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A large, observational, multinational cross-sectional pharmacoepidemiological study was performed to determine the prevalence of diabetes and other metabolic disorders in patients with schizophrenia receiving atypical antipsychotic drugs in Europe.
The study included adult outpatients with schizophrenia (DSM-IV-TR) treated for at least three months by an antipsychotic drug. Patients treated with classical or atypical antipsychotic drugs were recruited into two parallel strata (ratio of 1:3). A fasting blood sample was taken and height, weight, waist and hip circumference and blood pressure measured during a single visit. Biochemical parameters assessed included glucose, insulin, HbA1c, triglycerides, total cholesterol, HDL-cholesterol and apolipoprotein B.
2463 patients (median age: 41.0 years; 54.6% male) were included in twelve countries. among these, 10.9% of patients were treated for hypertension, 7.1% for a lipid disorder, 0.3% for type I diabetes and 3.5% for type II diabetes. in addition, 26% of untreated patients had dysglycaemia, 67.7% dyslipidemia and 38% had hypertension. 34% of the patients presented a metabolic syndrome. No overall difference was observed in the proportion of patients with glycaemic and lipid disorders between the two treatment strata. Values for weight-related variables were slightly higher in the atypical stratum, whereas hypertension was more frequent in the classical stratum (47.3%) than in the atypical stratum (42.2%).
The results of this study emphasise the need for careful follow-up of patients with schizophrenia treated with antipsychotic drugs to detect the occurrence of metabolic disorders. the proportion of patients with glycaemic or lipid disorders was very high and largely underdiagnosed.
Neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) have revealed structural deviations of the corpus callosum in children and adolescents. However, little is known about the link between callosal morphology and symptoms of inattention or hyperactivity in adulthood, especially later in life.
We aimed to further expand this understudied field by analyzing a large population-based sample of 280 adults (150 males, 130 females) in their late sixties and early seventies.
We applied a well-validated approach capturing the thickness of the corpus callosum with a high regional specificity at 100 equidistant points. In addition to correlating point-wise callosal thickness with ADHD symptom measures within the whole sample, we tested for sex interactions.
There were significant sex interactions with respect to measures of inattention and hyperactivity, with follow-up analyses revealing significant negative correlations in males (see Fig. 1 – Top). In contrast, there were positive correlations with respect to hyperactivity only in females (see Fig. 1 – Bottom).
A thinner corpus callosum may be associated with fewer fibers or less myelination. Thus, the negative correlations, as observed in males, suggest an impaired inter-hemispheric communication necessary to sustain motor control and attention, which may contribute to symptoms of hyperactivity, impulsivity and/or inattention. The functional relevance and underlying mechanisms of the positive correlations, as detected in females, remain to be resolved.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Chapter 6 examines how later stories about artistic competition, related by al-Maqrizi, Mustafa ‘Ali, and Qadi Ahmad, consider painting in the context of deceptive rhetoric in pursuit of truth, as advocated in Plato’s Phaedrus. The chapter concludes by comparing this understanding of painting with that rooted in a similar story, the competition of Zeuxis and Parrhasius. Adopted from antiquity by German Enlightenment thinkers as the paradigm for representation and the disinterested observer, this story establishes paradigms of artistry and mimesis in the Western tradition that cannot account for opposite premises established in Islamic discourses. The comparison between the two narratives underscores the antique tradition as part of a shared Islamic and European heritage diverging through distinct histories of interpretation. Comparison with European theorization of the image uncovers the bias inherent to normative art-historical premises about the social and psychological functions of the image that obscure alternative modes of perception, whether in cultures whose alterity is determined by being in the past or by being elsewhere. The story of the competition of the artists outlines an alternative paradigm, rooted in spiritually trained subjectivity rooted in the heart and resisting the rationalist exteriority of representation presumed in dominant modern models.
