‘Your mother loved you very much and wanted to keep you’: Judge’s remarkable message to baby girl of woman who was forced to have caesarean

  • Judge Roderick Newton, who ruled that the baby born to sedated mother be put up for adoption, tells child her mother wanted to keep her
  • Girl was born to mother, who has bipolar disorder, by court-ordered caesarean 15 months ago
  • Her Italian mother, 35, says she has suffered ‘like an animal’ at having child she wants to raise taken away from her
  • Judge Newton wrote: ‘If she reads this judgement I hope she will appreciate that her mother loved her and wished to bring her up’
  • He explained his decision by describing how the mother had been hospitalised when unwell
  • Judge also said one of her older children had suffered trauma after witnessing her mother’s bipolar episodes
  • The mother says she is ‘suffering like an animal’ after treatment in Britain described by her lawyer in Rome as ‘like something from a Hitler regime’
  • Lawyer Stefano Oliva says forcing the woman to deliver baby by caesarean was ‘absolutely unreasonable’

By  Harriet Arkell

PUBLISHED: 04:47 EST, 4 December 2013 |  UPDATED: 07:35 EST, 4 December 2013

A judge has written a heart-breaking message to the baby born by forced caesarean after ruling that the little girl be put up for adoption against her mother’s wishes.

Judge Roderick Newton said he wanted the baby, who is now 15 months old, to know when she is older that her mother – who suffers from a mental illness – had not chosen to abandon her.

He said: ‘If in later life she reads this judgement, as she may well do, I hope that she will appreciate that her mother in particular loved her and wished for her to return to live with her and to bring her up.

‘It is not the mother’s fault, nor the child’s, that it was not possible and that a predictable home could only be secured by way of adoption.

NAC ( N-Acetyl Cysteine ) amino acid offers a potential therapeutic alternative in psychiatric disorders

Contact: Sonja Mak s.mak@update.europe.at 43-140-55734 European College of Neuropsychopharmacology

This press release is in support of a presentation by Professor Michael Berk on Monday Oct. 7 at the 26th ECNP Congress in Barcelona, Spain

BARCELONA, SPAIN (7 October 2013) – Improved understanding of the roles of inflammation and oxidative stress in psychiatric disorders has generated new leads in the search for novel therapies. One such investigative compound currently in clinical trials is an amino acid, N-Acetyl Cysteine (NAC), which appears to reduce the core symptoms of bipolar disorder, schizophrenia, depression, autism and cravings in addictions including cocaine, cannabis abuse and cigarette smoking.

At the start of the decade of the brain, in the early 1990s, there was great hope that a flurry of new treatment discoveries would eventuate. In contrast, today, most pharmaceutical companies have a drying psychiatry and neurology pipeline and many have exited the field entirely. “One of the factors has been an over reliance on typical monoamine pathways as targets for drug discovery,” said Professor Michael Berk, Chair in Psychiatry at Deakin University, Geelong, Australia.

Professor Berk pointed out that the situation regarding new drug development for psychiatric problems was best summarised by former National Institute for Mental Health Director, Steven Hyman: “drug discovery is at a near standstill for treating psychiatric disorders such as schizophrenia, bipolar disorder, depression and common forms of autism.”

Beyond the monoamine-based drugs, neuroscience has elucidated an array of other important pathways that are involved in most major psychiatric disorders, for example schizophrenia and both unipolar and bipolar depression. According to Professor Berk, there is now an incontrovertible evidence base that these disorders share inflammation and oxidative stress as part of their disease physiology. In addition, associated pathways including reduction in proteins that stimulate neuronal growth (neurotrophins), and increased cell death (apoptosis), as well as energy generation in organelles called mitochondria are intimately involved. “This understanding provides an entirely new set of treatment targets.”

The amino acid, NAC, seems to have multiple effects on all these pathways: it boosts glutathione, which is the body’s major antioxidant defence; has anti-inflammatory properties; enhances levels of nerve cell growth proteins and the growth of new neurons; and reduces cell death pathways. It also appears to reduce dysfunction of mitochondria.

