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Culture and Schizophrenia: the DOSMD Challenge

Published online by Cambridge University Press:  02 January 2018

Robert B. Edgerton  and
Alex Cohen
Robert B. Edgerton*
Affiliation:
Departments of Psychiatry and Anthropology, UCLA School of Medicine, 760 Westwood Plaza, Los Angeles, California 90024–1759, USA
Alex Cohen
Affiliation:
School of Public Health, Alcohol Research Group, University of California, Berkeley, CA 94720, USA
*
∗Correspondence
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Abstract

The World Health Organization's International Pilot Study on Schizophrenia (IPSS) and subsequent Determinants of Outcomes of Severe Mental Disorder (DOSMD) studies have reported that the course of schizophrenia is more favourable in ‘developing’ than ‘developed’ societies. The 1992 DOSMD study attributes this difference to culture. We review studies concerning the course of schizophrenia and conclude that the evidence for a more favourable course in developing societies is not conclusive. Indeed, a favourable course has also been reported in various industrialised societies. We also raise questions about the findings reported in the recent DOSMD study, including the conclusion that the putatively more favourable course is a product of culture. Finally, we argue that longitudinal, direct observation of patients in their natural environments must be carried out before variations in the course of schizophrenia can be adequately understood.

Type
Papers
Information
The British Journal of Psychiatry , Volume 164 , Issue 2 , February 1994 , pp. 222 - 231
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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