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November 14, 2019

Is Transcultural Psychiatry Possible?

Author Affiliations
  • 1The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, New York
  • 2Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
  • 3Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
JAMA. 2019;322(22):2167-2168. doi:10.1001/jama.2019.17331

Psychiatry is arguably the medical specialty most sensitive to cultural influences. An individual’s experience, expression, assessment, and regulation of feelings, thoughts, and behaviors are shaped by culture. Since mental health issues are particularly vulnerable to stigmatization, the expression of such issues and their evaluation by others can vary significantly. Culture creates a framework for the assessment of emotional, cognitive, and behavioral expressions and for the thresholds of disease and disorder. While the field of psychiatry is committed to emphasizing the uniformity of psychiatric disorders across groups, partly to provide stable phenotypes and identify successful treatment, the limitations of this position have been articulated by anthropology, cultural psychiatry, and recently by neuroscience, which has given rise to the search for more biologically based classification systems. However, there is still little research about how culture affects the evaluation of symptoms and signs that are relevant for psychiatric diagnosis and treatment. For example, would individuals in Germany and Canada respond to antidepressants the same way?

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    1 Comment for this article
    Transcultural Psychiatry and Anthropology
    Niccolo Caldararo, Anthropology and Psycholo | Dept of Anthropology San Francisco State University
    There has long been discussion in anthropology over the facility to extend psychiatric methods and theories to abnormal psychological adaptations produced by members of non-western cultures. From the time of Freud's initial publications, anthropologists like Malinowski and William H.R. Rivers (both a physician and anthropologist) attempted to determine the utility of methods developed in the west to non-European peoples. Both Margaret Mead and Francis L.K. Hsu (1) worked to produce research opportunities to test such methods and Hsu's 1972 text, is a compilation of papers from a variety of practitioners, contributed their experiences and results. Dr. Horatio Fabrega, a professor of psychiatry as well as anthropology, produced several books on disease and healing in the 1990s. I wrote a text summarizing disease and illness in cross-cultural context in 2012 as Evolutionary Aspects of Disease Avoidance. The future of this work requires collaboration to understand the etiology of disease and context of healing.


    1. Francis L.K. Hsu, (ed.) Psychological Anthropology, Cambridge, Schenkman Publishing, 1972.