Psychiatry and Chinese culture.

When we examine the cultural characteristics that influence mental disorders and related behavior among the Chinese, no major differences are found between Chinese and other groups in the range of disorders or in overall prevalence. Several cultural factors influence the recognition and treatment of mental illness, among which are attitudes toward emotional display, somatic as opposed to psychogenic disorders and features of the traditional medical belief system in Chinese culture. The Chinese have a relatively favorable prognosis of schizophrenia, low rates of depressive illness, a strong tendency towards somatization and the presence of several unique culture-bound syndromes. From studying Chinese in Vancouver, it was found that they have a characteristic way of dealing with mental illness in the family, in that there is first a protracted period of intrafamilial coping with serious psychiatric illness, followed by recourse to friends, elders and neighbors in the community; third, consultation with traditional specialists, religious healers or general physicians; fourth, outpatient or inpatient treatment from specialists, and, finally, a process of rejection and scapegoating of the patient. The efficacy of Western psychiatric treatment of Chinese patients has yet to be objectively assessed.