Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-14T07:27:03.637Z Has data issue: false hasContentIssue false

13 - Outcomes elsewhere: course of psychosis in ‘other cultures’

from Part III - Social factors and the outcome of psychosis

Published online by Cambridge University Press:  07 December 2009

By
Kim Hopper
Edited by
Craig Morgan ,
Kwame McKenzie  and
Paul Fearon
Kim Hopper
Affiliation:
Nathan Klein Institute for Psychiatric Research and Mailman School of Public Health, Colombia University, 722 West 168th Street, Sociomedical Sciences #928, New York, NY, USA
Craig Morgan
Affiliation:
Institute of Psychiatry, King's College London
Kwame McKenzie
Affiliation:
University College London
Paul Fearon
Affiliation:
Trinity College, Dublin
Get access

Summary

Introduction

In the mid-1970s, a fledgling anthropologist and her family landed in Dublin, ready to tackle the runes and riddles of ‘Gaelic sexuality’. Fortune had other plans. Within days of her arrival, a chance meeting with a psychiatrist convinced Nancy Scheper-Hughes to try her hand at a more consequential topic, runaway rates of schizophrenia in rural Ireland. Settling down in a seafaring village on the Dingle peninsula, she set out (as she would later put it) to ‘study madness among bachelor farmers as a projection of cultural themes’ (Kreisler, 1999). Drawing on Bateson's notion of pathogenic paradoxical communication snares (Bateson et al., 1956), she made good on the dare. Hospitalised Patrick was one of many last-born sons ‘crippled by his parents’ double-binding attempts' to keep him in reserve (single, at home, on call for their old age). Commonplace in this ‘demoralised, dying, western village’ (Scheper-Hughes, 1979, p. 190), these desperate parental gambits were late expressions of ‘the breakdown of traditional patterns of Irish familialism’. Patrick's plaintive ‘I am their dead son’ was less psychotic delusion than dreary, de facto truth.

When Saints, Scholars and Schizophrenics was published in 1979, it caused a sensation, one that has yet to fade entirely. Alternately hailed and denounced as breakthrough ethnography and heart-breaking exposé, its place in medical anthropology's canon was quickly secured. Complaints about its inaccuracies and betrayals aside, the book was plagued by a more fundamental methodological difficulty.

