G. Baltrusaityte Psychiatry and the Mental Patient an Uneasy Relationship1

7/28/2019 G. Baltrusaityte Psychiatry and the Mental Patient an Uneasy Relationship1

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SveikatoS Sociologija

Psyhiatry an the Mental Patient:An Uneasy Relationship

Giedr BaltruaitytVytautas Magnus University

AbstrAct. Te second hal o the 20th century has witnessed major changes in the way mental healthcare in the Western countries has been organized and provided or people suering rom mental ill-ness. Deinstitutionalization and community care became common terms used to defne a policy thataims to shit the locus o psychiatric care rom large mental hospitals and custodial institutions intocommunity.

Deinstitutionalization o psychiatric care requires an empowering approach towards the mentally ill

individuals and their capabilities to lead a sel-dependent lie in the community. Such an approachimplies accepting the mentally ill health-care service users as credible individuals capable o takingresponsibility or their actions and lie.

Te aim o this article is to examine psychiatric conception o mental illness, treatment and the psychi-atric encounter. Te presentation largely draws upon analysis o Lithuanian psychiatric texts, althoughsome oreign psychiatric literature is also used. Te article starts with an introduction o a changingsituation o the mental patient and proceeds to the analysis o the psychiatric discourse. Te authorargues that by conceptualizing mental illness as pathology located within the unctioning o the indi-vidual body that aects the ability o a sick individual to apprehend the reality and to retain criti-cal insight towards ones health problem, psychiatric discourse may reproduce paternalistic approachtowards the mentally ill individuals even in the deinstitutionalized settings. Such an approach may

have certain implications or the individuals ability to lead an independent lie in the community.Keywords:psychiatry, mental illness, mental patient, paternalism, empowerment.

rAKtAodiAi: psichiatrija, psichikos liga, psichikos liga sergantis pacientas, paternalizmas, galinimas.

D sd 20 s d w p z d dv d (d ps-) . as s p dss s b d ss d d d dvp w pp

wds d ss. Ts d s d pds: w bd d dd d p v b bdd b s-d bpss pspv db, ps d s s d


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ss d ws bsd pv d p (r1999).

i w s s ws s d sd d-

s pd b d d p d 1s pv d ss qd v -b bw w. W bpss pspv, p b dd s q ps ws pbs qds, dvdzd pp d /s ws s v p-p d ws sbjv xp d ss w p b sbs dss d ds (md d Bw 2000). S p d ds b dvpd pszd ps pp

d ds-k d wds ps ds d xps.

a w s s d s p sp d b spd b d pds, s vs 1960s d 1970s s pss ps d s s uSa d Ws ep s. T ps sv d s dss d d ws - ps ws dp d w d s.Vs ps zs d ss ps spk

svs d d w ds. Ts sd sbsq sw dss ps bs ss sz ps s, d d s(mcd d Szk 2000).

a s dvps d ps pspv d d s d ds k p, dpd b psss d p ks.

What about the Mental Patient?

W s b sd s s ps pspv , ps sbjv xp ss d d s kd, q , psvss d . T . (2002), xp, v zd pspbsd bw 1980 d 1996 d s s d qv sds d w s sp w ws k v w dss pspv dvd vvd. T d

ws sds v p sd dvds w , -dvs, d dsds, w pss w ps-

1 i.., s d d d sbssv p.


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Psychiatry and the Mental Patient / Giedr Baltruaityt

ps dsds d ps ss dd skds sds (T . 2002, 443).

nss, d p ps vws v-

ps svs s b zd w d vv ps ssss . T s- p s kd b dvs ws w s svs ds s d w s spd p ps, d p dsss sw s s . P d rs (1999, 192) ws s svs:

s s p; s s s; s s svv; s s pvd.h s s p ps d d dss w

w dvd s p s s d b ss d d pss p. T s s s s ss dss, w pszs d k sv b d ss s (lp 1997).2T s s svv ws dd b s v ss ps svs d 1970s vs ep

s d uS (h 2001). Ts dss dsss sb ps d d s d ps d ps svs.3 f, s s pvd s bsd vw pp w v xpd ss d sd b pvds svs pp w pbs s kw bs w s b (Pd rs 1999).

css d css (2001) d v pb p d pb pd w s s v-

s s ps, s d bk b vs vqsd k--d ssps d b vs ps-s, s d dsss. Ts vs d s-p - 1960s pvd w ss v ws sd b s s -ss. Ts ss v d sp sbs v p d v b pp ds s v (css d css 2001).

