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Women and Mental Health Edited By Dora Kohen. London: Routledge. 2000.239 pp. £16.99 (pb). ISBN 0415 188857

Published online by Cambridge University Press:  02 January 2018

Kathryn M. Abel*
Affiliation:
Institute of Psychiatry and Maudsley Hospital, Denmark Hill, London SE5 8AZ, UK
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Abstract

Type
Columns
Copyright
Copyright © 2001 The Royal College of Psychiatrists 

Prevalence data estimating the number of women compared with men with significant psychiatric disorder or psychological symptoms have consistently found women to have higher rates both in the UK and other Western countries. Clinicians and researchers alike are increasingly aware of gender differences and their potential effect on aetiology, presentation, course and management issues in a range of mental disorders. This multi-author book takes a closer look at depression, schizophrenia, perinatal illness, eating disorders and substance misuse and the possible effects of gender on them. It adds to the expanding literature that seeks to address the lack of provision of appropriate services for groups with distinctive needs. Women clearly are a group of health service users with specific needs related to their place in modern society and their particular presentation of mental health problems. Therefore, any book focusing on women's mental health is welcome and this one has the advantages of being easy to read, disorder-specific for ‘quick dip’ information and well presented.

The main criticism is that one could easily get the impression that gender differences in mental illness expression and therapeutic response are, in the main, of biological, rather than biosocial origin, despite a paucity of good biological data. Although some of the differences in mental health presentation between women and men are traceable to biological gender differences, it is increasingly apparent that these are minor players in any gender effect. Attempts to modify psychiatric disorder with hormonal therapies have at best been relatively harmless, but have certainly not provided the elixir once promised. The likelihood is that hormonal or genetic gender effects are most prominent in relatively early neurodevelopment and neuronal plasticity and that oestrogens are likely to have greatest effects on physical and cognitive symptoms in women across their reproductive life.

Perhaps predictably, then, the most interesting and thought-provoking chapters address the sociobiological and psychological viewpoint. That said, the chapters on eating disorders by Ulrike Schmidt and on alcohol and substance misuse by Jane Marshall provide excellent academic reference. Given the title of Women and Mental Health, it is puzzling that there were no chapters discussing mental health in minority groups of women (ethnic, lesbian), older women or children. Personally, I would also like to have seen a broader approach to this fascinating and important topic, for example with chapters addressing the feminist and historical perspective in depth. A more questioning examination of the role of gender and the clinical and service provision implications for women's mental health would also have set the book in a firmer context.

References

EDITED BY SIDNEY CROWN and ALAN LEE

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