Facts and meaning in psychiatry. An anthropological approach to the lifeworld of schizophrenics.

Dominant research paradigms in psychiatry appear broadly unequipped for explaining the diversity of outcome in schizophrenics. The author builds on anthropological approaches to meaning construction and on European psychiatric phenomenological descriptions of forms of "being-in-the-world" to propose alternative research perspectives. Data have been collected on schizophrenics contrasted on the base of hospitalization rate. Statistical analysis has evidenced recurrent structural features in the stance-toward-the-world among non-rehospitalized patients. Qualitative analysis of patients' narratives enlightens the meaning of these data from the patient's perspective. It shows the centrality of a "positive withdrawal" position toward-the-world for schizophrenics in the sample and exemplifies the function of specific cultural signifiers for constructing one's experience. In reference to Tellenbach's idea of endo-cosmo-genesis, the author hypothesizes that individual vulnerability associated with schizophrenia interacts with Western cultural values and enforces the "withdrawn" component of "positive withdrawal" in North American schizophrenics.