In contrast to the transcendent image eliding idolatry through immateriality or dematerialization, the transgressive image courts sin to transcend the self. Through the Abrahamic story of the prophet Joseph and Zuleikha, transformed from Judaic and Islamic exegesis to poetry and painting, Chapter 8 explores the trope of the transgressive image. Development of the story from the Talmud into the Bible and subsequent interplay between Jewish and Islamic commentaries suggests close interreligious communication. The story’s fifteenth-century romantic popularization in Persian poetry, first by Sa’di and then by Jami, used tropes of dreams and idols to transform the story into a parable describing the path to divine union. Combining text with image, Bihzad’s famous rendition of the climactic scene responds to the poem’s intermediality. Comparison with the transgressive dream vision central to the tale of Shaykh Sam’an in Attar’s Language of the Birds underscores a broader recognition of idolatrous transgression as a path to salvation. The chapter concludes by contrasting the mystical, humanizing interpretation embodied in these tales with depictions of the same romance in Europe. Recognizing the independence of European painting from text as an inappropriate paradigm for manuscript paintings embedded in texts, the chapter suggests the need for contextual critical reading of poetry through theology as well as politics to ascribe visual meaning.
Far from a mere technique of three-dimensional spatial representation, perspective has become a dominant metaphor for objectivity, rationalism, mastery, and domination. Conversely, to lack perspective, as in Islamic art, suggests an absence or ineptitude in these qualities often Chapter 10 examines the roots of European perspectivalism from the Italian Renaissance in its relationship with knowledge from Islamic discourses; interaction with European religious doctrines; and the rise and normalization of colonialism. It argues that, far from presaging a modern, secular, and supposedly objective way of looking, discussions of perspective in the seventeenth century were deeply engaged with proofs of the existence of God. This limited the potential of multi-perspectivalism to enable
Chapter 4 examines how the Quran informs perception outside of the parameters of art. It traces an ontology of perception rooted in the heart emerging from a hierarchy of the senses implicit in Quranic passages. It contrasts the complex ontology of the Quran as representation of the divine tablet as simultaneously writing and sound, always complete and always immanent, with secular interpretations of its material history. The Quran emerges less as a book than as a sonic image of the divine continually present in all its parts. The second part of the chapter examines how internalized perception of the Quran gave way to extensive discourses of love, the composite senses, and the metaphor of the heart-as-mirror as central to sensory and imaginary experience. The emotive response to Quranic beauty reverberates with discourses of the heart, the imaginary, and the contemplative faculties in Islamic thought. The discussion suggests that the aesthetics of the Quran reflected and promoted existing norms of inward mimesis. Drawing out connections with Greek and Buddhist philosophy inherited through Sasanian and Abbasid policies of translation, the chapter belies later European appropriations of antiquity as exclusively ‘Western.’
Chapter 7 explores the ephemeral image, transcended on the journey to truth. Emphasis on inward mimesis and perception through spiritual training shifts the art-historical emphasis on material objects toward a recognition of the importance of dreams, visions, and dematerializing images in Islamic discourses. The similar functions of the trope of the image and the dream image underscore their functional interchangeability as well as the reality often ascribed to dreams and visions over materiality. This emerges in uses of the image as identification; in Prophetic visions proving his miraculous journeys; ibn Arabi’s interpretation of sleep as a metaphor for exile in the Quranic parable of the Cave of the Seven Sleepers; and in the theorization of sleep and dreams as enabling an interface with reality impossible in the waking or material world. The resulting valorization of meaning over matter suggests a mode of preservation rooted in ideas rather than physical forms, accepted as inevitably perishable. Similar tropes of the image in Nizami’s Shirin and Khosrau, and Rumi’s story of the Three Princes, suggest that the image should be approached with neither love nor hate, but with indifference.
Often conceived as the abstract counterpoint to the supposedly absent representational image, geometry suffuses visual cultures of the Islamic world. Chapter 9 examines its theorization in relation to legacies of Sufi cosmology and music. While often contrasted with European representational traditions, the geometry of Islamic pattern is, like perspective, an optical device structuring surface treatment. Without offering a hermeneutic of geometry, Islamic discourses suggest an implicit understanding of geometry as an agent of meaning without a semiotic structure of signifier and signified. Geometry does not re-present; it presents. As such, its religious significance has everything to do with perception and little to do with intention. Putting forth its own quiddity, geometry induces subjects to infinitely reaffirm their own transience. It prepares them for enhanced religious insight and theological theorization. The infinitely shifting subjectivity it induces both enacts and contrasts the doctrinal absoluteness of God. This chapter examines the meanings accorded to geometry both in Islamic and Western discourses. The first section suggests origins for the common art-historical premise that geometry functions decoratively rather than mimetically. The subsequent section uses Islamic discourses about geometry to reveal its meanings not only as a cultural sign but as a mimetic practice.
