At the Research Front*: Social Function and Psychiatric Disorder

So omnipresent it is often ignored, the relationship between social function and psychiatric disorder poses one of the most difficult questions in our field. In fact, the lay term ‘breakdown’ may express better than any professional concept the recognition that the interpersonal and work matrix in which we operate has an essential role in psychopathology. Although with rare exceptions (Gruenberg, 1972), the term ‘breakdown’ is avoided vigorously by professionals in the field, this concept brings together the idea of symptomatology andcessation of competent functioning in a particularly powerful way. Perhaps the avoidance of this term by professionals is based on some rational premise. It is commonly implied, for example, that pathology and competent functioning are at opposite extremes of a continuum in which case the concept, breakdown, adds little beyond merely noting the occurrence of disorder. However, such a continuum view under-estimates the complexitiy of the processes involved in the relationships between psychiatric disorder and competent functioning. From many studies carried ou t in recent years, there is increasing evidence to suggest that the nature of psychiatric disorder, its aetiology, prognosis, and treatment is interwoven with social functioning in many intricate ways. Prognosis in schizophrenja, for example, does not a p B < to be, as had often been thought, a s i m F matter of symptom-based deterioratin course/Strauss and Carpenter, 1974).