Ciba Foundation Symposium - Transcultural Psychiatry

406 Pages·1965·10.773 MB·English

TRANSCU L T UR AL PSYCHIATRY
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TRANSCU LTURAL
Ciba Foundation
Sym posi um PSYCH IA TRY
Edited by A.V.S. DE REUCK, M.Sc., D.I.C., A.R.C.S.
and
RUTH PORTER, M.R.C.P.
With 10 illustrations
J. & A. CHURCHILL, LTD.
104 GLOUCESTER PLACE
I965 LONDON, W. I.
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Printed in Gred Britain
THEC iba Foundation, a uitique international institution, owes
its inception to the gciierosity of CIBA Limited, Basle. However,
being established under Brirish trust law, it enjoys complete
independence in practice aiid policy.
Under the guidaiice of its ,distinguished Trustees, the Founda-
tion offers accommodatioii to scicntists from all over the world
at its home in Portland Place. Foremost in its activities is the
organization of siiiall coiifcrc~iccs,t he proceedings of which are
published in book form in the inaiiiier of the present volume.
The Foundation convenes iiiaiiy other informal discussions
bctwceii research workers of different disciplines and different
iiatioiialitics and cach year invites an outstanding authority to
deliver a special lecturc. An exchange programme between
French and British postgrad.uates is conducted and a library
service is available. Furthcrxorc, the Ciba Foundation attempts
in evcry other way possiblc to aid scientists, whether they be
Nobel Laureates or young graduates making their first original
coiitribution to research.
The purpose of the Ciba Foulidation, which is to promote
international co-operation in medical and chemical research, is
synibolized in tlie armorial bcariiigs by five interlaced rings
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the ired sword of St. Paul and the British lion; the wyvern and
the crozier, symbols associatcd with Basle, refer to the sponsoring
firni located in ths ancient Swiss town.
V
The Ciba Foundation
for the Promotion of Inteinational Co-operation in Medical and Chemical Research
41 PORTLAND PLACE, LONDON, W.1
Trustees The Rt. Hon. Lord Brain, LL.D., D.C.L., F.R.S.
Sir Howard Florey, F.R.S.
The Hon. Sir George Lloyd-Jacob
Sir Raymond Needham, Q.C., F.S.A.
The Rt. Hon. Lord Todd, F.R.S.
Executive Lord Brain, Chairman
Council Dr. F. Gross
Professor A. Haddow, F.R.S.
Sir Arthur Vere Harvey, C.B.E., M.P.
Sir George Lloyd-Jacob
Professor F. G. Young, F.R.S.
Director
& Secretary
to the Executive
Council Dr. G. E. W. Wolstenholme, O.B.E., F.R.C.P.
Deluty
Director Mr.A.V. S. de Reuck, M.Sc.
Assistant
Secretary Miss Nadia Bland
Medical
Assistant Miss Ruth Porter, M.R.C.P.
Editorial Miss Maeve O’Connor, B.A.
Assistants Miss Julie Knight, B.A.
Conference
Assistant Mrs. Nancy G. Spufford
Librarian Mrs. Margarete Silverman
Preface
THISs ymposium was originally proposed by Professor E. D.
Wittkower who suggested that one of the small interdisciplinary
conferences convened under the auspices of the Ciba Foundation
might afford an admirable opportunity for transcultural psychiatric
research workers and anthropologists to share their observations,
compare problems and exchangc views. In planning the scopc
and membership of this meeting-the first devoted by the Founda-
tion to psychiatry-thc collaboration of Professor Wittkower
and of Dr. H. B. M. Murphy were invaluable and are most
gratefully acknowledged.
Not surprisingly the intcrnational membership of this meeting
was as far-flung as that of an11 Ciba Foundation symposium. Of
course, it is in the naturc of th&r avocations that both transcultural
psychiatrists and anthropologists tend to spend much of their
time in the field, and in the event their duties overseas ultimately
preventcd a number of those who had accepted invitations from
attending, including Dr. Gregory Bateson (Hawaii), Dr. Margaret
Field (Accra), Dr. Paul Parin (Zurich), Professor Melford Spiro
(Chicago) and Dr. N. C. Surya (Bangalore). A very august
reason for dropping out at thc last moment was that of Dr. Tigani
el Mahi, who shortly before thc meeting was appointed member
of the Council of Sovereignty in the Republic of the Sudan.
Sir Aubrey Lewis was persuaded to take the Chair on this
occasion and it is a sincerc plcasurc to record here how much the
symposium owed to his light and masterly guidance, and also the
debt the Foundation owes to him for his generous advice and
assistance during the planning stages of the meeting.
vii
Contents
. . . .Page
Sir Aubrey Lewis Chairman's opening remarks I
Introduction
E. D. Wittkower Recent developments int ranscultural psychiatry 4
H. Rin
Discussion Carstairs, Cauclill, Leighton, Lewis, Lin, Margetts, Mead,
Murphy, Rubin, Shepherd, Wittkower, Wolfenstein, Yap . 17
A. 1. Hallowell Hominid evolution, cultural adaptation and
. . . . .
mental dysfunctioning 26
.
