acknowledge that some physicians deal poorly with schizophrenic patients and suggest that when conflicts arise the patient consider asking for a second opinion. The book categorically dispels various dangerous myths such as the efficacy of multivitamin therapy.
The first edition, published in 1982, has been updated to include recent developments such as changes in mental health acts and advances in research. A new chapter deals with the outcome of schizophrenic illness. An appendix that gives the names and the usual dose of commonly used antipsychotics has been added to the appendices in the first edition, which listed community agencies and self-help groups.
Physicians may not want to read the book from cover to cover. I suggest, however, that they read the short “Personal accounts” section at the end of the book. It graphically depicts some of the problems encountered by patients and their families. Unfortunately, some of these problems have arisen as the result of the insensitivity of medical professionals.
I highly recommend this book as an information guide for patients and their families. Some psychiatrists and family physicians might suggest to patients or family members that they purchase the book themselves. To be realistic, many more people will read it if their doctor is prepared to lend it out. So why be mean? Buy a couple of copies for your office and help the authors cope with the high cost of living in Toronto!