These molecular effects of NAC have been investigated in a series of clinical trials, which show that NAC reduces the core symptoms of schizophrenia including negative symptoms such as improved apathy, social interaction and motivation. It also appears to reduce depression in people with bipolar disorder and at this meeting, new data on its role in unipolar major depression was presented. Furthermore, there is intriguing evidence that it reduces cravings in a number of addictions including cocaine, cannabis and cigarette smoking. “Apart from nausea, it appears to be relatively free of problematic side effects,” said Professor Berk.

In addition to NAC, a range of other compounds that target similar pathways, particularly inflammation, seem to have therapeutic potential. These include aspirin, cyclooxygenase (COX) inhibitors, statins, omega-3 fatty acids and even some anti-diabetic agents such as pioglitazone. “Capitalising on our understanding of inflammation and oxidative stress in major psychiatric disorders appears to give us an entirely new range of potential treatments for these common, severe and disabling conditions,” said Professor Berk.



Michael Berk Chair in Psychiatry at Deakin University Geelong, Australia  Email: MIKEBE@BarwonHealth.org.au

ECNP Press Office

For all enquiries, please contact:

Sonja Mak  Update Europe GmbH  Tigergasse 3/5  1080 Vienna, Austria  T: +43 1 405 5734  F: +43 1 405 5734-16  E-mail: s.mak@update.europe.at

About ECNP

The European College of Neuropsychopharmacology (ECNP) is an independent scientific association dedicated to translating advances in the understanding of brain function and human behaviour into better treatments and enhanced public health. ECNP organises a wide range of scientific and educational activities, programmes and events across Europe, promoting exchange of high-quality experimental and clinical research and fostering young scientists and clinicians in the field. The annual ECNP Congress attracts around 4,000-7,000 scientists and clinicians from across the world to discuss the latest advances in brain research in Europe’s largest meeting on brain science.

Disclaimer: Information contained in this press release was provided by the abstracts’ authors and reflects the content of the studies. It does not necessarily express ECNP’s point of view.

Why ARE so many people being labelled bipolar? More and more celebrities say they have it, but here a top psychiatrist warns the disorder is far too readily diagnosed, leaving many trapped on ‘zombie’ pills

  • What it means to be bipolar has undergone  a transformation
  • Once seen as rare and disabling, it now  vaguely refers to ‘mood swings’
  • The drugs used to treat the condition are  powerful, harmful – and profitable

By  Dr Joanna Moncrieff

PUBLISHED: 16:08 EST, 23  September 2013 |  UPDATED: 16:12 EST, 23 September 2013

Bipolar disorder has become the  ‘fashionable’ mental health diagnosis – helped, no doubt, by the fact that many  celebrities, including Catherine Zeta-Jones and Stephen Fry, have said they,  too, are sufferers.

But as a new book reveals, the readiness  with which so many people are being diagnosed as bipolar means they’re  needlessly prescribed heavy-duty drugs – with serious consquences for their  health…

Psychiatrists are interested in drugs because  we use a lot of them. Most people who visit a doctor for a mental health problem  will come away with a prescription for at least one.

Celebrity sufferer: Stephen FryCatherine Zeta-Jones

Celebrity sufferers: Both Stephen Fry and Catherine  Zeta-Jones are bipolar, contributing to its increasing vogue as a  diagnosis


The most powerful and controversial are the  antipsychotics. Heavyweight tranquillisers, they transformed the treatment of  schizophrenia 60 years ago.

But remarkably for drugs designed for a  relatively small number of very disturbed patients, antipsychotics are now among  the most profitable drugs in the world, just behind statins and on a par with  diabetes medications.

Indeed, newer versions of the drugs, such as  Zyprexa and Seroquel, have become some of the most profitable drugs in history.

In the last ten years prescriptions for  antipsychotics for adults in the UK have increased by 67 per cent – last year  nearly 8 million prescriptions were written in England alone.

But only a minority of these prescriptions  will have been for  schizophrenia, suggests the evidence – antipsychotics  are no longer used only to treat severe mental disturbance, but have broken into  the mainstream.

This rapid expansion of their use may be good  news for the pharmaceutical companies, but often it’s far from being in the best  interests of patients and we should be worried about their increasing  use.

For while antipsychotics can be useful for  those who are severely psychotic, these are dangerous drugs.

The growing popularity of antipsychotics has  occurred partly because of the newly fashionable diagnosis of bipolar  disorder.