Keywords

cross-cultural epidemiologycross-cultural psychiatrydiscursive schoolepidemiological recordschizophreniaWHO studies
Type
Chapter
Information
Society and Psychosis , pp. 198 - 216
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amsterdam, A. and Bruner, J. (2000). Minding the Law. Cambridge: Harvard University Press.
Appadurai, A. (1996). Modernity at Large: Cultural Dimensions of Globalization. Minneapolis: University of Minnesota Press.
Appadurai, A. (2004). The capacity to aspire. In Culture and Public Action, ed. Rao, V. and Walton, M.. Stanford: Stanford University, pp. 59–84.
Bateson, G., Jackson, D. D., Haley, J.et al. (1956). Toward a theory of schizophrenia. Behavioral Science, 1, 251–64.Google Scholar
Benedict, R. (1934). Patterns of Culture. Boston: Houghton Mifflin.
Bhugra, D. (2006). Severe mental illness across cultures. Acta Psychiatrica Scandinavica, 113 (suppl. 429), 17–23.Google Scholar
Bibeau, G. (1997). Cultural psychiatry in a creolizing world. Transcultural Psychiatry, 34, 9–41.Google Scholar
Biehl, J. (2005). Vita. Berkeley: University of California.
Bleuler, E. (1950). Dementia Praecox or the Group of Schizophrenias (translated by J. Zincs from the original German edn. Dementia Praecox oder die Gruppe der Schizophrenien, 1911). London: Heinemann.
Bourdieu, P. and Wacquant, L. (1992). An Invitation to Reflexive Sociology. Chicago: University of Chicago Press.
Boydell, J., Os, J., McKenzie, K.et al. (2001). Incidence of schizophrenia in ethnic minorities in London: ecological study into interactions with environment. British Medical Journal, 323 (7325), 1336–8.Google Scholar
Bresnahan, M., Menezes, P., Varma, V. et al. (2003). Geographical variation in incidence, course and outcome of schizophrenia: a comparison of developing and developed countries. In The Epidemiology of Schizophrenia, ed. Murray, R. M., Jones, P. B., Susser, E., Os, J. and Cannon, M.. Cambridge: Cambridge University Press, pp. 18–33.
Brown, G. W. (1966). Schizophrenia and Social Care. London: Oxford.
Campion, J. and Bhugra, D. (1998). Religious and indigenous treatment of mental illness in South India – a descriptive study. Mental Health, Culture and Religion, 1, 21–9.Google Scholar
Cantor-Graae, E. and Selten, J. P. (2005). Schizophrenia and migration: a meta-analysis and review. American Journal of Psychiatry, 162, 12–24.Google Scholar
Cohen, C. I. (1993). Poverty and the course of schizophrenia: implications for research and policy. Hospital and Community Psychiatry, 44, 951–8.Google Scholar
Cooper, B. (2005). Immigration and schizophrenia: the social causation hypothesis revisited. British Journal of Psychiatry, 186, 361–3.Google Scholar
Cooper, J. and Sartorius, N. (1977). Cultural and temporal variations in schizophrenia: a speculation on the importance of industrialization. British Journal of Psychiatry, 130, 50–5.Google Scholar
Corin, E. E. (1990). Facts and meaning in psychiatry: an anthropological approach to the life-world of schizophrenics. Culture, Medicine and Psychiatry, 14 (2), 153–88.Google Scholar
Corin, E. E., Thara, R. and Padmavati, R. (2004) Living through a staggering world: the play of signifiers in early psychosis in South India. In Schizophrenia, Culture and Subjectivity, ed. Jenkins, J. H. and Barrett, R. J.. New York: Cambridge University Press, pp. 110–45.
Davidson, L. and Strauss, J. S. (1992). Sense of self in recovery from severe mental illness. British Journal of Medical Psychology, 65, 131–45.Google Scholar
Demerath, N. J. (1942). Schizophrenia among primitives: the present status of sociological research. American Journal of Psychiatry, 98, 703–7.Google Scholar
Desjarlais, R. (1997). Shelter Blues: Sanity and Selfhood among the Homeless. Philadelphia, PA: University of Pennsylvania Press.
Douglas, M. (2004). Traditional culture: let's hear no more about it. In Culture and Public Action, ed. Rao, V. and Walton, M.. Stanford: Stanford University, pp. 84–109.
Eaton, W. and Harrison, G. (2000). Ethnic disadvantage and schizophrenia. Acta Psychiatrica Scandinavica, 102 (suppl. 407), 38–43.Google Scholar
Edgerton, R. B. and Cohen, A. (1994). Culture and schizophrenia: the DOSMD challenge. British Journal of Psychiatry, 164, 222–31.Google Scholar
