Schizophrenia: Culture

Research suggests there is a significant variation between countries when it comes to diagnosing schizophrenia. For example, Harrison et al.'s (1984) research suggested that those of West Indian origin were over-diagnosed with schizophrenia, by white doctors in Bristol, because of their ethnic background. In addition, Copeland et al. (1971) gave a description of a patient to 134 US and 194 British psychiatrists. 69% of the US psychiatrists diagnosed schizophrenia but only 2% of the British gave the diagnosis of schizophrenia. No research has found any cause for this, so it suggests that the symptoms of ethnic minorities are misinterpreted. This calls into question the reliability of the diagnosis of schizophrenia as it suggests that patients can display the same symptoms but receive different diagnoses because of their ethnic background; i.e. a patient’s ethnicity makes it more or less likely that they will be diagnosed with schizophrenia.

One issue is that positive symptoms such as the hallucination or hearing voices may be more acceptable in African cultures because of cultural beliefs in communication with ancestors, and therefore people are more ready to acknowledge such experiences. When reported to a psychiatrist from a different culture these experiences might be seen as bizarre and irrational as the psychiatrists are culturally biased towards what is ‘normal’ in their culture and therefore are ethnocentric unknowingly; i.e. any deviation from what is normal in their culture is misinterpreted and therefore mislabelled as a symptom of schizophrenia.

Escobar (2012) has pointed out that White psychiatrists may tend to over-interpret the symptoms of Black people during diagnosis. Such factors as cultural differences in language and mannerisms, difficulties in relating between black patients and white therapists, and the myth that black people rarely suffer from affective disorders may be causing this problem. Therefore clinicians and researchers must pay more attention to the effects of cultural differences on diagnosis

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