Bill OddieKerry Katona

What do they have in common? Bill Oddie and Kerry Katona  both suffer from the disorder


Once considered rare and seriously disabling,  bipolar disorder has been transformed – under pharmaceutical industry influence  – into a vaguer notion of ‘mood swings’ that can apply to almost  anyone.

As a result, if you now visit your GP with  depression or anxiety or if you have symptoms such as irritability, and  moodiness, there is a significant possibility you will be given a diagnosis of  bipolar disorder and prescription for an antipsychotic.

Worryingly, the drugs have also been  suggested as a preventative measure in young people who are not psychotic, but  might be ‘at risk’, and have been widely prescribed to elderly patients with  dementia.

And these drugs are harmful. I first became  aware of how harmful they can be when as a junior doctor 20 years ago I worked  in one of those vast asylums that was in the process of being closed  down.

Some of the old inmates were still shuffling  stiffly and aimlessly along the endless corridors. They looked heavily doped up  and it struck me that the drugs hadn’t returned patients to normality, as we  were told they did.

I got a strong feeling that as a doctor I was  not being told the whole story about antipsychotics.

The text books had almost nothing about the  experiences of the people who took them. I was determined to find out more about  their effect.


When these drugs were discovered – more than  60 years ago – they were embraced by psychiatrists.

Unlike the straitjacket or electric shock  therapy, they were said to treat not just the symptoms of schizophrenia –  dulling the voices and the visions – but also to correct the underlying  disease.

Unwelcome side-effects: For many people, the dampening down of feelings that results from taking antipsychotics is intolerable 

Unwelcome side-effects: For many people, the dampening  down of feelings that results from taking antipsychotics is  intolerable


They did it, said leading researchers, by  reversing a ‘chemical imbalance’ in the brain (although the evidence never  really stacked up – a rival, and I believe far more plausible, theory said the  drugs worked by damping down brain activity, but this was rapidly  forgotten.)

As a result, the drugs came to be seen as a  cleverly targeted and sophisticated, and essentially benign, treatment. It was a  seductive claim, but it was a myth; one swallowed hook, line and sinker by the  medical profession at the time.

The claim is still being propagated today,  but it has been extended – now it’s said that large numbers of people may need  antipsychotics to rebalance the malfunctioning chemicals that cause bipolar  disorder.

The notion that they can restore some form of  biochemical harmony has allowed these unpleasant and risky substances to be  misleadingly portrayed as essentially harmless.

These are some of the things that patient  information leaflets should tell you, but don’t.

Antipsychotics are likely to make you feel  slow and groggy and they will sap your initiative, reduce your sex drive and  dampen your emotions.

The bitterest pills: Antipsychotics are likely to make you feel slow and groggy 

The bitterest pills: Antipsychotics are likely to make  you feel slow and groggy


When I looked at how patients described the  drugs’ effect, typically they used terms such as ‘sluggish’, ‘inhibited’,  ‘feeling nothing’, ‘feeling weird’, ‘spacey’, ’empty’.

(Not for nothing are antipsychotics also used  as animal tranquillisers in veterinary medicine.)

For people who are acutely psychotic, the  damping down of feelings may be welcomed, but for many they are intolerable.  This is one patient’s memorable description: ‘Beware. This medication is Satan  in a flipping pill.’


Then you need to know about the variety of  metabolic changes they can induce in your body; major weight gain, high  cholesterol and other harmful fats, along with raised glucose that can lead to  diabetes and heart disease (the drugs have been linked with 1,800 deaths from  stroke and heart disease a year in people with dementia).

Despite these now well-recognised effects,  two years ago the British Medical Journal reported that out of 300,000  psychiatric patients on antipsychotics, fewer than half were getting a metabolic  check.

Antipsychotics can also shrink the brain.  This had long been suspected but it was difficult to prove because schizophrenia  is believed to have the same effect.

However, earlier this month a long-running  brain scanning study, reported in the American Journal of Psychiatry, concluded  that ‘the higher the antipsychotic medication, the greater the loss of both grey  and white brain tissue’.

‘This is one  patient’s memorable description: Beware. This  medication is Satan in a flipping pill.”‘


Long-term treatment can also cause an  irreversible form of brain damage called tardive dyskinesia which results in  embarrassing involuntary movements and may be associated with some mental  decline.

