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Book ReviewFull Access

The Impact of the Environment on Psychiatric Disorder

The book The Impact of the Environment on Psychiatric Disorder provides a comprehensive review of the extant biomedical, psychological, and social research that explores the highly complicated bimodal relationship between various environmental factors and psychiatric disorders and psychological symptoms. The editors, Hugh Freeman, honorary visiting fellow at Green College, Oxford, and former editor of the British Journal of Psychiatry, and Stephen Stansfeld, professor of psychiatry at the London School of Medicine and Dentistry, have assembled expert contributions from 14 social scientists and mental health professionals from the United Kingdom and the United States.

The topics discussed include the better-known linkages between emotional health and overcrowding, rural versus urban living, degree of social support, and seasons of the year. Also included are reviews of the nature-versus-nurture literature and a particularly useful discussion of the effect of disasters and their sequelae of acute and posttraumatic stress disorder, pathological grief, substance abuse, and major depressive disorder. The discussion of the role of personality among persons who are peripherally exposed to disaster is equally valuable.

Three additional topics may be of particular interest to the American reader, whether mental health professional, social planner, or even architect or residential planner. One chapter deals with disorders associated with the immigrant population, including stress, depression, grief, decreased social support, and special problems with the refugee population. One discussion addresses the relationship between housing and psychiatric disorders or psychological symptoms. The housing chapter will be of special interest to multifamily residential planners, and it also addresses psychiatric hospital and crisis program design concepts. Perhaps the most interesting chapter discusses the relationship between noise and psychiatric disorder. Correlated symptoms of individuals exposed to excessive noise include annoyance, aggravation, aggressiveness, bitterness, anger, tension, anxiety, stress, insomnia, hypertension, tachycardia, and decreased cognitive performance. For persons with preexisting psychiatric illness, the exposure to excessive noise can exacerbate the symptoms of the illness in addition to triggering other symptoms. The results of this research provide pertinent guidance to mental health professionals who staff psychiatric units or facilities.

In summary, The Impact of the Environment on Psychiatric Disorder provides a thorough review of relevant research into the environmental factors that may affect psychiatric disorders or produce psychological symptoms. Anyone concerned with the connections with mental health of noise, housing, immigration, and disasters will find this book especially of interest.

Dr. Manning is medical director, Georgia Division of Mental Health, Developmental Disabilities and Addictive Diseases, Atlanta.