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      Indian culture and psychiatry

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          Abstract

          ‘Culture’ is an abstraction, reflecting the total way of life of a society. Culture uniquely influences mental health of people living in a given society. Similarity in thinking and understanding of mental health across the ancient cultures has been observed. Studies which relate to the demographic factors, cultural factors influencing presentation of illness, diagnosis of the illness-culture bound syndromes and influence of the cultural factors and the belief system on psychopathology, stigma and discrimination towards the patient have been reviewed. An attempt has been made to critically look at the research on culture and psychiatry in different areas. There is a need for culturally oriented modules of non-pharmacological management.

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          Experiences of stigma and discrimination endured by people suffering from schizophrenia

          Santosh Loganathan, Srinivasa Murthy (2008)
          Objective: It is important to understand stigma in India, given its varied culture and mixture of rural and urban populations. Information from western literature cannot be applied without considering the sociocultural differences. Aims: The research aimed to study the subjective experiences of stigma and discrimination undergone by people suffering from schizophrenia in rural and urban environments in India. Settings and Design: Patients were selected from the outpatient services of six adult psychiatric units of the National Institute of Mental Health and Neurosciences (NIMHANS), India, and from the six outreach centers located in rural areas. Materials and Method: Two hundred patients diagnosed with schizophrenia were selected from rural and urban areas. The experiences of stigma and discrimination were assessed using a semi-structured instrument. Statistical Techniques: Both quantitative and qualitative analyses were done. Results: Significant differences were seen between rural and urban respondents. Urban respondents felt the need to hide their illness and avoided illness histories in job applications, whereas rural respondents experienced more ridicule, shame, and discrimination. The narratives provide direct views of patients, supporting the key findings. Conclusion: Mental health programs and policies need to be sensitive to the consumers’ needs and to organize services and to effectively decrease stigma and discrimination.
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            Belief models in first episode schizophrenia in South India.

            Kerstin David, Naduparambil K. Jacob, Dinesh Bhugra … (2007)
            Existing evidence indicates that dissonance between patients' and professionals' explanatory models affects engagement of patients with psychiatric services in Western and non-Western countries. To assess qualitatively the explanatory models (EMs) of psychosis and their association with clinical variables in a representative sample of first episode patients with schizophrenia in South India. One hundred and thirty one patients with schizophrenia presenting consecutively were assessed. Measures included the patient's explanatory models, and clinician ratings of insight, symptoms of psychosis, and functioning on standard scales. The majority of patients (70%) considered spiritual and mystical factors as the cause of their predicament; 22% held multiple models of illness. Patients who held a biomedical concept of disease had significantly higher scores on the insight scale compared to those who held non-medical beliefs. Multivariate analyses identified three factors associated with holding of spiritual/mystical models (female sex, low education and visits to traditional healers); and a single factor (high level of insight) for the endorsement of biological model. Patients with schizophrenia in this region of India hold a variety of non-medical belief models, which influence patterns of health seeking. Those holding non-medical explanatory models are likey to be rated as having less insight.
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              Culture-bound syndromes: the story of dhat syndrome.

              S. Siribaddana, Dinesh Bhugra, A Sumathipala (2004)
              Culture-bound syndrome is a term used to describe the uniqueness of some syndromes in specific cultures. Dhat (semen-loss anxiety) has been considered to be an exotic 'neurosis of the Orient'. To ascertain the presence of similar symptoms and syndromes in different cultures and historical settings. Electronic and manual literature searches were used to gather information on the existence and description of semen-loss anxiety in different cultures and settings. Most of the empirical studies on dhat syndrome have emerged from Asia, whereas its concepts have been described historically in other cultures, including Britain, the USA and Australia. The different sources indicate the universality of symptoms and global prevalence of this condition, despite its image as a 'neurosis of the Orient'. It appears that dhat (semen-loss anxiety) is not as culture-bound as previously thought. We propose that the concept of culture-bound syndromes should be modified in line with DSM-IV recommendations.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Indian J Psychiatry
                Journal ID (publisher-id): IJPsy
                Title: Indian Journal of Psychiatry
                Publisher: Medknow Publications (India )
                ISSN (Print): 0019-5545
                ISSN (Electronic): 1998-3794
                Publication date (Print): January 2010
                Volume: 52
                Issue: Suppl1
                Pages: S309-S313
                Affiliations
                Department of Psychiatry, Sr. Professor, Superintendent, Addl. Principal, SMS Medical College, Jaipur - 302 004, India
                [1 ]2 nd yr. Resident Doctor, Psychiatric Centre, SMS Medical College, Jaipur - 302 004, India
                Author notes
                Address for correspondence: Dr. Shiv Gautam, Psychiatric Centre, Medical College, Jaipur - 302 004, India. E-mail: dr_shivgautam@ 123456yahoo.com
                Article
                Publisher ID: IJPsy-52-309
                DOI: 10.4103/0019-5545.69259
                PMC ID: 3146223
                PubMed ID: 21836701
                SO-VID: 36a7d315-da5e-4df6-81bb-32a18d169822
                Copyright © © Indian Journal of Psychiatry
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Subject: Review Article

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: culture & psychiatry,belief system,culture bound syndromes
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: culture & psychiatry, belief system, culture bound syndromes

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