Estroff, S. E. (1981). Making it Crazy. Berkeley: University of California.
Estroff, S. E. (2003). Subject/subjectivities in dispute: the poetics, politics and performance of first-person narratives of people with schizophrenia. In Schizophrenia, Culture and Subjectivity, ed. Jenkins, J. H. and Barrett, R. J.. New York: Cambridge University Press, pp. 282–302.
Evans, P. (2002). Liveable Cities. Berkeley: University of California Press.
Faris, R. E. L. (1934). Cultural isolation and the schizophrenic personality. American Journal of Sociology, 39, 155–69.Google Scholar
Fearon, P. and Morgan, C. (2006). Environmental factors in schizophrenia: the role of migrant studies. Schizophrenia Bulletin, 32, 405–8.Google Scholar
Finnerty, A., Keogh, F., O'Grady Walshe, A. et al. (2007). Dublin, Ireland. In Recovery from Schizophrenia – An International Perspective, ed. Hopper, K., Harrison, G., Janca, A. and Sartorius, N.. New York: Oxford, pp. 129–40.
Geertz, C. (1985). The Uses of Diversity. The Tanner Lectures on Human Values. University of Michigan. www.tannerlectures.utah.edu/lectures/geertz86.pdf.
Gillin, J. (1939). Personality in preliterate societies. American Sociological Review, 4, 681–702.Google Scholar
Gureje, O. and Bamidele, R. (1999). Thirteen-year social outcome among Nigerian outpatients with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 34 (3), 147–51.Google Scholar
Halliburton, M. (2004). Finding a fit: psychiatric pluralism in South India and its implications for WHO studies of mental disorder. Transcultural Psychiatry, 41, 80–98.Google Scholar
Hammer, M. and Leacock, E. (1961). Source material on the epidemiology of illness. In Field Studies in the Mental Disorders, ed. Zubin, J.. New York: Grune and Stratton, pp. 418–86.
Harrison, G. (2004). Course and outcome in schizophrenia: towards a new social biology of psychotic disorders. In Search for the Causes of Schizophrenia, vol. 5, ed. Gattaz, W. F. and Häfner, H.. Darmstadt: Steinkopff Verlag, pp. 32–53.
Harrison, G., Owens, D., Holton, A.et al. (1988). A prospective study of severe mental disorder in Afro-Caribbean patients. Psychological Medicine, 18, 643–57.Google Scholar
Harrison, G., Amin, S., Singh, S. P.et al. (1999). Outcome of psychosis in people of African-Caribbean family origin. British Journal of Psychiatry, 175, 43–9.Google Scholar
Harrison, G., Hopper, K., Craig, T.et al. (2001). Recovery from psychotic illness: a 15 and 25 year international follow-up study. British Journal of Psychiatry, 178, 506–17.Google Scholar
Hopper, K. (1991). Some old questions for the new cross-cultural psychiatry. Medical Anthropology Quarterly (new series), 5, 299–330.Google Scholar
Hopper, K. (2003). Interrogating the meaning of ‘culture’ in the WHO international studies of schizophrenia. In Schizophrenia, Culture and Subjectivity, ed. Jenkins, J. H. and Barrett, R. J.. New York: Cambridge University Press, pp. 62–86.
Hopper, K. and Wanderling, J. (2000). Revisiting the developed vs developing country distinction in course and outcome in schizophrenia: results from ISoS, the WHO-Collaborative Follow-up Project. Schizophrenia Bulletin, 26 (4), 835–46.Google Scholar
Hopper, K., Harrison, G., Janca, A.et al. (eds) (2007a). Recovery from Schizophrenia – An International Perspective. New York: Oxford University Press.
Hopper, K., Wanderling, J. and Narayanan, P. (2007b). To have and to hold: a cross-cultural inquiry into marital prospects after psychosis. Global Public Health, 2(3), 257–80.Google Scholar
Jablensky, A., Sartorius, N., Ernberg, G.et al. (1992). Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychological Medicine. Monograph Supplement, 20, 1–97.Google Scholar
Kapur, R. I. (1979). The role of traditional healers in mental health care in rural India. Social Science and Medicine, 13, 27–31.Google Scholar
Kebede, D., Alem, A., Shibre, T.et al. (2005). Short-term symptomatic and functional outcomes of schizophrenia in Butajira, Ethiopia. Schizophrenia Research, 78, 171–85.Google Scholar
Karp, I. (1985). Deconstructing culture-bound syndromes. Social Science and Medicine, 21, 221–8.Google Scholar
