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Guest Editorial
Modern Views of Autism

Eric Fombonne


In Review
Autism Spectrum Disorders: Early Detection, Intervention, Education, and Psychopharmacological Management

Susan E Bryson, Sally J Rogers, Eric Fombonne


Diagnosis and Epidemiology of Autism Spectrum Disorders
Lee Tidmarsh, Fred R Volkmar


Genetic and Neurodevelopmental Influences in Autistic Disorder
Rob Nicolson, Peter Szatmari


Original Research
Attitudes of Senior Psychiatry Residents Toward Persons with Intellectual Disabilities

Hélène Ouellette-Kuntz, Philip Burge, David B Henry, Elspeth A Bradley, Pierre Leichner


The Efficacy of 2 Different Dosages of Methylphenidate in Treating Adults With Attention-Deficit Hyperactivity Disorder

Rachelle Bouffard, Lily Hechtman,, Klaus Minde, Fiorella Iaboni-Kassab


Delirium in Hospital: an Underreported Event at Discharge

Louis T van Zyl, Paul R Davidson


Brief Communication
Removing Barriers to Treatment of First-Episode Psychotic Disorders

Derek J Scholten, Ashok K Malla, Ross MG Norman, Terry S McLean, Elizabeth M McIntosh, Chris L McDonald,, Michael Eliasziw, Kathy N Speechley


Book Reviews

Couple Therapy with Gay Men.
Reviewed by
Peter Moore, MD, FRCPC

What Forever Means After The Death of a Child.
Reviewed by
Philip Cheifetz, MD, FRCPC

Fighting for Mental Health: A Personal View.
Reviewed by
Paul Grof, MD, FRCPC

Understanding the Mind: The Nature and Power of the Mind. 2nd ed.
Reviewed by
Scott Bishop, PhD, CPysch Zindel Segal, PhD, CPsych

Letters to the Editor

Response of Catatonic Schizophrenia to Amisulpride: A Case Report

Medication Noncompliance Among Psychiatric Outpatients In Iran

Diogenes Syndrome in a Pair of Siblings

Treatment Option for Seasonal Affective Disorder

Factitious Anemia and Magnetic Resonance Imaging Abnormalities

Pregnancy and Respiratory Nocturnal Panic Attacks

Book Review

General Psychiatry 2922_Sartorius2.JPG - 5014 Bytes

Fighting for Mental Health: A Personal View. Norman Sartorius. Cambridge (UK): Cambridge University Press; 2002. 256 p. US$45.00.

Reviewer rating*: Very Good

Review by: Paul Grof, MD, FRCPC
Ottawa, Ontario

Dr Norman Sartorius is an eminent psychiatrist who, for a couple of decades, directed the Mental Health Division of the World Health Organization (WHO). In this collection of essays, he reflects on many critical challenges facing psychiatry and mental health globally.

In the preface, Dr Sartorius explains that, in his professional life, he has attempted to strengthen psychiatry ethically and scientifically and has sought ways to bring psychiatry closer to medicine, for the benefit of both. He has also explored how political tools can be used to develop mental health programs and improve education, research, and training in the field of mental health. When one’s goal is to significantly improve the fate of most of the 500 million people with mental illness and their families, one clearly deals with a different dimension of problems than does a psychiatrist facing a single patient.

The book is divided into 3 sections: “The Context of Health and Mental Health Programs,” “Mental Health and Medicine,” and “Psychiatry and Mental Health Programs.” No reviewer can do justice to topics of this scope, and I will focus on a few examples that illustrate what fascinating reading this book represents.

The first 7 essays deal with the context of mental health programs. Given the set of problems one encounters at a global level, it is important to start with the right principles. Dr Sartorius clarifies that this context includes some basic principles of society that are important for mental health programs: equity, solidarity among people, and the recognition of duties and rights of the society’s members, including those who have mental illness. These principles sound abstract and philosophical but are indeed of direct relevance to psychiatry. The interesting differences between ethical principles, societal morals, and local laws emerge quite clearly when one deals with practical issues, such as the certification of mentally disturbed persons in different countries under different circumstances and how the process has been changing over time. Particularly intriguing are 2 essays discussing Dr Sartorius’ pessimism with respect to the potential impact that currently funded research can have on speeding up progress and to health systems’ capacity to learn from examples or advice based on other peoples’ experience. Another challenging set of problems for mental health emerges from increasing global urbanization.

The second group of essays deals with issues at the border between medicine and mental health. Incorporating mental health elements into primary health care emerges as both critical and challenging, and it is important to define the limits of a sound interpenetration of mental health and general health care services. The example of how difficult it has been to develop the mental health division within the WHO over the past 50 years tellingly illustrates the problems and misunderstandings one encounters and the persistence needed to put the mental health domain on a solid, stable footing.

The third part of the book focuses specifically on psychiatry. It points out how important, yet challenging, it is to assess mental health needs—a task essential to building services that respond to these needs. Dr Sartorius points out that many measures for primary prevention of mental disorders are the responsibility of several sectors other than health and require solid interdisciplinary collaboration.

What will happen to psychiatry in the years to come is the question that particularly preoccupies him. He concludes that, for ethical and immediate practical reasons, we cannot abandon established mental health programs. Rather, we must achieve a change of emphasis for them: we must elevate mental health on the scale of values of individuals, communities, and governments. Because of what we, as individuals and as a society, owe to people with mental illness and to their families, psychiatrists must help their patients and must fight the necessary social and political battles to improve the fate of people struck by mental illness. The message emerges that psychiatrists must make psychiatry and related disciplines useful to society and responsive to its ethical duties. These principles sound abstract when offered in summary; however, with his unique international experience, Dr Sartorius converts them into intensely captivating reading.

*Reviewer Rating Scale/ Échelle d’évaluation du réviseur

Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé


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