Cross-culturalpsychiatry

What is culture?

• Culture refers to the meanings, values and behavioural norms that are learned and transmitted in the dominant society and within its social groups. Culture powerfully influences cognition, feelings, and self concept as well as the diagnostic process and treatment decisions

What is Cross-cultural psychiatry?

• The cultural context of mental disorders• Studies the prevalence and form of

disorders in different cultures or countries

What is Cross-cultural psychiatry?

• Early colonist psychiatrists and anthropologists assumed the universal applicability of Western psychiatric diagnostic categories

• A seminal paper by Arthur Kleinman in 1977 followed by a renewed dialogue between anthropology and psychiatry started a new cross-cultural approach to many psychiatric conditions

CULTURE CAN CONTRIBUTE TO PSYCHOPATHOLOGY IN SIX DIFFERENT WAYS

• PATHOGENIC EFFECTS• PATHOSELECTIVE EFFECTS• PATHOPLASTIC EFFECT• PATHOELABORATIVE EFFECTS• PATHOFACILITATIVE EFFECTS• PATHOREACTIVE EFFECTS

PATHOGENIC EFFECTS

• Pathogenic effects refer to situations in which culture is a direct causative factor in forming or ‘generating’ psychopathology

• Cultural ideas and beliefs contribute to stress, which in turn produces psychopathology

PATHOGENIC EFFECTS EXAMPLES

• DHAT SYNDROMEA condition found in India where

patients show anxiety and hypochondriacal concerns associated with the discharge of semen

This is based on an old Hindu belief that it takes forty drops of blood to create a drop of bone marrow and forty drops of bone marrow to create a drop of sperm

PATHOSELECTIVE EFFECTS

• Culture-specific coping patterns to deal with stress

• Examples:FAMILY SUICIDE: In Japan, cultural influences

may lead a family encountering serious stress to commit suicide together

AMOK ATTACK: In Malaysia, a man humiliated in public may feel a need to take a weapon and kill people indiscriminately to show his manhood

PATHOPLASTIC EFFECT

• The ways in which culture changes the manifestations of the psychopathology

• Example:Religious delusions and delusional guilt are

primarily found in Christian societies than Islamic, Hindus or Buddhist

ATHOELABORATING EFFECTS

• Certain behavior reactions may become exaggerated to the extreme in some cultures through cultural reinforcement

ATHOELABORATING EFFECTS EXAMPLES

• In western countries and urban areas of developing countries there is increasing concerned with body weight in relation to health (a common reason for eating disorders)

PATHOFACILITATIVE EFFECTS

• Culture may promote the frequency of occurrence

• A liberal attitude towards weapons control may result in more weapon-related violence or homicidal behaviour

• Cultural permission to consume alcohol freely may increase the prevalence of drinking problems

PATHOREACTIVE EFFECTS

• Culture influences how people perceive pathologies and label disorders, and how they react to them emotionally, and then guide them in expressing their suffering

PATHOREACTIVE EFFECTS EXAMPLE• Faith healing practices in cases of major

psychiatric disorders like schizophrenia, bipolar disorders or in OCDS . People attribute illness as results of “Black magic”.

Culture-bound syndrome

a combination of psychiatric and somaticsymptoms that are considered to be a

recognizable disease only within a specific society or culture