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Subjective experience of persistent schizophrenia and depression among US Latinos and Euro-Americans

Published online by Cambridge University Press:  03 January 2018

Janis Hunter Jenkins*
Affiliation:
Russell Sage Foundation, 112 East 64th Street, New York, NY10021, USA

Abstract

Background

The aims were to investigate cross-culturally the subjective experience of long-term psychiatric patients to determine whether or not they would define their current life situation predominantly in terms of illness.

Method

The design is a two-by-two comparison by ethnicity (Latino and Euro-American) and diagnosis (schizophrenia and unipolar depression) of 80 subjects for DSM–III–R criteria according to the SADS. Patients were interviewed using a semi-structured interview (Context of Illness Experience) yielding data coded for qualitative and quantitative analyses.

Results

While significant ethnic differences were observed, nearly half the sample did not include illness in their description of their life situation. Other domains (e. g. activities, events) and the extent to which patients perceived themselves as in- or out-of-step with the “rhythm of life” were identified as central patient concerns.

Conclusions

Empirical research on the subjective experiences and representations of the life situation of patients offers clues to the course and treatment of persistent psychiatric disorder.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington. DC: APA.Google Scholar
Bobbington, P. & Kuipers, L. (1994) The predictive utility of expressed emotion in schizophrenia: an aggregate analysis. Psychological Medicine. 24, 111.Google Scholar
Brown, G. & Harris, T. (1978) Social Origins of Depression: A Study of Psychiatric Disorder in Women. New York: The Free Press.Google Scholar
Coehlo, V. (1995) Culture and psychopathology: schizophrenia and depression among Latinos and Euro-Americans. PhD thesis. Department of Psychology. Case Western Reserve University.Google Scholar
Corin, E. (1990) Facts and meaning in psychiatry: an anthropological approach to the lifeworld of schizophrenics. Culture. Medicine, and Psychiatry. 14, 153188.CrossRefGoogle Scholar
Cuellar, I., Harris, L. C. & Jasso, R. (1980) An acculturation scale for Mexican-American normal and clinical populations. Hispanic Journal of Behavioural Science, 2, 199217.Google Scholar
Good, B. G. (1992) Culture and psychopathology: directions for psychiatric anthropology. In New Directions for Psychological Anthropology (eds T. Schwartz, G. White & C. Lutz), pp. 181205. Cambridge: Cambridge University Press.Google Scholar
Good, B. G. (1994) Medicine, Rationality and Experience: An Anthropological Perspective. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Helman, C. G. (1995) The body image in health and disease: exploring patients' maps of body and self. Patient Education and Counselling, 26, 169175.CrossRefGoogle ScholarPubMed
Jenkins, J. H. (1988) Ethnopsychiatric conceptions of schizophrenic illness: the problem of nervios within Mexican – American families. Culture, Medicine, and Psychiatry, 12, 303331.CrossRefGoogle ScholarPubMed
Jenkins, J. H. (1994) Culture, emotion, and psychopathology. In Emotion and Culture: Empirical Studies of Mutual Influence (eds S. Kitayama & H. Markus), pp. 307335. Washington, DC: American Psychological Association Press.Google Scholar
Jenkins, J. H. & Karno, M. (1992) The meaning of “expressed emotion”: Theoretical issues raised by cross-cultural research. American Journal of Psychiatry. 149, 921.Google ScholarPubMed
Karno, M. & Jenkins, J. H. (1997) Culture and the diagnosis of schizophrenia and related disorders and psychotic disorders not otherwise classified. In Considerations for DSM–IV: A Sourcebook, vol. 3 (eds J. E. Mezzich, A. Kleinman, H. Fabrega, et al), in press. Washington, DC: APA.Google Scholar
Karno, M. & Jenkins, J. H., de la Selva, A., et al (1987) Expressed emotion and schizophrenic outcome among Mexican–American families. Journal of Nervous and Mental Disorders. 175, 143151.CrossRefGoogle ScholarPubMed
Kleinman, A. (1980) Patients and Healers in the Context of Culture. An Exploration of the Borderland between Anthropology. Medicine, and Psychiatry. Berkeley, CA: University of California Press.CrossRefGoogle Scholar
Kleinman, A. (1988a) Rethinking Psychiatry: From Cultural Category to Personal Experience. New York: The Free Press.Google Scholar
Kleinman, A. (1988b) The Illness Narratives: Suffering, Healing and the Human Condition. New York: Basic Books.Google Scholar
Kleinman, A. (1995) Writing at the Margin: Discourse between Anthropology and Medicine. Berkeley. CA: University of California Press.Google Scholar
Kring, A. M., Kerr, S. D., Smith, D. A., et al (1993) Flat affect in schizophrenia does not reflect diminished subjective experience of emotion. Journal of Abnormal Psychology, 102, 507517.CrossRefGoogle Scholar
Laing, R. D. (1967) The Politics of Experience. Harmonds-worth: Penguin.Google Scholar
Leff, J. & Vaughn, C. (1985) Expressed Emotion in Families: Its Significance for Mental Illness. New York: Guilford Press.Google Scholar
Lewis, O. (1968) La Vida: A Puerto Rican Family m the Culture of Poverty. New York: Panther Modern Society.Google Scholar
Scheper-Hughes, N. (1979) Scents, Scholars and Schizophrenics: Mental Illness in Rural Ireland. Berkeley. CA: University of California Press.Google Scholar
Spitzer, R. L. & Endicott, J. (1978) A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry, 35, 837844.Google Scholar
Strauss, J. (1989) Subjective experiences of schizophrenia: toward a new dynamic psychiatry – II. Schizophrenia Bulletin, 15, 179187.CrossRefGoogle Scholar
Strauss, J. & Estroff, S. (1989) Foreword to subjective experiences of schizophrenia: toward a new dynamic psychiatry – II. Schizophrenia Bulletin, 15, 177178.CrossRefGoogle Scholar
Strauss, J. (1994) The person with schizophrenia as a person. II: Approaches to the subjective and complex. British Journal of Psychiatry, 164 (suppl. 23). 103107.CrossRefGoogle Scholar
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