Anatomy of an Epidemic

出版者:Crown Publishers

作者:Robert Whitaker

页数:416

出版时间:2010

价格:GBP 20.60

装帧:Hardcover

isbn号码:9780307452412

具体描述

In this astonishing and startling book, award-winning science and history writer Robert Whitaker investigates a medical mystery: Why has the number of disabled mentally ill in the United States tripled over the past two decades? Every day, 1,100 adults and children are added to the government disability rolls because they have become newly disabled by mental illness, with this epidemic spreading most rapidly among our nation’s children. What is going on?

Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals.

Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?

This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?

By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?

In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

作者简介

ROBERT WHITAKER is the author of Mad in America, The Mapmaker’s Wife, and On the Laps of Gods, all of which won recognition as “notable books” of the year. His newspaper and magazine articles on the mentally ill and the pharmaceutical industry have garnered several national awards, including a George Polk Award for medical writing and a National Association of Science Writers Award for best magazine article. A series he cowrote for the Boston Globe on the abuse of mental patients in research settings was named a finalist for the Pulitzer Prize in 1998.

用户评价

这部作品无疑是一部引人入胜的叙事杰作，它以一种近乎病态的精准度，剖析了现代社会中某种看不见的、却又无处不在的结构性困境。作者的笔触如同手术刀般冷静而锐利，没有丝毫的煽情，却能让你在字里行间感受到那种深入骨髓的无力感。我尤其欣赏他对复杂系统内部运作机制的细腻描摹，那种层层递进的逻辑推演，让人不得不停下来，反思自己习以为常的那些“常识”究竟建立在怎样脆弱的基石之上。书中引用的案例和数据，虽然看似零散，但最终汇集成一股强大的洪流，直击核心。它不是一本提供廉价安慰的读物，恰恰相反，它迫使你直面那些不愿触碰的真相，让你在阅读的沉浸感中，体验到一种知识的“阵痛”。读完之后，世界在你眼中的色彩似乎发生了一些微妙的变化，那种对既有秩序的质疑，会像种子一样在你心底悄然生根发芽，久久不能散去。这种对深度思考的激发，是衡量一本好书的重要标准，而这部作品无疑做到了极致。

坦白说，刚翻开这本书时，我有些担心它会陷入枯燥的学术泥沼，毕竟主题的严肃性摆在那里。但作者高超的叙事技巧彻底打消了我的顾虑。他仿佛一位技艺高超的魔术师，将原本晦涩难懂的概念，编织成了一张张扣人心弦的故事网。节奏的掌控简直是教科书级别的，时而悠长舒缓，铺陈背景；时而陡然加速，抛出惊人的发现，每一次转折都恰到好处地勾住了读者的好奇心。我发现自己常常是在深夜里，被书中的某个论点或某个鲜活的例子所吸引，无法自拔地一口气读下去。这种阅读体验，更像是在追看一部结构严谨、悬念迭起的长篇电影，而非简单地吸收信息。那种被故事牵着鼻子走，最终却收获深刻洞察的满足感，是阅读的最高享受之一，而这部作品完美地提供了这种享受。

阅读过程中，我强烈感受到作者那种近乎偏执的求证精神。大量的背景资料和历史脉络被梳理得井井有条，形成了一个异常坚固的论证框架。这并非那种“空中楼阁”式的理论构建，而是建立在无数次田野调查、档案挖掘和跨学科对话之上的实在之作。它成功地将宏大的、抽象的社会现象，拉回到具体的人、具体的时间点和具体的环境之中进行审视。这种“向下扎根”的写作方式，极大地增强了文本的说服力。你会感觉到，作者并非在“告诉”你该相信什么，而是在“展示”给你看，他是如何通过严谨的路径抵达这个结论的。这种透明的、可追溯的论证过程，极大地提升了阅读的安全感和对结论的信任度，让人心甘情愿地被引导向那个最终的、令人不安的理解。

这本书带给我的最持久的感受，是一种对“常态”的彻底颠覆。它成功地解构了许多我们视若当然的社会运行法则，揭示了在那些看似稳定的表象之下，是如何被一系列看似无关的、却又彼此咬合的因素所共同塑造和维持的。这种“去魅”的过程是痛苦的，但又是无比必要的。它迫使我跳出自己的经验局限，用一个全新的、更具批判性的视角去重新审视周遭的一切。更重要的是，它提供了一种思考的工具和框架，而不是简单的答案。读完之后，你会发现自己不再满足于表面的解释，而是本能地去探究“为什么是这样？”以及“还有没有其他可能？”。这种对知识边界的持续推移，是任何一本真正伟大的非虚构作品所应具备的特质，而这部作品，无疑是这一领域的佼佼者。

这本书的语言风格，用“克制而有力”来形容最为贴切。它没有使用华丽的辞藻去渲染气氛，而是依赖于事实的重量和逻辑的严密性来构建其影响力。但这种克制绝不等于平淡，相反，它蕴含着一种强大的内在张力。作者似乎在用最经济、最精准的词语，来传递最复杂、最沉重的含义。这种近乎新闻报道般的客观性，反而赋予了文本一种不容置疑的权威感。读到某些段落时，那种感觉就像是站在一个高处，俯瞰整个棋局的布局，清晰地看到了每一步棋背后的深层意图和潜在后果。它挑战了我们对“清晰表达”的传统认知，证明了真正的深度，往往不需要外在的喧哗来证明自己的存在。对于追求信息密度和思想穿透力的读者来说，这本书简直是一场盛宴。

As we have discussed in class, the whole book is too one-sided. It's hard for readers especially "psychologists" to buy his idea. But it is noteworthy for everyone that drugs may lead to negative longer-term effects. We, and also psychiatrists should be cautious to recieve or make a drug based treatment.

非专业读者，个人认为作者大部分观点还是比较convincing的，全书基于evidence-base来论证，三分之二篇幅引用大量数据事例说明精神类药物只产生短期的症状缓解，长期数据显示还不如不服药效果好，而且还会导致长期的医源性精神疾病。非常敬佩作者这么大胆提出违背广大既得利益群体的言论。正如后记引用的一句话"Few dare to announce unwelcome truth."

有理有据的对心理学/精神科bad mouthing，让我对这个行业前景再次产生怀疑。临床上从Diagnosis到Prescription都没有solid的科学标准，靠Marketing撑起一片天。利益才是幕后大Boss。还是做Research靠谱，苦一点，就算骗钱也别害人。吃健康，睡足，按期运动，不喝酒不吸毒，剩下的就交给基因和随机事件吧。

As we have discussed in class, the whole book is too one-sided. It's hard for readers especially "psychologists" to buy his idea. But it is noteworthy for everyone that drugs may lead to negative longer-term effects. We, and also psychiatrists should be cautious to recieve or make a drug based treatment.

As we have discussed in class, the whole book is too one-sided. It's hard for readers especially "psychologists" to buy his idea. But it is noteworthy for everyone that drugs may lead to negative longer-term effects. We, and also psychiatrists should be cautious to recieve or make a drug based treatment.