This was clearly recognised in the early days  of the drug, but as the idea that antipsychotics could treat disease became more  widely accepted, psychiatrists increasingly dismissed or downplayed these  involuntary movements, saying they were an effect of the disease and that anyway  they were infrequent and unimportant.

But these disturbing side-effects – jerky  uncontrolled movements, particularly around the face, mouth and tongue – do  occur, and I regularly see patients who suffer from them.

Some will claim that the benefits of the  drugs outweigh such risks, and point to ‘good’ evidence that antipsychotics are  an effective treatment for bipolar disorder.

However, the trials testing the effectiveness  of antipsychotics on bipolar disorder have been done on patients suffering from  manic depression.

What we now call bipolar is a greatly  expanded version of this rare condition, which is characterised by a manic  period lasting weeks (but possibly months), when the patient becomes  hyperactive, elated, disinhibited; they don’t sleep, barely eat and act quite  out of their normal character.

This is often followed by a crash and a  period of deep depression.



The symptoms that can get you a diagnosis of  bipolar disorder today are quite different from those of classic manic  depression.

It’s all so vague you can now be diagnosed as  bipolar simply as a result of going through changes of mood caused by the ups  and downs of daily life.

But a diagnosis of bipolar disorder can lead  to lifelong prescriptions for heavyweight drugs that should be reserved for  serious psychiatric conditions. And yet almost all the drug trials testing  antipsychotics have been conducted on people suffering from classic manic  depression.

This means they tell you nothing about what  the drugs will do for people with milder emotional problems.

Brain damage: Long-term treatments can cause tardive dyskinesia, which results in embarrassing involuntary movements and may be associated with mental decline 

Brain damage: Long-term treatments can cause tardive  dyskinesia, which results in embarrassing involuntary movements and may be  associated with mental decline


Another serious problem with the trials done  to test the effectiveness of antipsychotics in general is that the patients who  go in the placebo group – those given a ‘dummy’ pill to compare against the  patients having the real treatment – will virtually all have been on drug  treatment prior to the study, often for years, since they have serious long-term  conditions such as schizophrenia and manic depression.

They then have to come off their treatments  to be part of the drug trial, usually quite abruptly.

But coming off antipsychotics, like many  other mind-altering drugs, is known to have all sorts of very unpleasant effects  – agitation, insomnia, anxiety, restlessness and irritability.

In other words, the group getting the drug is  being compared with a group who are in a state of cold turkey.

These flaws mean you can’t be certain the  trial results are reliable, even for the classic version of manic depression.  Given the brain damage, diabetes and heart disease associated with these drugs,  not to mention the sexual impairment, weight gain, mental clouding and emotional  suppression, trends towards this unfounded and increasingly unrestrained  prescribing represent a serious threat to public health.

Other senior psychiatrists share my  reservations about the value of expanding the definition of bipolar disorder so  widely.

The editor of the Canadian Journal of  Psychiatry has described it as ‘bipolar imperialism’, while journalist Robert  Whitaker sums up the recent history of antipsychotics like this: ‘Behind the  public façade of medical achievement is a story of science marred by greed,  death and the deliberate deception of the American public.’

I think it is going to be seen to be just the  latest in a series of scandals that have engulfed these drugs in recent  years.


'Bipolar imperialism': Several senior psychiatrists share Dr Moncrieff's reservations about the value of expanding the definition of bipolar disorder 

‘Bipolar imperialism’: Several senior psychiatrists  share Dr Moncrieff’s reservations about the value of expanding the definition of  bipolar disorder


So what are the alternatives for people who  might be offered antipsychotics for emotional problems? What will work is going  to be different for each person.

It depends on why they are feeling the way  they are and what is going on in their lives that has led to this.

Therapy might be the best thing, some sorts  of short-term medication might be appropriate but most importantly, you have to  look at the circumstances. Antipsychotics have not been properly tested on  people troubled by milder emotional issues.

They can be helpful in reducing the symptoms  of an acute attack of schizophrenia or classic mania,  but the benefits of  long-term treatment are less certain, even in these serious  conditions.

Going on any drug for a psychological  disorder is a serious step. Patients need to be very clear about what is  involved. What is the benefit, what are the risks? There’s a long history of  failing to warn people about all the effects of antipsychotics.

