Infectious Madness

August 10, 2015
Washington (Deadly Monopolies) brings her controversy-chasing style to the fringes of medical research, examining the idea that many of diseases commonly thought of as psychological ailments and treated as such are actually caused by microbial infection. Believing that acknowledgement of infectious etiology for mental illness would lead to better prevention, understanding, and treatment, Washington accuses the psychological and medical communities of adhering to a “reductionist anachronism of mind/body dualism” and being prone to the “Semmelweis reflex,” the tendency to reject paradigm shifts because they upset the status quo. She begins by discussing well-established relationships, including the connection between syphilis and its late-stage paresis, before moving on to address Susan Swedo’s work on pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and studies that attempt to connect schizophrenia to a range of infections during fetal development. Washington overextends her premise to explore culture-bound diseases such as “Khmer blindness,” the functions of the enteric nervous system and its potential connection to autism, a general war on microscopic pathogens, and problems of infection in the developing world. Her sloppy scientific thinking and the vehemence with which she blames the establishment for ignoring the research into communicable mental illness make this more a political diatribe than a tale of surprising science.

Quiet wonder and intellectual security dominate Robert Petkoff's narration of this engaging audiobook, an astute and fast-moving exposition on how microbes can figure in mental disorders as diverse as anorexia, schizophrenia, and obsessive-compulsive disorder. Petkoff's pleasing voice and conversational phrasing lighten the book's subject matter and give the narrative verve. The author's writing, relaxed and evocative, also facilitates listening as she offers colorful dialogues and reviews history to show how we typically overlook the connections between mental and biological phenomena. Rather than simply resulting from psychosocial or hereditary factors, many psychiatric disorders arise from the interactions of infectious diseases and vulnerabilities in the immune system. The author excels at minimizing medical jargon and probing medical and cultural biases. This is a fascinating, mind-broadening audio. T.W. Winner of AudioFile Earphones Award � AudioFile 2017, Portland, Maine

August 15, 2015
A pitch for infections as a major cause of mental illness, arguing for a paradigm shift from mainstream psychiatric doctrine. Journalist Washington (Deadly Monopolies: The Shocking Corporate Takeover of Life Itself-And the Consequences for Your Health and Our Medical Future, 2011, etc.) champions the work of E. Fuller Torrey and colleagues. As a young man, Torrey was appalled when his sister was diagnosed with schizophrenia attributed to "family problems." It was a time when "schizophrenogenic mothers" were all the fashion. Torrey became a psychiatrist and started his infection-oriented research. It's unquestionable that some severe mental illness is rooted in infections-e.g., syphilis, rabies, Sydenham's chorea, the World War I flu that led to encephalitis lethargica, and, more recently, Creutzfeldt-Jakob, and mad cow disease. However, Torrey and his colleagues see infectious causality in a much wider variety of mental illnesses, including schizophrenia, bipolar disease, obsessive-compulsive disorder, Tourette syndrome, autism, and anorexia. The evidence is scant, largely based on association studies such as finding evidence of infections in blood or spinal fluid or a seasonal increase in some disorders that could be a sign of a viral infection. Furthermore, conjecture abounds. Do children really pick up the parasite Toxoplasma gondii from cat urine in park sandboxes and later develop schizophrenia? For all that infections are touted, researchers cite genetics, stress, and trauma as making a difference in whether disease will manifest. A better case is made regarding strep throat, after which a few children develop OCD seemingly overnight. In a small study, their symptoms were reversed when their blood was filtered to remove strep antibodies. In making the infectious pitch, Washington rightly argues that it strengthens the case for abandoning the Cartesian dualism that separates mind from body and leads to stigma and fear. It's acceptable to study how infection and immunity affect the brain, but only as part of a larger agenda to understand the brain in all its plasticity and complexity. Conclusion: an unproven but undoubtedly provocative case. Expect dissent and discussion.

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September 15, 2015
Washington, whose credentials include fellowships at Harvard and Stanford and a National Book Critics Circle Award for Medical Apartheid (2007), convincingly argues that infections cause 10 to 15 percent of mental disease. She lays out good evidence from the present and the past. For example, paresis, which causes delusions and hallucinations in the final stage of syphilis, vanished after doctors started using penicillin to cure the sexually transmitted disease. Feline fanciers may be alarmed to read that the parasite Toxoplasma gondii, reproduced in cats' stomachs, is associated with schizophrenia. Washington, a former journalist, visits and interviews microbe hunters in addition to referring to previous research. The result is usually interesting enough to make it worth wading through technical terms like Clostridium (bacteria that thrive when kids get antibiotics) and Firmicutes, Bacteroidetes and proteobacteria (which rule the colon). Washington covers germ theory, fetal exposure, catching anorexia and obsessive-compulsive disorder, gut issues, pathogens in societies, strategies to outwit pathogens, and tropical madness (clean water and toilets in the Third World would help address untamed infectious threats and unaddressed disease ). A thought-provoking book.(Reprinted with permission of Booklist, copyright 2015, American Library Association.)

August 1, 2015

Researchers estimate that known pathogens account for ten to 20 percent of mental illness cases. In this daring book, prize-winning author Washington (Deadly Monopolies: The Shocking Corporate Takeover of Life Itself) reviews research, historical examples, and case studies to trace the development of this new mental health paradigm. Earlier shifts from Freudian to biological theories are documented. More current research and controversies regarding the efficacy of psychiatric medications and the limitations of the DSM (Diagnostic and Statistical Manual of Mental Disorders) are also covered. Specific linkages between pathogens and mental disease are described, such as toxoplasma and schizophrenia; streptococci and obsessive compulsive disorder (OCD), anorexia, and Tourette's; and gut bacteria's role in autism. Prenatal pathogenic exposure is discussed, with the author remarking on research implicating influenza as a cause of schizophrenia. Practical advice for avoiding infection is also provided. Less convincing are cited studies on infection's role in shaping national characteristics and events such as genocide. The book concludes with a discussion of the "infection connection" in developing countries. Although the author stretches the bounds of the term mental illness, an impressive array of technical research is presented in a readable style. The title will complement others on the power of pathogens, such as Hans Zinsser's Rats, Lice, and History and Paul DeKruif''s Microbe Hunters. VERDICT Recommended for fans of science journalism and readers interested in the next "hot topic" in biological psychiatry. [See Prepub Alert, 4/13/15.]--Antoinette Brinkman, formerly with Southwest Indiana Mental Health Ctr. Lib., Evansville

Copyright 2015 Library Journal, LLC Used with permission.

May 1, 2015

Washington is not someone to dismiss lightly when she argues that we can actually "catch" mental illness; she won the National Book Critics Circle Award, the PEN/Oakland Award, and the American Library Association Black Caucus Nonfiction Award for Medical Apartheid. Here she presents new germ theory showing that conditions like Alzheimer's, obsessive compulsive disorder, and schizophrenia may be caused by viruses, prions, and bacteria and, thankfully, presents ways we can deal with such threats. With a 40,000-copy first printing.

Copyright 2015 Library Journal, LLC Used with permission.