title: Cross cultural variations in psychiatrists' perception of mental illness: A tool for teaching culture in psychiatry.
abstract: A frequent debate in psychiatry is to what extent major psychiatric diagnoses are universal versus unique across cultures. We sought to identify cultural variations between psychiatrists' diagnostic practices of mental illness in Boston Massachusetts and Bangalore, India. We surveyed psychiatrists to identify differences in how frequently symptoms appear in major mental illness in two culturally and geographically different cities. Indian psychiatrists found somatic symptoms like pain, sleep and appetite to be significantly more important in depression and violent and aggressive behavior to be significantly more common in mania than did American psychiatrists. American psychiatrists found pessimism about the future to be more significant in depression and pressured speech and marked distractibility to be more significant in mania than among Indian psychiatrists. Both groups agreed the top four symptoms of psychosis were paranoia, lack of insight, delusions and auditory hallucinations and both groups agreed that visual hallucinations and motor peculiarities to be least significant. Despite a different set of resources, both groups noted similar barriers to mental health care access. However, American psychiatrists found substance abuse to be a significant barrier to care whereas Indian psychiatrists found embarrassing the family was a significant barrier to accessing care. Because psychiatrists see a large volume of individuals across different cultures, their collective perception of most common symptoms in psychiatric illness is a tool in finding cultural patterns.
authors.affiliation: Bridgewater State Hospital, Massachusetts Partnership in Correctional Healthcare, Visiting Associate Psychiatrist at Brigham and Women's Hospital, USA. Electronic address: Jhilam@gmail.com.
authors.forename: Jhilam
authors.initials: J
authors.lastname: Biswas
authors.affiliation: Department of Psychiatry, Director, National Institute of Mental Health and Neuroscience (NIMHANS), USA.
authors.forename: B N
authors.initials: BN
authors.lastname: Gangadhar
authors.affiliation: Department of Psychiatry. Professor, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, USA.
authors.forename: Matcheri
authors.initials: M
authors.lastname: Keshavan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel / Q000208:ethnology*; D001900:Boston / Q000208:ethnology; D003431:Cross-Cultural Comparison; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D010820:Physicians; D011570:Psychiatry
keywords: Cross cultural psychiatry; Global mental health; Psychiatric diagnoses; Psychiatric perception