Chapter 3 examines discussions about the mimetic possibilities of musical and visual images as reflected in late twelfth-century Persian-language epic poetry, focusing on intertextual and intermedial commentaries on philosophical discourses. Focusing on the narration and a sixteenth-century Mughal painting of a story about Plato as a musician in of the Iskandarnamah (1194) of Nizami of Ganj, the chapter argues that poetry served as a popularizing vehicle for Platonic thought consciously engaged at multiple moments in Islamic intellectual history. Painting augmented this discourse, enabling complex references to other texts including the fabular Kalila and Dimna and The Language of the Birds (1177) by Farid al-Din Attar. Delving into the poetry referenced through visual cues in the painting, the chapter reveals powerful currents of Platonic thought traced through Plotinus, the Brethren of Purity, ibn Sina, and the mystic Suhrawardi into the popular epic work by Attar. The analysis suggests that the mythic Simurgh central to the Language of the Birds incorporates complex Platonic symbolism into Islam, with strong implications about the limits and possibilities of representation. The intimacy of the poetry with Platonic thought suggests that far from inimical, philosophy and Islamic discourses may be indivisible.
Chapter 5 traces the heart as a polished mirror in transformations of the story of the competition of the artists as told by al-Ghazali and retold by Nizami, Rumi, and ibn Khaldun. Following the episteme of inward mimesis established in earlier chapters, the story reveals reflection as an enhancement of representation rather than through the model of deception common to modern interpretations of Platonic thought under the influence of biblical image prohibitions. The parable reflects insights suggestive of Platonic and Buddhist sources. Tropes of the heart and the curtain, metaphors for the heart and revelation, persist in later poetic renditions by Nizami and Rumi. They add the figure of Mani, mentioned already in Firdausi’s Shahnameh, to the story, elaborated through the thought of Suhrawardi and ibn Arabi. Ibn Khaldun reprises the tale to compare science and mysticism as paths to knowledge. The story reflects a relationship with the image not founded in prohibition so much as in its utility as a vehicle of transcendence. Far from the modern assertion of latent secularism in epic poetry and underlying representational painting, the cultural and religious aspects of Islam emerge as indivisible as a reflection and its mirror.
In contrast to the dearth of discussions about visual images in the first centuries of Islam, discussions of music abounded, often incorporating discourses inherited from Greek antiquity. Chapter 2 considers how juridical discussions of music reflected antique traditions of inward mimesis. Inheriting aspect of Eastern Roman music theory, discussions generally distinguished between theory and performance, affectivity and entertainment. Inheriting the Pythagorean–Platonic tradition, theorists emphasized the capacity of music to engage with the harmonies between the universe and the body that enabled its therapeutic and curative capacities. Music and instruments could be characterized through an iconography of sound. Music needed to be treated with caution due to its association with forbidden practices such as drinking and licentiousness. Yet it was also recognized as facilitating transcendence by opening the heart to the workings of the divine. Both aspects became central to literary gatherings devoted to the ritualized recitation of poetry with music, wine, food, and real or imaginary gardens. The centrality of music in the Islamic intellectual corpus undermines the oculocentrism of art history, offering instead a field of multimedial perceptual culture.
The discursive sphere of Islam explored in this book emerges through the interaction of texts of many genres, elaborating faith and engaging with multiple previous, neighboring, and intertwined cultures, and disseminated through ritual, poetry, music, geometry, and painting. The ideas about perception woven through them suggest that the questions that we ask through modern, Euronormative frameworks of religion, art, and history often veil Islamic culture in the name of revealing it. This not only alters dominant understandings of Islam and its arts, but also destabilizes the presumed universalism of disciplinary art history. Positing the broader category of ‘perceptual culture’ against the analytic limitations implicit in the categories ‘art’ and ‘history,’ this introduction critiques the modern segregation of culture from religion as disingenuous. Rather than inviting a ‘Western’ reader trying to understand an Islamic ‘other,’ it situates the reader, regardless of faith or heritage, as a modern subject using historical theological, philosophical, and poetic discourses to enter an earlier episteme and engage with Islamic cultures of the past. The resulting study emphasizes interfaith communication and Sufism as central aspects of Islamic perceptual cultures. It reflects on the performative character of perception as experienced through the eye, the ear, or the heart.