If an antipsychotic drug is suggested for  you, make sure you ask your doctor some hard questions before starting a  prescription. Such as: How is this drug meant to work? How will it make me feel?  Will you be monitoring me for any metabolic changes? How much weight is it safe  to put on?

Your doctor probably won’t have the answer to  all of these questions because the research hasn’t been done. And that is the  problem.

There just hasn’t been enough attention paid  to the toxic effects of these drugs and how they impact on people’s everyday  lives.

But what we do know indicates they are often  unpleasant and can be dangerous. You may decide you are better off without  them.

Dr Moncrieff is Senior Lecturer in  Psychiatry at University College London. Her book, The Bitterest Pills: the  Troubling Story of Antipsychotic Drugs, is published by Palgrave Macmillan  £19.99.

Read more: http://www.dailymail.co.uk/health/article-2430129/Bipolar-Why-ARE-people-More-celebrities-say-theyve-got-.html#ixzz2fxnEIfaQ Follow us: @MailOnline on Twitter | DailyMail on Facebook

Faulty body clock may make kids bipolar

2009 study posted for filing

Contact: Graeme Baldwin graeme.baldwin@biomedcentral.com 44-020-319-22165 BioMed Central

Malfunctioning circadian clock genes may be responsible for bipolar disorder in children. Researchers writing in the open access journal BMC Psychiatry found four versions of the regulatory gene RORB that were associated with pediatric bipolar disorder.

Alexander Niculescu from Indiana University School of Medicine, Indianapolis, US, worked with a team of researchers at Harvard, UC San Diego, Massachusetts General Hospital and SUNY Upstate Medical University to study the RORA and RORB genes of 152 children with the condition and 140 control children. They found four alterations to the RORB gene that were positively associated with being bipolar. Niculescu said, “Our findings suggest that clock genes in general and RORB in particular may be important candidates for further investigation in the search for the molecular basis of bipolar disorder”.

RORB is mainly expressed in the eye, pineal gland and brain. Its expression is known to change as a function of circadian rhythm in some tissues, and mice without the gene exhibit circadian rhythm abnormalities. According to Niculescu, “Bipolar disorder is often characterized by circadian rhythm abnormalities, and this is particularly true among pediatric bipolar patients. Decreased sleep has even been noted as one of the earliest symptoms discriminating children with bipolar disorder from those with attention deficit hyperactivity disorder (ADHD). It will be necessary to verify our association results in other independent samples, and to continue to study the relationship between RORB, other clock genes, and bipolar disorder”.

Pediatric bipolar disorder is a controversial diagnosis characterized by alternating bouts of depression and mania in children, although it does not affect all young people in the same way and the duration and severity of the disorder can vary enormously.


Notes to Editors:

1. Evidence for Genetic Association of RORB with Bipolar Disorder Casey L McGrath, Stephen J Glatt, Pamela Sklar, Helen Le-Niculescu, Ronald Kuczenski, Alysa E Doyle, Joseph Biederman, Eric Mick, Stephen V Faraone, Alexander B Niculescu and Ming T Tsuang BMC Psychiatry (in press)

During embargo, article available here: http://www.biomedcentral.com/imedia/2045253254258777_article.pdf?random=807999

After the embargo, article available at journal website: http://www.biomedcentral.com/bmcpsychiatry/

Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BioMed Central’s open access policy.

Article citation and URL available on request at press@biomedcentral.com on the day of publication

2. BMC Psychiatry is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of psychiatric disorders, as well as related molecular genetics, pathophysiology, and epidemiology. BMC Psychiatry (ISSN 1471-244X) is indexed/tracked/covered by PubMed, MEDLINE, CAS, Scopus, EMBASE, PsycINFO, Current Contents, Thomson Reuters (ISI) and Google Scholar.

3. BioMed Central (http://www.biomedcentral.com/) is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector.

Young adults may outgrow bipolar disorder

2009 study posted for filing
Contact: Kelsey Jackson
University of Missouri-Columbia

MU researchers find evidence that there may be developmentally limited forms of bipolar disorder

COLUMBIA, Mo. –Bipolar disorder, or manic-depression, causes severe and unusual shifts in mood and energy, affecting a person’s ability to perform everyday tasks. With symptoms often starting in early adulthood, bipolar disorder has been thought of traditionally as a lifelong disorder. Now, University of Missouri researchers have found evidence that nearly half of those diagnosed between the ages of 18 and 25 may outgrow the disorder by the time they reach 30.