T z ps s s d s

2 P d rs (1999) p s s pb pss w vs ps d ps s pv.

3 T v svv ps s p: b ds s jxps bw p d pss s ps.


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dvds. td j pp v w psdsd vs svs bd sp ws. T xps ss, d v

v b zd vs s d sds (s,.., Sz d a 2002; ok d S 2000; tp 2001).Ts kd s s p p - ps pspv ds d pp. a s , s-ps s ps b pp s pss js s bps, vps xp ss.4

m ps xps dv ps p ss d s . Ps, s p, s bk10Secrets o a Successul Lie or Persons with Mental Health Problems(2002) d s-w pp s ss b psz- v xd xps s pp . a-d , ps s dsd p d sss, s ds k sbjv ss dvd. P ss w ss s bsds s d s d . a , v pp- xps, bs d pps sd , d , b sdd b s d b zd, dvpd

d v sd (Ps 2002, 75). Ps s dssd bw psv (pdv) d v (dsv) sps ssd s d p s q s v dd q .5

i pss dsss, dssss s db dvds jds d vws (s, ..,axs . 2000; Bk d o 1999; Sp . 2000). mps dd s pb k d sk s (lw 1998). i l, k es ep

s, dvds s pssv ps pssvs: vs ds dd b p ks, d psss, ss bs b -svs (Ss 2000; Ps 2000).Ts sss s psss, pks d s sd ps s pb d

4 ad Sz d a (2002), s-ps s ss ws v s dss ps s w s js s Schizophre-

nia Bulletin Psychiatric Servicessd pbs ps xps s d ds-. hwv, s s p , ss s s d, s jsq kp s sdds w d s pp w ss xp ws w s pssbs.

5 ad , ps p ss b p ss xps d .


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ds d ss; v, dvds d b s.

Ts s b d b v ps dss

ds p ss s b dvds p pp d sp pb d ss b ps vws d b vdd b bjvs.

The Psyhiatri coneption of Mental Illness

cp Ws ps s ss bd

pss kwd d p. i vs d d sd ws vw d ss. Dsp v p pps, p ps s d k ps vd ss6 d pp s (Bsd2000).7 Ts pp s bsd w, d, s bd s d d.8

adp d d ps s p ps w psss ddss p ss: dss s , ss s dsd s d w dvd bd. Ts

s s p dvd d s v s pbzd d d w. as, s Sb d K (1998) p ,b ss ss, b ds ps psss, d d ps vs sk dvd s pb . as s,

6 Ps ds d p bw b, psd s s s d s s s dsds. idd,

s-d bpss d s b bkd pd bsdps. hwv, s r (1999) ps , s sv ss s, ..,szp d psss, s s s s b pvd.S s s s b b d s sdsds.

7 ep ps s b b s pd a- ps s d, , psd pspv (m1978).

8 i s ss bd d s sd. T d dvss d d s s d d s s pps s kwd d ds ds d ss (t 1987;

m 1978). Dss w s d s psd s: 1) d w dvd bd; 2) b ds d dsb ; 3) v- sp s b bjv dd d d p w p ds d d s (Bsd 1989). Ts, ps ppds pssv bjs d z xs d s bd w .


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s vd dvds s d s (ib 1981) ds ps dpd ps .

a ps s dpd d d s

d p, s ds bw d d psxs w d ss. i d ss sdd b ps d b ps, s sw, b s v, bd pss, . e sps s vs. Dv s vs dsp. Ps sd s w pd ps bsv ss d dw d-ss s ps ss b dd b bss (Bds 2005). i bs ps d b ss,

psss dpd xp, jdsd , w s sk s psss wd - ps s psp sdds kw dss (Dbsks 2003, 101).

