PSYCHIATRIC SERVICES ♦ ps.psychiatryonline.org ♦ September 2007 Vol. 58 No. 9 1230 BOOK REVIEWS T his volume is based on the find- ings of the International Study of Schizophrenia, a project coordinated by the World Health Organization. The book has some 69 contributors from around the world. The first three editors, Kim Hopper, Glynn Harrison, and Aleksandar Janca, are from the Nathan S. Kline Institute in the United States, the University of Bristol in the United Kingdom, and the University of Western Australia, respectively. Norman Sartorious is the previous director of the Division of Mental Health at the World Health Organization. Although somewhat difficult to navigate, this book offers some valu- able and interesting information on schizophrenia worldwide. This work focuses on the results of a global lon- gitudinal study of persons with schiz- ophrenia by the World Health Orga- nization. It concentrates on findings from 16 cities in 12 countries around the world. The International Study of Schizophrenia encompasses several treated incidence cohorts, primarily from earlier World Health Organiza- tion studies, with results supplement- ed with data from several Asian loca- tions. In total, information was col- lected on 1,043 individuals, with fol- low-up times ranging from 12 to 26 years. The book is laid out in a systematic manner. After the initial seven chap- ters describe the background and overall findings of the study, 16 chap- ters follow, each describing the stud- ies in the different geographic loca- tions. These chapters are grouped in clusters. Three centers—Agra, India; Cali, Colombia; and Prague—had been part of a World Health Organi- zation study beginning in 1968 and had a 26-year follow-up period. Find- Jeffrey L.Geller, M.D., M.P.H., Editor Recovery From Schizophrenia: An International Perspective edited by Kim Hopper, Glynn Harrison, Aleksandar Janca, and Norman Sartorious; New York, Oxford University Press, 2007, 392 pages, $89.50 Frederick J. Frese, Ph.D. Dr. Frese is assistant professor at the Northeastern Ohio Universities College of Medicine, Rootstown, and executive direc- tor of the Ohio Adult Recovery Network. ings from a 15-year follow-up period are included from an additional seven locations: Chandigarh, India; Dublin; Honolulu; Moscow; Nagasaki; Not- tingham, United Kingdom; and Roch- ester, New York. Findings from three additional cen- ters—Groningen, Netherlands; Mann- heim, Germany; and Sofia, Bulgaria — where cohorts were followed for 14 to 16 years, are reviewed in a third group of chapters. Next are three chapters overviewing retrospective findings from centers in Beijing, Hong Kong, and Chennai, which the authors indi- cate were included to strengthen the “cultural diversity” of the report. Finally, the book has an exhaustive tabular summary, comparing and con- trasting the data from the various centers. I found the organization of this work to be very complex. I had diffi- culty keeping in mind the differ- ences in the parameters of the sever- al substudies being reported. Never- theless, the findings are most inter- esting. One salient finding reflected throughout the text is that schizo- phrenia seems to have a less dis- abling course in developing coun- tries. Also the recovery rates report- ed in all locations tend to be consid- erably higher than those generally expected for persons diagnosed as having schizophrenia, raising signifi- cant questions about the traditional premise concerning the deteriorat- ing course of the illness. One caveat should be mentioned. The manuscript for this book was com- pleted in 1999. There has been an un- explained, lengthy delay in its publica- tion. Potential readers should be aware that information in this volume is more dated than one would expect in a vol- ume with a 2007 publication date. ♦ The Truth About Health Care: Why Reform Is Not Working in America by David Mechanic; New Brunswick, New Jersey, Rutgers University Press, 2006, 228 pages, $26.95 John Bischof, M.D. I thought as I read the title of this book, “Finally someone who knows what’s what and is willing to say it.” In The Truth About Health Care, David Mechanic, director of the Institute for Health, Health Care Policy, and Aging Research at Rutgers University and national director of the Robert Wood Johnson Foundation Investiga- tor Awards in Health Policy Re- search, provides a thorough and thoughtful summation of the chal- lenges we face. He starts out strong on the first page, stating the problem plainly: “American values and cul- ture, reliance on markets, and the de- centralized character of health care markets and professional groups and their local cultures prevent steps to achieve a more rational system of health promotion, health care provi- sion, and reasonable cost constraints.” Mechanic proceeds to detail the dilemmas we face: 46 million people without health insurance and many more with glaring gaps and limita- tions in continuity and coverage; the challenges of chronic disease and end-of-life care; rampant medical er- ror; soaring costs, especially of phar- maceuticals; problems of nosology and etiology, especially in mental health; the continuing trend toward specialization over primary care; growing socioeconomic, racial, and ethnic disparities; and the neglect of long-term care. Dr. Bischof is assistant professor of psy- chiatry at Oregon Health and Science University and chief psychiatrist at Ore- gon State Hospital, Salem.