Countervailing medicalization: A relational approach to the medicalization of psychosis

This paper provides a relational analysis of the medicalization of prodromal psychosis, a period of low-level symptoms that might or might not escalate into an official psychotic disorder (e.g., schizophrenia). Data consists of 30 in-depth interviews with the complete staff of two prodromal psychosis programs. While both programs medicalize psychosis, they do so in markedly different ways. One program applies extensive community surveillance but does not provide treatment, whereas the other program treats individuals before they develop an official disorder but does not conduct community surveillance. To explain this difference, I conduct a relational analysis of medicalization, arguing that medicalization efforts in one domain (e.g., surveillance) can constrain medicalization in other domains (e.g., treatment), which I refer to as countervailing medicalization. The paper discusses the implications of countervailing medicalization for medicalization theory and the utility of relational approaches for medicalization analyses.