rs (1991) sd sdb vs b psdss w, s sd, ss w ss ss bvs ps pbs d dss d pssps b p d vs. o dd sp, s psd-ps sd s sps. W

xp s, ps w dsd w szp d sd w dss szp ss. a w dsd d . Ts sd dsd psss pp d v w b pb. as, rss sd swd w d ps- spz d b vd, p p vd sp dss. o bss s sd rs d ws pssb dss s s d psdss w b.9

m (1978) s ps dsb b vvwd s , s s dvp s, s ss, s sq s-, s s ss.a s s b ps s dvd s-, pss pszs s b d p

9 T b ps dss s j sss sd s ss. a (1998) s, .., ds sss ss sd b psss ds q vsd. Ts, d

, ds w ss ps kwd s ws d . Ps- ds sss zd b d w qs w s ss xs p s ss d v

jds s ds s (Sb d K 1998). T pps ps v v v skd w dss sss (s, .., Szsz 1974).


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ps dvd p. Ds d p dss p v jds.10 T pps bv, ds wds svs d w s k p .11

as ws d d, ps dss d s- dpd dvd ps . Ts s s bsps s s s pp wds pssb v ss ( s w s s j sss s szp dpss). i l ps xs, xp, ss s pzd s d d ps; , sd b psss sp- d s v b ss (s, .., Dbsks dg-md 2003; nvks 2003).

r s v s ss s v ss ds. i s dpss, xp, pssb v s s s ds w v -sq ps. ad nvks (2003), s d v-d psd dpss s dsd b ps w , pp d w p v.Ts, s s, sps dpss pp d pd sx s p s sdd b recovered thispsd dps-s (nvks 2003, 301, pss).

ev dvd s sp pd d sd s v s , s s dd s pssb s- d ds b bsvd (s, .., nvks 2003).ad (nvks 2003), v b sv pss, p ss sd d pp ps k ds d pd .

T p ss, , s bds w sp- bw d ss. Ws d bs sps ws wdw dss, ps p

ss s dvd w s sd ss ss p sk , k s d dsbj -s .

10 S ds s ss bsd b s sp dw s. Ts ws s w sxw ws ddsd, d s s s w dss s ps- dsds. e.., ds sd s s ps

s bv p dvd s dsd s s d s dspsb s w pp (s ms 2003, 436); s- ps s psd ppp b (ms 2003,438).

11 a sq ps dss s s d s xs (gs2003).


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Psyhiatri Treatment an the MisbehavingPatient

as b d s d, ps s ws pd s ps: w d s b q sss b- sp b ss vs ps ss, ps d pvd vd w sd ssd w v (Pss 1993). i ws w dv psp ds d 20 ps d ds s ss sss dsd.12

td ds sdd b p d

sss. hwv,

w xpd psp ds pd sd s s w sps. Dbsks dg-md (2003), xp, d pv s dsp, p, s wdw szp b b sp dss d sd -ps ds. o sds d s, pb , s, pbs ds d s, s dsbs , s w d s d s ds ds k p s-d, w s d p 10% ss (s rdvs 2003).

app psp ds q d s s sps pv b ss s ps ds, ss dpd dvd s psbd b s , sx, d, s, . (s, .., Ps 2003). e ds, wv, s vd s q pss spzs d s sd s (s, .., Dbsks dg-md 2003). i ps xs, ds dd sv pd w ws dsd d ss: d s sd dvp ps, d ss

ps (d pd ps s s, wk- b d pvd q ) s w s ss d wdsps. B d , s dsb s vwd s ss pb d b ps -d - . Ps s s -d bs vsd s ds bs wds ss dsd p (s, .., Dbsks d g-md 2003; Kp . 2001). i ps, s s s d dvp w s d js s s

ds ( s-d dp ds) w b - pb d (B 2004).f s p vw, d s vs ss

12 T dv j qzs d 1950s vzd sp w p-d sp ps.


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d bs v sd s. ad B (1992),ds p kp pvs spzd - ps b v- d ps

bs d s sv pvs, p d sv ps s pbs. T d w d s 1960s d p ps p. ad B, psss d w s svs s:

. . . xps p xps bv.ab bv ps d b d: d b d-sd. T pss d s wk s ds dd vd bds p w psss dsbdds, s d pxs ss, psss

p, sqd s ds d p . Tws d j s v, d, p,. i ws d ss w d d spb s d s (B 1992, 14).

ev psp ds v d sps, s ds dvp ps b d w s pbs.ib ss s ss:

W d w v? as s v dsb

sd-s; d ect ds p vs b p p , qzs k pp b d s b v w s d, k bs . i ss, , ds v (ib 1981, 37).

