Schizophrenie ist eine schwere und zumeist chronisch verlaufende psychiatrische Erkrankung und stellt eine enorme finanzielle Belastung für das Gesundheitssystem dar. Daten zu den medikamentösen Kosten liefern Hinweise zur Verbesserung der Kosteneffektivität innerhalb der Patientenversorgung. In der vorliegenden Arbeit erfolgt eine Analyse der internationalen Unterschiede im Arzneimittelverbrauch und der Kosten der psychotropen Medikation im Rahmen der Behandlung von schizophren Erkrankten. Die Analyse basiert auf Daten aus einer naturalistischen, prospektiven Längsschnittstudie über einen Zeitraum von zweieinhalb Jahren (European Schizophrenia Cohort) in den Ländern Frankreich, Deutschland und Großbritannien. Ausgangspunkt der multivariaten Regressionsanalyse ist die Vermutung, dass die Höhe der Kosten in der medikamentösen Therapie von folgenden soziodemografischen Eigenschaften schizophren Erkrankter beeinflusst werden: dem Alter, klinischen Status, Geschlecht und der Zahl der vorangegangenen stationären Aufenthalte. Es ist festzustellen, dass es internationale Unterschiede im Medikamentenverbrauch gibt. Unterschiede in der Erstattungsfähigkeit, vorhandene Arzneimittelbudgets, verschiedene Behandlungsleitlinien und Verschreibungspraxen sind mögliche Erklärungen. Es wird gezeigt, dass ein an Schizophrenie erkrankter Patient in Deutschland signifikant höhere Arzneimittelkosten bei gleicher Therapie verursacht. Das ist möglicherweise durch die unterschiedlichen Gesundheitssysteme mit den unterschiedlichen Einflussnahmen des Staates auf die Pharmaindustrie zu erklären. Die Variablen Herkunftsland, Alter und Krankheitsschwere beeinflussen die Höhe der Kosten der medikamentösen Therapie.

My thesis aims to explore how Anna successfully makes her breakthrough from her schizophrenia by emancipating herself from sado-masochistic interpersonal relationships in Doris Lessing¡¦s The Golden Notebook. R. D. Laing redefines schizophrenia as a process for individuals to cope with the modern world whose increasing division has caused the divorce between body and mind. Laing points out that individuals are confined in such social phantasy systems as political parties, family, and marriage. Schizoid individuals suffer from the alienation between body and mind in striving to extricate themselves from this confinement. Moving a step further than Laing, Lessing highlights that for schizoid individuals, sado-masochistic interpersonal relationships are, in fact, responsible for schizoid individuals¡¦ breakdown. In The Golden Notebook, Lessing demonstrates how Anna endeavors to get rid of the entanglement from sado-masochistic interpersonal relationships as well as the confinement of the Communist Party, family, and marriage. In Chapter One, I delineate the background for the emergence of a new interpretation of schizophrenia under the influence of anti-psychiatry movement and the association between Lessing and one major proponent of the movement, Laing. Both Lessing and Laing emphasize using the perspective of existential psychoanalysis to analyze the relation between schizophrenia and interpersonal relationships. In Chapter Two, I focus on depicting how different victims, including Anna, are trapped in different social phantasy systems and in sado-masochistic interpersonal relationships. Anna¡¦s schizoid process starts with her recognition of phantasies fabricated by different social systems, which leads to her attempt to extricate herself from such confinement as the Communist Party and marriage. In Chapter Three, I apply Laing¡¦s theory of false self system to explore how conflicting social demands result in Anna¡¦s multiple false selves. These false selves lead to Anna¡¦s disintegrated life, which is the main cause of Anna¡¦s writer¡¦s block. Therefore, in Chapter Four, I depict Anna¡¦s effort to reintegrate her life by experimenting with different representations of her self in novels and journals. However, Anna realizes that the difficulty in overcoming her writer¡¦s block lies in the lack of an integrated Anna. In Chapter Five, I discuss how Anna recognizes her schizoid condition from observing Saul Green¡¦s in her love affairs with him. She also realizes that her total breakdown is inevitable unless she can extricate herself from their sado-masochistic relationship. In addition, the revelation from her dreams also helps her to realize that the principle of joy-in-destruction plays an important role in subverting wrong divisions in society. In conclusion, I stress Anna¡¦s emancipation from schizophrenia and Lessing¡¦s new interpretation of representation in The Golden Notebook. For Anna, she successfully achieves her emancipation from total breakdown by elevating herself from sado-masochistic interpersonal relationships. With the revelation from Camus¡¦s Sisyphus myth, she redefines herself as a boulder-pusher, discarding her role as a victim. For Lessing, she offers a new interpretation of the gaps between reality and art through the collage of different representations of Anna¡¦s life.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2001. / Vita. Includes bibliographical references.

Thesis (M.A.) - Simon Fraser University, 2005. / Theses (Dept. of Psychology) / Simon Fraser University. Also issued in digital format and available on the World Wide Web.

Thesis (Ph.D.)--University of Texas at Arlington, 2009.

Thesis (Ph. D.)--Rutgers University, 2009. / "Graduate Program in Microbiology and Molecular Genetics." Includes bibliographical references (p. 190-210).

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2001. / Vita. Includes bibliographical references (leaves 92-104).

Thesis (Ph. D.)--University of Hong Kong, 2001. / Includes bibliographical references.

Thesis (M.D.), University of Hong Kong. / Type-written copy. Includes bibliographical references (p. 142-147).

Thesis (M. Phil.)--University of Hong Kong, 2002. / Includes bibliographical references (leaves 111-122).