Psychosis precipitated by marriage: a culture-bound syndrome?

A retrospective study of 258 psychiatric out-patients in Jerusalem compared 122 patients from an ultra-orthodox Jewish community with 136 other Jewish patients. It was found that six patients who had a psychosis within a month of marriage all belonged to the ultra-orthodox community. The possible links between cultural and educational practice in the ultra-orthodox community and the vulnerability to the stress of marriage are discussed. It seems feasible to regard the precipitation of major mental illness by marriage as a largely culture-bound phenomenon.