“Using two large nationally representative studies, we found that there was a strikingly high peak prevalence of bipolar disorders in emerging adulthood,” said David Cicero, doctoral student in the Department of Psychological Sciences in the College of Arts and Science and lead author of the paper. “During the third decade of life, the prevalence of the disorder appears to resolve substantially, suggesting patients become less symptomatic and may have a greater chance of recovery.”

By examining the results of two large national surveys, MU researchers found an “age gradient” in the prevalence of bipolar disorder, with part of the population appearing to outgrow the disorder. In the survey results, 5.5 to 6.2 percent of people between the ages of 18 and 24 suffer from bipolar disorder, but only about 3 percent of people older than 29 suffer from bipolar disorder.

“Young adults between the ages of 18 and 24 are going through significant life changes and social strain, which could influence both the onset and course of the disorder,” said Kenneth J. Sher, Curators’ Professor in the Department of Psychological Sciences and co-author of the study. “During this period of life, young adults are exploring new roles and relationships and begin to leave their parents’ homes for school or work. By the mid 20s, adults have begun to adjust to these changes and begin to settle down and form committed relationships.”

Researchers predict the prevalence of the disorder also could be affected by brain development, particularly the prefrontal cortex. The prefrontal cortex, the very front part of the brain, is thought to control perception, senses, personality and intelligence. In particular, it controls reactions to social situations, which can be a challenge for people with bipolar disorder.

“The maturing of the prefrontal cortex of the brain around 25 years of age could biologically explain the developmentally limited aspect of bipolar disorder,” Cicero said. “Other researchers have found a similar pattern in young adults with alcohol or substance abuse disorders.”

While some scholars suggest that the difference could be due to discounting factors such as early mortality, the sheer number of those who are recovering rules out this possibility, Sher said.




The study, “Are There Developmentally Limited Forms of Bipolar Disorder?” was published in the Journal of Abnormal Psychology. It was co-authored by Cicero, Sher and Amee Epler, a doctoral student in the Department of Psychological Sciences.

Link between creativity and mental illness confirmed

Simon Kyaga

[PRESS RELEASE 16 October 2012]

People in creative professions are treated more often for mental illness than the general population, there being a particularly salient connection between writing and schizophrenia. This according to researchers at Karolinska Institutet, whose large-scale Swedish registry study is the most comprehensive ever in its field.

Last year, the team showed that artists and scientists were more common amongst families where  bipolar disorder and schizophrenia is present, compared to the population at large. They subsequently expanded their study to many more psychiatric diagnoses – such as schizoaffective disorder, depression, anxiety syndrome, alcohol abuse, drug abuse, autism, ADHD, anorexia nervosa and suicide – and to include people in outpatient care rather than exclusively hospital patients.


The present study tracked almost 1.2 million patients and their relatives, identified down to second-cousin level. Since all were matched with healthy controls, the study incorporated much of the Swedish population from the most recent decades. All data was anonymized and cannot be linked to any individuals.


The results confirmed those of their previous study: certain mental illness – bipolar disorder – is more prevalent in the entire group of people with artistic or scientific professions, such as dancers, researchers, photographers and authors. Authors specifically also were more common among most of the other psychiatric diseases (including schizophrenia, depression, anxiety syndrome and substance abuse) and were almost 50 per cent more likely to commit suicide than the general population.


The researchers also observed that creative professions were more common in the relatives of patients with schizophrenia, bipolar disorder, anorexia nervosa and, to some extent, autism. According to Simon Kyaga, consultant in psychiatry and doctoral student at the Department of Medical Epidemiology and Biostatistics, the results give cause to reconsider approaches to mental illness.


“If one takes the view that certain phenomena associated with the patients illness are beneficial, it opens the way for a new approach to treatment,” he says. “In that case, the doctor and patient must come to an agreement on what is to be treated, and at what cost. In psychiatry and medicine generally there has been a tradition to see the disease in black-and-white terms and to endeavour to treat the patient by removing everything regarded as morbid.”


The study was financed with grants from the Swedish Research Council, the Swedish Psychiatry Foundation, the Bror Gadelius Foundation, the Stockholm Centre for Psychiatric Research and the Swedish Council for Working Life and Social Research