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PaperclipPerfector  6mo ago (text post)   2708 thread views

Small-Scale Question Sunday for October 29, 2023

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Does anyone have a good source for a deep dive into the dichotomy of schizophrenia between first world and third world countries? It's a commonly cited fact (myth?) that it presents differently in different cultures - i.e. in America schizophrenics often experience paranoia, violent episodes, ideations of suicide or self-harm, while in sub-Saharan Africa their symptoms manifest as religious experiences. A recent culture war thread comment suggested the possibility that genuinely violent, dangerous schizophrenics in third world countries are quietly abandoned or disposed of, but didn't cite any sources. Is this even a real phenomenon? Is there any useful research into it?

  1. Some mental disorders are more culturally bound than others, with Schizophrenia being something we see pretty much everywhere with similar patterns but different content being common.
  2. Severity of symptoms is variable, with some with most people experiencing a step-wise decline but with the extent of this being variable.
  3. Less severe or alarming symptoms means less presentation for help ex: hallucinations not being as distressing they can be not as bad, or fit better in the cultural milieu (think religious delusions back in the day), or if someone is more negative symptom predominant (think apathetic, reserved, anti-social).
  4. Religious delusions are common but tend to be unsurprisingly related to the culture at hand. Same for other delusions and hallucinations. Someone in rural Africa might think the chief of the next village over is out to get him, where an American might think it's Joe Biden etc.
  5. Manic episodes and full blown psychosis were historically deadly. If you were manic in a pub in London in 1630 you might get killed in a bar fight and nobody cares or you might end up summarily executed by the police for being a total idiot. It would not surprise me if the same phenomena happens today in certain places.
  6. Not sure if we'd have good quality of research on this though.

I should note that Western psychosis is more likely to be dangerous because of things like easy access to weapons, poor policing, good social safety net etc. Remove those things and they are likely to get killed, unable to arm people, exiled, whatever is my thought.

It's not like violence is Wester specific - read the wiki page on running amok for an interesting example.

I only have limited psychiatric experience, but the handful of schizophrenics I've encountered in India had what any Western doctors would consider "Western" schizophrenia symptoms, including my friend who just tried to commit suicide that I personally diagnosed. That means the hallucinations were outright malign in nature, or certainly delusional in a negative way, as opposed to claims that they can be benign or even helpful.

For what it's worth, they didn't know they were schizo till they had the diagnosis, so it's not like I expected them to be culturally primed to interpret it in that light.

Overall I personally find the claims dubious, but I can't conclusively rule it out.

I have no idea but one thing I always wondered is wether a person that only present so called negative symptoms should be classified as schizophrenic https://en.wikipedia.org/wiki/Schizophrenia#:~:text=activity.%5B7%5D-,Negative%20symptoms,-Negative%20symptoms%20are IMHO there is great diversity in symptomatology and imho the root causes can be very different such as different brain regions being subject to damage/dysfunctions

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