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Psychiatric Topics for Community Workers SIGNS OF STRESS the social problems of psychiatric illness PSYCHIATRIC TOPICS for community workers General Editor: Alistair Munro Psychiatrist-in-Chief, University of Toronto Left Behind: a study of mental handicap Dr. W.Alan Heaton-Ward, Stoke Park Group of Hospitals, Bristol Insanity: a study of major psychiatric disorders Professor R.G.Priest, St. Mary’s Hospital Medical School, London Dr. J.Steinert, Springfield Hospital, London Alcoholism and Addiction Dr. R.Swinson, Toronto General Hospital Dr. Derek Eaves, Western Regional Medical Centre, British Columbia Growing Pains: a study of teenage distress Dr. Edna M.Irwin, Hollymoor Hospital, Birmingham Signs of Stress: the social problems of psychiatric illness J.Wallace McCulloch, University of Bradford Herschel A.Prins, University of Leicester SIGNS OF STRESS the social problems of psychiatric illness J.Wallace McCulloch Senior Lecturer School of Applied Social Studies, University of Bradford Herschel A.Prins Senior Lecturer School of Social Work, University of Leicester THE WOBURN PRESS This edition published 1978 in Great Britain by THE WOBURN PRESS Gainsborough House, Gainsborough Road, London E11 1RS, England This edition published in the Taylor & Francis e-Library, 2005. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” and in the United States of America by THE WOBURN PRESS c/o Biblio Distribution Centre 81 Adams Drive, P.O. Box 327, Totowa, N.J. 07511 Copyright © 1978 J.Wallace McCulloch and Herschel A.Prins ISBN 0-203-98814-0 Master e-book ISBN ISBN 0 7130 0165 8 (Print Edition) All rights reserved. No part of this publication may be reproduced in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of The Woburn Press in writing. We wish to acknowledge much encouragement and kindly advice from the editor of this series—Professor Alistair Munro; also from Mr. D.A.F.Sutherland of the publishers. We owe a special debt of gratitude to Miss Sarah Prins, not only for typing our manuscript with such care, but for the correction whilst doing so, of some of our more gross grammatical errors. Finally our thanks to our wives and families who tolerated our absences from domestic responsibilities so uncomplainingly. To them, this book is dedicated with affection and thanks. J.W.M. H.A.P. Contents 1 Possession—containment—tolerance? 2 Mental health and mental illness 14 3 The neuroses 22 4 The functional psychoses 39 5 Psychiatric conditions due to old age or organic disorders 53 6 Abnormalities of personality and psychosexual disorders 65 7 The problems of drugs and alcohol 80 8 Social aspects of suicidal behaviour 92 9 Mental subnormality (mental handicap) 105 10 The legal aspects of psychiatric disorders 117 11 General discussion and conclusions 128 Index 1 Editor’s Foreword One of the questions constantly being asked of a psychiatrist is, ‘Are mental illnesses on the increase?’ A second is, ‘Do you think the stress of modern living is responsible for the increase in mental illness?’ To take the second question first: no one will persuade me that, for the average individual in a Western country, modern living is more stressful than it was for his parents or his grandparents. We all have our private difficulties and sorrows, but at the present time, the average man’s expectati