T ps p v ss pbsv: s sdd b sss w sp-s d b s, d pps s s v p, w p ps w b s w ds dv, k p-sbd ds d d d ss.

T ps -d, p s d , b d s v b d; s ss,wv, s sdd b p pb. Ps ds -d s j bss v-ss ps . c d V (2002) ps d ds , p pss s d sdsd s s ps d d dsds. ad ,ps -d s s p s (.., k sswss) s sdd b s ss(s s Kp . 2001). is s s s s ss vpp dss: s , b b s vs s p d d


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d (t d Sks 2000, 211). T ps ds s dss s xpd s k s d sq s s pss p.

Ps p -d pvds d b s ps dss bs d d p. ad P d K (1998, 306), p d pss wd-vw s b pss s ds, psb d. i s , p s xpd p w dss d -. T -d bv s s s pss dbs, xps d s. ad s, s s d d vw -d ps s b dv d pb.13 Pd K ps dss s k w

-d d s s p.14 T p s w b p w d ds s d p. i s w ps d p w - pss ps s s b vd d bv d s sp s b dvpd.15 i ps p, psd k s pvds b jsd pp pss ps, ds dvd (P d K 1998, 309). i wds,-d s s s p p

pss d ps ds d xps (lw 1998; P d K 1998).

i s -d s pb ps -. ad ps ps s sss k, ..,sz dsd, pd s ps dsds, p b -p w d b s d vsps v . Ts, w s p qssp s. T pd ps, xp, s dsbd s ssp-s d s. Ts, pss sd ds p

b s b s d d kwd s sks d ds pv ps ss (ms 2003, 446).16 T s- p ps s vwd s s d. ad

13 as, s lw (1998) s, d d d ds k s p d -d bv: , d, s ss,d ss . Ts, d lw, s pb s s v p s p d.

14 T d d ds ss p v -d bv s dd s sps d s xps

(t d Sks 2000).15 Bz (1998) s ds k sd ps w w -

b p s w pv.16 ts s s s p sp ps . i s p

sd s pss; , wv, sd s ds. ad Dbsks (2003), sps b d d p.


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ms (2003), pss sd d d d s b pps p d d w s pb- d s. i wds, ps ds s

p p s p d, w sd bd w .17

S dvd b b ppd d s wds s pb, s s qs w pss sd dsss ss d sss w p. Ps s vw dss ss d - p sd b w sdd d wd. i s s-sd dsss ss d sss p, s w v p:

W k p, pss sd s ss dsd, s s, sps vs ss xs. ips dd b xpd v spss dsd ss (Dbsks 2003, 102).

as S . (1998) p , ss dss ss d d dsss p,p dss s sz s p pss. as gs(2003) s, hpp o bs d d bs p d p d . Ts p s

dsd s d p b s s p s d x b sd b dss - b ss. Ts pp d d sd ps (gs 2003).18

i ps d d dsss, wdw - p s jsd s b xsd ps wsk. gs ps , wv, bdsv k p dss ss dvds s-d d s d (gs 2003).19

t sz, ss ps dss s pzd17 S, .., Dbsks (2003) sbv p.18 Ps b dd s w ss pss b jsd xsv

b sd pss w d w d d s sps w s p (Bz 1998, 260). i s w ps -sp s s sp bw ps d d. i vv s v d s sd s s b p (Bz 1998,260).

19 cp wks d pss ds s k, .., Declaration o Hawaiidpd 1977 Madrid Declaration on Ethical Standards or Psychiatric Care(ppvd 1996 d dd 2002), p v ps dd ds k. Lithuanian Mental Health Care Law(1995) s ps ps ss d d . i s pss, wv, dds w ds wdw s p (s a 15, cp 4). h, v lw s s p, s ds p w b b xs .


