1. Cross-cultural
psychiatry

2. What is culture?
• Culture refers to the meanings, values and
behavioural norms that are learned and
transmitted in the dominant society and
within its social groups. Culture powerfully
influences cognition, feelings, and self concept
as well as the diagnostic process and
treatment decisions

3. What is Cross-cultural psychiatry?
• The cultural context of mental
disorders
• Studies the prevalence and form of
disorders in different cultures or
countries

4. What is Cross-cultural psychiatry?
• Early colonist psychiatrists and anthropologists
assumed the universal applicability of Western
psychiatric diagnostic categories
• A seminal paper by Arthur Kleinman in 1977
followed by a renewed dialogue
between anthropology and psychiatry started
a new cross-cultural approach to many
psychiatric conditions

5. CULTURE CAN CONTRIBUTE TO
PSYCHOPATHOLOGY IN SIX DIFFERENT WAYS
• PATHOGENIC EFFECTS
• PATHOSELECTIVE EFFECTS
• PATHOPLASTIC EFFECT
• PATHOELABORATIVE EFFECTS
• PATHOFACILITATIVE EFFECTS
• PATHOREACTIVE EFFECTS

6. PATHOGENIC EFFECTS
• Pathogenic effects refer to situations in which
culture is a direct causative factor in forming
or ‘generating’ psychopathology
• Cultural ideas and beliefs contribute to stress,
which in turn produces psychopathology

7. PATHOGENIC EFFECTS EXAMPLES
• DHAT SYNDROME
A condition found in India where
patients show anxiety and
hypochondriacal concerns
associated with the discharge of
semen
This is based on an old Hindu belief
that it takes forty drops
of blood to create a drop of bone
marrow and forty drops of bone
marrow to create a drop
of sperm

8. PATHOSELECTIVE EFFECTS
• Culture-specific coping patterns to deal with
stress
• Examples:
FAMILY SUICIDE: In Japan, cultural influences may
lead a family encountering serious stress to
commit suicide together
AMOK ATTACK: In Malaysia, a man humiliated in
public may feel a need to take a weapon and kill
people indiscriminately to show his manhood

9. PATHOPLASTIC EFFECT
• The ways in which culture changes the
manifestations of the psychopathology
• Example:
Religious delusions and delusional guilt are
primarily found in Christian societies than
Islamic, Hindus or Buddhist

10. ATHOELABORATING EFFECTS
• Certain behavior reactions may become
exaggerated to the extreme in some cultures
through cultural reinforcement

11. ATHOELABORATING EFFECTS
EXAMPLES
• In western countries and
urban areas of developing
countries there is increasing
concerned with body weight
in relation to health (a
common reason for eating
disorders)

12. PATHOFACILITATIVE EFFECTS
• Culture may promote the frequency of
occurrence
• A liberal attitude towards weapons control
may result in more weapon-related violence
or homicidal behaviour
• Cultural permission to consume alcohol freely
may increase the prevalence of drinking
problems

13. PATHOREACTIVE EFFECTS
• Culture influences how people perceive
pathologies and label disorders, and how they
react to them emotionally, and then guide
them in expressing their suffering

14. PATHOREACTIVE EFFECTS EXAMPLE
• Faith healing practices in cases of major
psychiatric disorders like schizophrenia,
bipolar disorders or in OCDS . People
attribute illness as results of “Black magic”.

15. Culture-bound syndrome
a combination of psychiatric and
somaticsymptoms that are considered to be a
recognizable disease only within a specific
society or culture