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[文化与主观疾病体验之间的心理健康观念]

[Mental health beliefs between culture and subjective illness experience].

作者信息

Ritter Kristina, Chaudhry Haroon R, Aigner Martin, Zitterl Werner, Stompe Thomas

机构信息

Institut für Suchtdiagnostik, Wien.

出版信息

Neuropsychiatr. 2010;24(1):33-41.

Abstract

OBJECTIVE

Subjective health beliefs are representations about pathogenesis, course and treatment options of psychic as well as somatic illnesses. They are important for a psychotherapeutic interaction as well as for a stable drug adherence. However, it remains unclear whether these representations are primarily affected by the cultural background or by an individual's specific illness experiences, a question of increasing importance in our era of globalized migration.

METHOD

The study sample consisted of 203 Austrians (125 with schizophrenia, 78 with obsessivecompulsive disorder) and 190 Pakistanis (120 with schizophrenia, 70 with obsessive-compulsive disorder). All patients completed the "Causal Explanations of Mental Disorders" (CEMD), a 41-item self-rating questionnaire.

RESULTS

Pakistani patients reported magic-religious oriented mental health beliefs more frequently. In contrast, Austrians' beliefs are more often in line with the bio-psychosocial explanations of Western medicine. Concerning mental health beliefs the cultural background seems to be more important than the subjective experience with a distinctive mental disorder.

CONCLUSIONS

Although the subjective experience is of importance for the shape of illnessspecific cognitions, mental health beliefs are primarily caused by the patients' socio-cultural origin. It is a challenge for psychiatry to improve the co-operation with culture-anthropology and other social sciences.

摘要

目的

主观健康信念是关于精神疾病和躯体疾病的发病机制、病程及治疗选择的认知。它们对于心理治疗互动以及稳定的药物依从性都很重要。然而,尚不清楚这些认知主要是受文化背景影响还是受个体特定疾病经历的影响,在我们这个全球化移民的时代,这个问题变得越来越重要。

方法

研究样本包括203名奥地利人(125名精神分裂症患者,78名强迫症患者)和190名巴基斯坦人(120名精神分裂症患者,70名强迫症患者)。所有患者均完成了《精神障碍的因果解释》(CEMD),这是一份有41个条目的自评问卷。

结果

巴基斯坦患者更频繁地报告以魔法 - 宗教为导向的心理健康信念。相比之下,奥地利人的信念更常符合西医的生物 - 心理 - 社会解释。关于心理健康信念,文化背景似乎比患有特定精神障碍的主观体验更重要。

结论

尽管主观体验对于特定疾病认知的形成很重要,但心理健康信念主要由患者的社会文化背景所致。精神病学面临的一项挑战是改善与文化人类学及其他社会科学学科的合作。

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