Interface between shamanism and psychiatry in Miyako Islands, Okinawa, Japan: a viewpoint from medical and psychiatric anthropology.

This study is the first report regarding the borderland between psychiatry and shamanism in Miyako Islands, Okinawa, Japan. Folk healing practices are still flourishing on the islands. Most mentally ill persons we examined admitted to having consulted shamans. Although there is a need to assess the positive and negative effects of shamanistic practices on Miyako Islands' health care system as a whole, this report indicates the urgent need to come to terms with the interaction between shamanism and psychiatry on a multidimensional level. We describe here psychotic illness attributed to kandaari. These cases underline the importance of understanding "the explanatory model" (Kleinman 1979) of people as regards the causes and the effective healing of illness. From the viewpoint of medical and psychiatric anthropology, aspects of the treatment of such patients in the biocultural context are described.