Kleinman, A. (1988). The Illness Narratives. New York: Basic Books.
Kraepelin, E. (1919). Dementia Praecox and Paraphrenia (ed. Robertson, G. M.); translated by R. M. Barclay. Edinburgh: E. and S. Livingstone (reprinted 1976 in Huntingdon, NY, by Robert E. Kreiger).
Kreisler, H. (1999). Habits of a militant anthropologist: conversation with Nancy Scheper-Hughes. http://globetrotter.berkeley.edu/people/Scheper-Hughes.
Kurihara, T., Kato, M., Reverger, R.et al. (2000). Outcome of schizophrenia in a non-industrialized society: comparative study between Bali and Tokyo. Acta Psychiatrica Scandinavica, 101, 148–52.Google Scholar
Laubscher, B. J. F. (1937). Sex, Custom and Psychopathology. London: Routledge.
Littlewood, R. (1993). Pathology and Identity: The Work of Mother Earth in Trinidad. New York: Cambridge University Press.
Lopez, C. (1932). Ethnographische Betrachtungen über Schizophrenie. Zeitschrift für die gesamte Neurologie und Psychiatrie, 142, 706–11.Google Scholar
Lovell, A. M. (1997). The city is my mother: narratives of schizophrenia and homelessness. American Anthropologist (new series), 99 (2), 355–68.Google Scholar
Lucas, R. (2003). In and out of culture: ethnographic means to interpreting culture. In Schizophrenia, Culture and Subjectivity, ed. Jenkins, J. H. and Barrett, R. J.. New York: Cambridge University Press, pp. 146–66.
Luhrmann, T. M. (2006). Subjectivity. Anthropological Theory, 6(3), 345–61.Google Scholar
McGrath, J. J. (2007). The surprisingly rich contours of schizophrenia epidemiology. Archives of General Psychiatry, 64, 14–16.Google Scholar
Miller, G. (2006). A spoonful of medicine – and a steady diet of normality. Science, 311, 464–5.Google Scholar
Mojtabai, R., Varma, V. K., Malhotra, S.et al. (2001). Mortality and long-term course in schizophrenia with a poor 2-year course – a study in a developing country. British Journal of Psychiatry, 178, 71–5.Google Scholar
Murphy, H. B. M. and Raman, A. C. (1971). The chronicity of schizophrenia in indigenous tropical peoples. British Journal of Psychiatry, 118, 489–97.Google Scholar
Pakaslahti, A. (1998). Family centered treatment of mental health problems at the Bajaji Temple in Rajasthan. In Changing Patterns of Family and Kinship in South Asia, ed. Parpola, A. and Tenhunen, S.. Helsinki: Finnish Oriental Society, pp. 129–66.
Patel, V. and Kleinman, A. (2003). Poverty and common mental disorders in developing countries. Bulletin of the World Health Organization, 81(8), 609–15.Google Scholar
Patel, V., Cohen, A., Thara, R.et al. (2006). Is the outcome of schizophrenia really better in developing countries?Revista Brasileira Psiquiatria, 28 (2), 129–52.Google Scholar
Phillips, M. R., Liu, H. Q. and Zhang, Y. P. (1999). Suicide and social change in China. Culture Medicine and Psychiatry, 23 (1), 25–50.Google Scholar
Price, P. S. (2006). Letter: social defeat and schizophrenia. British Journal of Psychiatry, 186, 393.Google Scholar
Raguram, R. (2002). Temple healing: spiritual care is important – response. British Medical Journal, 325 (7370), 969.Google Scholar
Ran, M., Xiang, M., Huang, M.et al. (2001). Natural course of schizophrenia: 2-year follow-up study in a rural Chinese community. British Journal of Psychiatry, 178, 154–8.Google Scholar
Rawls, J. (1971). A Theory of Justice. Cambridge, MA: Belknap Press.
Ribeiro, B. T. (1994). Coherence in Psychotic Discourse. Oxford: Oxford University Press.
Sadowsky, J. (1999). Colonial Bedlam: Institutions of Madness in Colonial Southwest Nigeria. Berkeley: University of California Press.
Saris, J. (1996). Mad kings, proper houses, and an asylum in Ireland. American Anthropologist, 98, 539–54.Google Scholar
Sass, L. A. (1992). Madness and Modernism. New York: Basic Books.
Sassen, S. (1993). Cities in a World Economy. New York: Pine Forge/Sage.
Sawa, A. and Snyder, S. H. (2002). Schizophrenia: diverse approaches to a complex disease. Science, 296, 692–5.Google Scholar
Scheper-Hughes, N. (1979; 2000) Saints, Scholars and Schizophrenics. Original and expanded edns. Berkeley: University of California.
Scull, A. (1977). Decarceration. Englewood Cliffs, NJ: Prentice Hall.