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s p b sk dvd ppd d s wds s pb.20 h, ss wds p bs s ps-

. S p s s s p k s, s ps-s s v d d dd ws bs p. Ts sss ps ps b d d ssd b v pz ss qs sp bv wds p.

as, ps ss d b s s k ps s. T p ss sd sd vs bds wd w sp bw d ss.Ts s dvd w s sd ss

ss p sk d dpd psss.Sss v b wds ps p-

z ss d s sq pp wds dvds. S ps dss s b zd s b bsd v d w k d bwbdss d skss ws s s k bjvss. Ts, pss b s s s s (Bs-d 2000).

ad nv (1976) d ps p d

s ps s d s s pss ps ss ss d s s, dvdzsd d-pzs ss. i ss s s s ps d s p b ps ds b . ib (1981, 44) s s ps ps ps s s-s b v d s ss w sps ss dvd ( bs ) ; s ps pvd s- ss w

p pbs. T d ps (s w s d ) dz s pbs s j s w s ss. T b d xd s pss dss pw d pss d d w -ss d ss. T d dv bdss sk-ss d s qd p . i pss s s ss b s w wd ws ps s b vds p pss (gd 1989).

Ps s v ds d p-

s v b s xsv zd. W (1994), xp, s

20 Ts s sss s s bs ps (.., b ps) pss ds d ps sbjv s ss sp.


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sdd -ss pp w szp Ws ss d- 20 d ds w p d -s spd s szp. ad , v s

szp dszd ss s kd s d qs b k. W ds s szp s pvd s-ss dvds b k d s ps .21

S d s d d ps v p dd w ss s d w s , v xds ps p-ps d d pz sss. f (1987) d b ps

s d s ss, d ps pd sp dvd s dsbd d.ad f b pp dsd, p qsds ss d d s p (f 1987, 15).

f zs s ps p s -v dsd ss. m ss vvs -v b s psv sds d s sd b zd d bdsd dvds d s v w d.22

Ts sd b xzd w sp bd p dss s p s ss -p. S s wd d s v p d wd d dsd s vb b d ss ss (f1987, 15).

disussion

cp p d s, d k- p l, dd wds s d pw v pp d d ds-k. t b pwd, , s ps v s (ok d S 2000). epw ps s s dszd ps s pbs dvds d s-dpd .

21 W s s v () wds dsdd pp : s pss b ds-d s d ssd d s dsp.

22 n s s ds Pss (2002) ps xp ss.


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epw, wv, b d v dvds bs ss s b sbs ps d ds b ss -

pss dsss.mcbb d c (1996) pw -

ps d ps ss b pbs s d d ds ps . T dd ps b dw s ss, w qs-s ps bs ppd , psss d k ps s d kws bs. i s w, d ds d sss sz ps ps.23

Ps sp b s v s sp d- d sbd d b d ss pw dss d jsd b s d pszs ps (abb . 1994). Ps s v sz xds s s sp bww dvds d s d b szd. i s p d-s sp vs sps sbds vs (abb . 1994, 307). h, ps d b sd s d b pwss s p wd

s.Ps, s d ss, pd

ps b k v d s d s pb w p sv s ws s s v ds d xps wds ss (Ws 1994). D sds p s pwd dpd pvds s xp ss d s xp vs ws bs psb wss pp d ds-k

v xps d s (s, .., ad-s 1996).24 Ts s p s pp s ss s w s vb pps (.., d, dsbd,w, .). i k dvds d, p d s w p qs pwssss b ps s d wd s. Ts s xp

23 o d, s ss ss ps b dspsb d v

b s (s, .., B 2006; lp 1997).24 Ts w dpd, vb, ds-pwd d pb

ss d vs w b k p w d d ppdb d psss. ad Ws (1994), pwss ppsd svs b, k w djs xps d ds svs d .


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w l pds w vvv sv ss.

