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各国的精神疾病现象学:体质、文化还是环境因素?

Psychiatric phenomenology across countries: constitutional, cultural, or environmental?

作者信息

Ndetei D M

机构信息

Department of Psychiatry, University of Nairobi, Kenya.

出版信息

Acta Psychiatr Scand Suppl. 1988;344:33-44. doi: 10.1111/j.1600-0447.1988.tb09000.x.

Abstract

Some literature on the significance of culture on psychiatric phenomenology and also literature on psychiatric phenomenology in immigrants, particularly in Great Britain, are reviewed. It is pointed out that paranoid and religious phenomenology is particularly common in some immigrant groups and that this can be understood to some extent as a reflection of cultural factors. In order to elucidate more the role of culture in psychiatric phenomenology in immigrants to Great Britain the socio-cultural backgrounds of the immigrants and in particular the Africans, the West Indians and the Asians are discussed in some details. The phenomenology of psychiatric illness as recorded in a hospital based population of diverse cultural backgrounds in a London hospital was studied to see if any variations across the various cultural groups could be understood in terms of cultural factors. It was found that paranoid and religious phenomenology was more associated with African and West Indian groups for cultural reasons rather than their socio-environmental and racial status in Britain. Paranoia was directed to fellow immigrants rather than to the host population. It is concluded that paranoia and religious phenomenology do not necessarily have the same clinical significance in various cultural groups. It is also pointed out that hallucinations, and in particular auditory hallucinations and First Rank Symptoms of schizophrenia, which have assumed diagnostic significance in some cultures, may not necessarily have the same significance in other cultures.

摘要

本文回顾了一些关于文化对精神现象学意义的文献,以及关于移民,特别是英国移民精神现象学的文献。文中指出,偏执和宗教现象在一些移民群体中尤为常见,在一定程度上可以理解为文化因素的反映。为了更深入地阐明文化在英国移民精神现象学中的作用,本文详细讨论了移民的社会文化背景,特别是非洲人、西印度人和亚洲人的背景。研究了伦敦一家医院中具有不同文化背景的住院患者群体所记录的精神疾病现象学,以探讨是否可以从文化因素的角度理解不同文化群体之间的差异。结果发现,出于文化原因,偏执和宗教现象与非洲和西印度群体更为相关,而非他们在英国的社会环境和种族地位。偏执的对象是移民同伴而非东道国人口。研究得出结论,偏执和宗教现象在不同文化群体中不一定具有相同的临床意义。还指出,幻觉,尤其是幻听和精神分裂症的一级症状,在某些文化中具有诊断意义,但在其他文化中不一定具有相同的意义。

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