Discussion Caudill, DeVos, Fortes, Hollowell, Lewis, Mead, Murphy 54
Cross-Cultural Variations in Psychiatric Symptomatology
T. A. Lambo Schizophrenic and borderline states . . 62
Discussion Carstairs, Caudill, DeVos, Fortes, Lambo, Leighton, Lewis,
. . . .
Lin, Margetts, Mead, Wittkower 75
P. M. Yap Phenomenology of affective disorder in Chinese
. . . . . .
andothercultures 84
Discussion Caudill, DeVos, Hes, Lin, Mead, Murphy, Pfeifer,
. . . . . . . .
Rubin, Yap 108
1. Z. Hes Housing a.nd m.enta.l he.alth .in d.evel.oping.
countries I I5
Discussion Carstairs, Cauclill, DeVos, Firth, Fortes, Hollowell, Hes,
Lambo, Leighton. Lewis, Lin, Margetts, Mead, Murphy,
. . . . . .
Rubin, Wolfenstein 123
Cross-Cultural Variations in Care of the Mentally Ill
. .
J. B. Loudon Social aspects of ideas about treatment I37
Discussion DeVos, Firth, Fortes, Lombo, Leighton, Lewis, Loudon,
. . . . . .
Margetts, Shepherd. 161
G. M.C arstairs Cultural elenrents int he response to treatment , 169
Discussion Carstairs, Caudill, DeVos, Firth, Fortes, Hes, Lambo,
SLheeigphhteornd,, WLeiwttikso, wLeoru, dWono,l feMnsatregine,t tsY,a pM ea.d , M.u rphy,, 176
ix
X CONTENTS
Interaction of Social and Cultural Factors in Mental Health
Poge
Martha
. . .
Wolfenstein Changing patterns of adolescence 195
Discussion MDeuVrpohs,y F, oWrtoelsf,e nHsetse,i nL,e Ywoisp, Lin, .L oudon., Mor.g etts,. M eod,, 208
A. H. Leighton Cultural change and psychiatric disorder . . 216
. .
Discussion Fortes, Leighton, Loudon, Murphy, Rubin, Yap 228
Margaret Mead Adult roles . . . . . . . 236
Discussion DeVos, Fortes, Hollowell, Lombo, Leighton, Lewis,
Loudon, Margetts, Mead, Murphy, Shepherd, Wolfenstein 257
Methodology
. .
E. L. Margetts Methods of psychiatric research in Africa 268
Discussion Coudill, DeVos, Fortes, Lombo, Leighton, Lewis, Lin,
LYoaupd on,. Morg.e tts, .M eod,. Rubin. , She.p herd., Witt.k ower., 294
H. 8. M. Murphy The epidemiological approach to transcultural
psychiatric research . . . . . . 303
. . .
Discussion Coudill, Lewis, Loudon, Murphy, Shepherd 323
G. DeVos Transcultural diagnosis of mental health by
. . . .
meansofpsychological tests 328
. .
Discussion Coudill, DeVos, Hollowell, Lewis, Rubin , 354
Group Discussion Corstoirs, Coudill, DeVos, Fortes, Hes, Leighton, Lewis,
LSihne,p Lhoeurdd,o nW, itMtkoorgweetrt,s ,W Molefeonds, teMinu,r pYhoyp, Pfe.i ffer, .R ubin., 357
Sir Aubrey Lewis Chairman’sclosingremarks . . . . 383
Index . . . . . . . . . . . . .385
Mem bership
Symposium on Transcultural Psychiatry held 23rd-25th
February, 1965
G. M. Carstairs . . . Dept of Psychological Medicine, University of
W. Caudili . . . . LaEbdoirnabtourryg h of Socio-Environmental Studies,
National Institutes of Mental Health, Bethseda,
Maryland
. . .
G. A. DeVos. Institute of Human Development, University of
California, Berkeley, California
R. W. Firth . . . . Dept. of Social Anthropology, London School of
Eco nom ic s
M. Fortes . . . . Faculty of Archaeology and Anthropology,
Cambridge
A. 1. Hallowell . . Dept. of Anthropology, University of Pennsyl-
van ia, Phi ladel p hia
. . .
J.Z. Hes . Dept. of Social Psychiatry, Talbieh Psychiatric
Hospital, Jerusalem, Israel
. . .
T.A.Lambo Dept. of Psychiatry, University of Ibadan,
Nigeria
A. H. Leighton Dept. of Psychiatry, Cornell University Medical
College, New York
Sir Aubrey Lewis Institute of Psychiatry, The Maudsley Hospital,
London
Tsung-Yi Lin . . . Dept. of Psychiatry, National Taiwan University
Hospital, Taipei, Taiwan
. . .
J.B.Loudon School of Social Studies, University College,
Swansea
E. L. Margetts . . . Dept. of Psychiatry, Faculty of Medicine,
University of British Columbia, Vancouver
. . .
Margaret Mead American Museumof Natural History, New York
H. B. M. Murphy . . Dept. of Psychiatry, McGill University, Montreal
W. M. Pfeiffer . . . Un i versi tats-Nerven kl in i k mit Pol i kli n i k,
Erlangen
xi