Paranoia by Daniel and Jason Freeman

Paranoia is associated with a whole series of social factors: urban living, isolation, migration and victimization. But the thread running through them all, intensifying their effects and magnifying distress is poverty and deprivation. 'Deprivation' and 'poverty' are used here as relative terms. The very poorest people in Western societies today have many more material comforts than their equivalents a hundred years ago. But colour television, central heating, and proper sanitation don't prevent them suffering the disadvantages associated with deprivation. It's not 'poverty' per se that's responsible. It's primarily a question of wealth inequality- the size of the gap between the richest and the poorest in society.

The effects of inequality have been eloquently summarized by the leading epidemiologist Richard Wilkinson, in his influential book Social Determinants of Health:

with large social-economic inequalities, societies will have bigger problems of low social status, feelings of inferiority, and subordination; with larger inequalities, the quality of social relations will deteriorate, leading to increases in violence and reductions in both trust and involvement in community life.

Which hardly makes for cheering reading in a world where inequalities of wealth show few signs of reducing. In the U.K., for example, the top 1 per cent of the population increased their wealth from 20 to 23 percent in the period 1997-2002; the wealth of the poorest 50 per cent of the population, on the other hand, steadily dwindled from 10 per cent in 1986 to 7 per cent in 1996 and 5 per cent in 2002.

The story is much the same in the U.S., which has the greatest inequalities of wealth of any nation. Between 1973 and 2002, for instance, the average income of the bottom 90 per cent of U.S. taxpayers fell by 7 per cent, while the income of the top 1 per cent grew by a massive 148 per cent. The top 20 per cent of U.S. househods now enjoys almost 50 per cent of the country's total income, while the bottom 20 per cent owns just just 3.4 per cent of it.

All of which means that the next item on our anti-paranoia wish list is government policies to reduce inequalities of wealth. The benefits of such an initiative are likely to be many and varied. But among them would be lower levels of social exclusion, stress, insecurity- and paranoia. However, rather like our suggestions regarding the media , it might be unwise to hold one's breath in eager anticipation. Many governments have committed themselves to the eradication of inequalities- indeed, a list of governments that hadn't declared such an aspiration would make interesting, although probably momentary reading. To date, at least, few of these pledges have been honored- though that only makes them more pressing.

An end to inequality. The transformation of our cities. A disciplined and temperate media. In sum, a range of measures in all areas of our society (from education, to town planning, employment to immigration policies) designed to build social cohesion. To which we might add- while we're aiming at the stars- the restoration of public trust in authority, from the government to the police to doctors and teachers.

When we survey our list of recommended measures for tackling paranoia, the spring soon leaves our step. It's difficult to hold out much hope that the problem is going to be tackled sucessfully any time soon, though these issues are certainly taken seriously by many in government. But if progress at this macro-economic level is going to be slow, thankfully we do at least have an armoury of tried and tested techniqies to combat paranoia on an individual level.