Medicine: Schizophrenics International

Although Pioneer Eugen Bleuler concluded half a century ago that schizophrenia is a worldwide disease, some psychiatrists continue to doubt it. Others contend that it is an essentially different disease among primitive peoples, especially African blacks. In Zurich last week (predominantly white) psychiatrists* got the benefit of research by psychiatrists of the black and yellow races. Their evidence suggested that 1) schizophrenia is most frequent where the tensions of Western technical civilization have caught up with primitive peoples; 2) when primitive people do suffer from schizophrenia, it-is essentially the same disease as in the West, though often colored by local superstitions, giving point to Carl Jung’s warning to the congress that even the most modern, drug-minded therapist “should have sound knowledge of myths and primitive psychology.”

¶Ghana’s Dr. Edward F. B. Forster based his report on research at the Accra mental hospital, of whose 1,117 patients 426 were schizophrenic (a somewhat smaller proportion than that usually found in the West). His findings: schizophrenia is commonest among the educated classes in southern Ghana, who are torn between native and imported Western cultures, and it decreases as distance from the coast and Western influence increases. Said Dr. Forster: “I maintain we are all. endowed with basically similar mental attributes. It is quite clear that the psychological reactions of our patients differ in no way from the reactions of similar groups of patients elsewhere in the world.”

¶ Haiti’s Dr. Louis Mars reported that in his country schizophrenia accounts for one-third of all psychoses (again a low proportion compared to the West), with the paranoid form most common. Haiti’s peasants rarely develop schizophrenia, but those who do, show in their delusions “a cultural African content with the gods and devils of the old black continent.” The disease is most often seen among the economically and culturally unstable fringes of the middle class in the towns, and these people in their mental disturbances “evoke the Christian god, electricity, radio and other elements of Western civilization.”

¶Thailand’s Dr. Prasop Ratanakorn reported a high percentage of schizophrenia: 72% of all mental illness. Reason for the high incidence, he said, lies in the country’s culture, which creates an introvert type of personality. The Thai religion (Buddhism) forbids aggressiveness, teaches contentment and moderation “to an immoderate degree,” thus encouraging lack of initiative and a turning away from reality. This also helps explain why nearly all Thai schizophrenics are quiet and “biddable.”

¶Hong Kong’s Dr. Pow Meng Yap found that, among schizophrenic Chinese, “customary beliefs have a strong molding influence on the clinical picture. Among our patients were four who showed clearly the syndrome of ghost possession. This is understandable in light of the tradition of ancestor worship.” Dr. Yap’s overall summation: secondary symptoms vary in accordance with culture, but “the primary symptoms of schizophrenia—especially the tendency to withdraw—are identical around the world, and it is thus truly a universal disease.”

* Missing: the Russian psychiatrists, whose invitations were withdrawn by the Swiss hosts following last year’s Hungarian revolution. When Soviet satellite delegations arrived in Zurich last week to find the Russians absent, they withdrew in a huff.