Seligman, C. G. (1929). Temperament, conflict and psychosis in a stone-age population. British Journal of Medical Psychology, 4, 195.Google Scholar
Selten, J. P. and Cantor-Graae, E. (2005). Social defeat: risk factor for schizophrenia?British Journal of Psychiatry, 187, 101–2.Google Scholar
Selten, J. P., Slaets, J. P. and Kahn, R. S. (1997). Schizophrenia in Surinamese and Dutch Antillean immigrants to the Netherlands: evidence of an increased incidence. Psychological Medicine, 27, 807–11.Google Scholar
Sharpley, M. S., Hutchinson, G., McKenzie, K.et al. (2001). Understanding the excess of psychosis among the African-Caribbean population in England. British Journal of Psychiatry, 178 (suppl. 40), s60–s68.Google Scholar
Silverman, J. (1967). Shamans and acute schizophrenia. American Anthropologist, 69, 21–31.Google Scholar
Spence, J. (1988). The Question of Hu. New York: Vintage.
Stevens, A. and Price, J. (2000). Prophets, Cults and Madness. London: Duckworth.
Sundar, M. (1999). Suicide in farmers in India. British Journal of Psychiatry, 175, 585–6.Google Scholar
Swartz, S. and Swartz, L. (1987). Talk about talk: metacommentary and context in the analysis of psychotic discourse. Culture, Medicine and Psychiatry, 11, 305–416.Google Scholar
Thara, R. (2004). Twenty-year course of schizophrenia: the Madras Longitudinal Study. Canadian Journal of Psychiatry, 49, 564–9.Google Scholar
Thara, R., Kamath, S. and Kumar, S. (2003a). Women with schizophrenia and broken marriages – doubly disadvantaged. Part I: patient perspective. International Journal of Social Psychiatry, 49, 225–32.Google Scholar
Thara, R., Kamath, S. and Kumar, S. (2003b). Women with schizophrenia and broken marriages – doubly disadvantaged. Part II: family perspective. International Journal of Social Psychiatry, 49, 233–40.Google Scholar
Thara, R., Rajkumar, S. and Joseph, A. (2007). Chennai (Madras) India. In Recovery from Schizophrenia: An International Perspective, ed. Hopper, K., Harrison, G., Janca, A. and Sartorius, N.. New York: Oxford University Press, pp. 266–76.
Os, J. (2003). Can the social environment cause schizophrenia?British Journal of Psychiatry, 182, 291–2.Google Scholar
Varma, V. K. and Malhotra, S. (2007). Chandigarh, India. In Recovery from Schizophrenia – An International Perspective, ed. Hopper, K., Harrison, G., Janca, A. and Sartorius, N.. New York: Oxford University Press, pp. 115–128.
Vaughan, M. (1983). Idioms of madness: Zomba Lunatic Asylum, Nyasaland, in the colonial period. Journal of Southern African Studies, 9, 218–38.Google Scholar
Wallace, A. F. C. (1961). Culture and Personality. New York: Random House.
Warner, R. (2003). Recovery from Schizophrenia: Psychiatry and the Political Economy, 3rd edn. London: Routledge.
Watzlawick, P., Bavelas, J. B. and Jackson, D. D. (1967). Pragmatics of Human Communication. New York: W. W. Norton.
Whitaker, R. (2001). Mad in America. New York: Perseus Publishing.
WHO (1973). Report of the International Pilot Study of Schizophrenia, vol. 1. Geneva: World Health Organization.
WHO (1979). Schizophrenia. An International Follow-Up Study. Chichester: Wiley and Sons.
Wilce, J. (2000). The poetics of ‘madness’: shifting codes and styles in the linguistic construction of identity in Matlab, Bangladesh. Cultural Anthropology, 15 (1), 3–34.Google Scholar
Wilce, J. (2003). To ‘speak beautifully’ in Bangladesh: subjectivity as Pagalami. In Schizophrenia, Culture, and Subjectivity, eds Jenkins, J. H. and Barrett, R. J.. New York: Cambridge University Press, pp. 196–218.
Williams, R. (1976). Keywords: A Vocabulary of Culture and Society. London: Fontana Press.
Wilson, P. (1974). Oscar: An Inquiry into the Nature of Sanity. New York: Random House.
Wing, J. and Brown, G. (1970). Institutionalism and Schizophrenia. London: Cambridge University Press.
Winston, E. (1934). The alleged lack of mental diseases among primitive groups. American Anthropologist, 36, 234–8.Google Scholar
Zolkowska, K., Cantor-Graae, E. and McNeil, T. F. (2001). Increased risk of psychosis among immigrants to Sweden: is migration a risk factor for psychosis?Psychological Medicine, 21, 669–778.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×