title: DSM-IV "criterion A" schizophrenia symptoms across ethnically different populations: evidence for differing psychotic symptom content or structural organization?
abstract: There is significant variation in the expression of schizophrenia across ethnically different populations, and the optimal structural and diagnostic representation of schizophrenia are contested. We contrasted both lifetime frequencies of DSM-IV criterion A (the core symptom criterion of the internationally recognized DSM classification system) symptoms and types/content of delusions and hallucinations in transethnic schizophrenia populations from Australia (n = 776), India (n = 504) and Sarawak, Malaysia (n = 259), to elucidate clinical heterogeneity. Differences in both criterion A symptom composition and symptom content were apparent. Indian individuals with schizophrenia reported negative symptoms more frequently than other sites, whereas individuals from Sarawak reported disorganized symptoms more frequently. Delusions of control and thought broadcast, insertion, or withdrawal were less frequent in Sarawak than Australia. Curiously, a subgroup of 20 Indian individuals with schizophrenia reported no lifetime delusions or hallucinations. These findings potentially challenge the long-held view in psychiatry that schizophrenia is fundamentally similar across cultural groups, with differences in only the content of psychotic symptoms, but equivalence in structural form.
authors: Queensland Centre for Mental Health Research (Queensland Health), University of Queensland, Brisbane, QLD, Australia, duncan_mclean@qcmhr.uq.edu.au.
authors: Duncan
authors: D
authors: McLean
authors: Rangaswamy
authors: R
authors: Thara
authors: Sujit
authors: S
authors: John
authors: Robert
authors: R
authors: Barrett
authors: Peter
authors: P
authors: Loa
authors: John
authors: J
authors: McGrath
authors: Bryan
authors: B
authors: Mowry
mesh_terms: D000328:Adult; D001315:Australia / Q000208:ethnology; D003431:Cross-Cultural Comparison; D003702:Delusions / Q000208:ethnology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006212:Hallucinations / Q000208:ethnology*; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000175:diagnosis / Q000208:ethnology*