S, d pv pss dsss ss

s psss, p ks d s k p ps s pb d ds d ss; , bjvs b psd w k ps pspv.as Ps (2000) s d, l ss s s ss s w dds sd ps ds.25

i s, d pss ps ss,sz ps d ps dpd pss sp w w dvd w spd ss s d w pbs . f, ds-

pw d ps d dsss w sz,ds, xs s w s ss-d dsb k q d ps pwss s s. as, s pw vvs q pw - d ps dsss d s sbd bvs pss pds d s dvd s ss, qs v , w ps ss v d, .., d d d s s p ss p dvds s ss. Ts b pb-

dvds d s d ss (w s s d b dsb pss pz-s dsd), w s ps ss pb s p d bss (B 2006).26

f s s d, wv, sd s w k v svs l wd s p-sv d b ps pp w sv -ss v s ps pp wds

ps. Ps (2000) s d pss v-s s dq l d s pssb pvd svs wd psv v d ss

25 t (1987) s d ss ds d pp ws s Sv : Sv d ss ws dvpd p ss ps-s ss d qs dsz ps ds. Spp s s ssd ps ss.

26 T b dssd d k v d xp w vszs l dw ps d vs d b psss ps vs sd ps svs. us s dvds s ss svs b s b pb spks s pp. o d, s v k s zs wd sd k svs vsb w p-sd b ps dd b pb s pb d wss.


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ps sps d bd ss. h, w b s d d d ps pp wds ps dspsb ss ppd b psss p

ss sd sp ws s w -v svs p dvpd.

Referenes

abb, n., . 1994. Te Penguin Dictionary o Sociology. hdsw:P Bks.

axs, B., . 2000. P Ss w i Pvdd Ps-

e u. Patient Education and Counseling40, 51-57.a, J. J. B. 1998. DSm-iV. i Encyclopedia o Mental Health, d. h.S. fd,v. 1, 29-41. S D: ad Pss.

ads, J. m. 1996. epw Ps: isss d Ss. Social Science andMedicine43 (5): 697-705.

Bds, a. 2005. Psks sk pd: kj, vk dv -s. Psichiatrijos inios5-6, 14-16.

B, g. 2006. Te Psychiatric Encounter in Primary Mental Health Care:Approach o the Mental Patient. D Dss. Ks: Vs msuvs.

B, P. 1992. Closing the Asylum. ld: P Bks.Bk, D. a., d m. W. o. 1999. T Ps c Ss Qs-

: a rb d Vd Sd. Social Psychiatry and Psychiatric Epidemiol-ogy34, 111-116.

B, S. 2004. rspp cs vs vks ps ps-ks k p bddbv. Nerv ir psichikos ligos3, 26-27.

Bz, J. 1998. c Ps b Jsd m h c? Journal oAdvanced Nursing28 (2): 260-265.

Bsd, J. 1989. Managing Madness: Changing Ideas and Practice. ld: uw

h.________. 2000 id: rk S m h. Sociologyo Health and Illness22 (5):543-558.

c, f., d e. V. 2002. n-ad Ps Dsds: msbv- c f?Acta Psychiatrica Scandinavica105, 161-163.

css, m. l., d n. css. 2001 P Vs, S mvs d hbs: hw Ps Svvs Spk o. Social Science and Medicine52,1477-1489.

Dbsks, a. 2003. Pd psks sk sp sd. iPsichiatrija, sd. a. Dbsks. 127-237. Vs: Vs s.

Dbsks, a., d n. g-md. 2003. zjs spk sk.i Psichiatrija, sd. a. Dbsks. 260-291. Vs: Vs s.

f, m. 1987. Mental Illness and Psychology. Bk: uvs cPss.


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25


gs, e. 2003. Psj ds k. i Psichiatrija, sd. a. Dbsks.51-61.Vs: Vs s.

gd, u. 1989. Ideas about Illness: An Intellectual and Political History o Medical

Sociology. nw yk: nw yk uvs Pss.h, i. 2001. ab ipssb S (ex-) us d Svv Ps-

Ps.Acta Psychiatrica Scandinavica104 (410): 102-106.ib, D. 1981. udsd m iss. i Critical Psychiatry: Te Politics o

Mental Health, d. D. ib. 23-72. nw yk: P Bks.Kp, o., K. l d V. lss. 2001. T rb cp

asssss Pd b Ds d Ps d np t: cps cp rs.Acta Psychiatrica Scandinavica104: 299-304.

lw, D. a. 1998. isss n-cp m h. Journal o AdvancedNursing28 (2): 280-287.

lp, D. 1997. css, rxv d md e. Social Sci-ence and Medicine45 (3): 373-381.

mcd, r., d g. Szk. 2000. cs d cp Ps Prvsd. European Journal o Health Law7, 47-55.

mcbb, m., d D. c 1996. ex ubd: is Dv dPw Dsps Bw cs d Ps. International Journal o Lawand Psychiatry19 (1): 1-25.

md, n., d P. Bw. 2000. P-cdss: cp fwk d

rvw ep l. Social Science and Medicine51: 1087-1110.m, D. 1978.Medical Sociology. nw yk: T f Pss.ms, r. 2003. asbs sk. i Psichiatrija, sd. a. Dbsks.

427-448. Vs: Vs s.nv, V. 1976.Medicine under Capitalism. nw yk: Pds.nvks, a. 2003. nks (k) sk. i Psichiatrija, sd. a. D-

bsks. 291-314. Vs: Vs s.ok, S. J., d e. S. 2000. Dsb id f d a: T

exps Pss w Sv m iss. Sociological Practice: A Journalo Clinical and Applied Sociology2 (2): 99-111.

Ps, S. 2002. 10 skmingo gyvenimo paslapi asmenims, turintiems psichikos sveika-tos problem. Vs: uaB ldbs s.

Ps, a. 2003. Psks k. i Psichiatrija, sd. a. Dbsks.83-98. Vs: Vs s.

P, D., d a. a. rs. 1999. Sociology o Mental Health and Illness, 2d d.Bk: op uvs Pss.

P, J., d P. K. 1998. n-cp d Pss Pw. Journal oAdvanced Nursing27, 304-311.

Pss, J. D. 1993. cps m iss Ws. i Te CambridgeWorld History o Human Disease, d. K. f. Kp. 59-85. cbd: uvsPss.

Ps, D. 2000. Bk s d psks svks sjs. i Psichikossveikatos prieira naujajame amiuje. c s. 9-12. Vs.


18/19

26

KR R VoMEN. m . 2010. Nr. 1(1). N 2029-4573

rdvs, l. 2003. apsz vs. i Psichiatrija, sd. a. Dbsks.521-546. Vs: Vs s.

r, D. 1999. c m iss d ls Bpss

md.Medicine, Health care and Philosophy2, 21-30.rs, D. l. 1991. o B S is Ps. i Down to Earth Sociology,

d. J. m. hs. 294-307. nw yk: T f Pss.Sb, t. r., d e. K. 1998. css m Dsds: nd

apps. i Encyclopedia o Mental Health, d. b h. S. fd, v. 2,461-473. S D: ad Pss.

Sz, B., d m. c. a. 2002. Sbjv exps S: Sz-p Ps, T rvs d m h Psss. Social Scienceand Medicine, 1-14.

S, S. S., D. Bk d m. gb. 1998. c PsDss. Social Psychiatry and Psychiatric Epidemiology33, 32-38.

Sp, K., B. hb, a. hs, J. t d P. t. 2000. P Ss: Vd idx Q c Ps Sv. Acta Psychiatrica Scandi-navica101, 330-333.

Ss, l. 2000. Pk z. i Psichikos sveikatos prieira naujajame amiuje.c s. 24-27. Vs.

Szsz, t. 1974.Myth o Mental Illness. nw yk: hb-hp.T S., B. Ps, S. a, c. c, g. J, c. Js. 2002. c

iss exp: iss msd. Qualitative Health Research 12 (4):

437-452.tp, a. 2001.Managing the Contradictions Recovery rom Severe mental Illness. D- Dss. Sk: Sk uvs.

t, t., d t. Sks. 2000. T rsp bw is d mdad Sv m i cs td c. Acta Psy-chiatrica Scandinavica102, 211-216.

t, B. S. 1987. Medical Power and Social Knowledge. ld: Sage Pb-s.

W, r. 1994. Recovery rom Schizophrenia. ld: rd.Ws, B. 1994. P Ss Vd cp? Social Science and Medi-

cine38 (4): 509-516.

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