Cultural variations in psychosis: Recent research and clinical implications.

Abstract

This article introduces a thematic issue of Transcultural Psychiatry dedicated to understanding the role of culture in the expression and treatment of psychotic symptoms. While many clinicians and researchers view psychotic disorders as brain diseases firmly rooted in neurological processes and requiring medical treatments to resolve, the papers in this issue propose something different: that psychotic symptoms are refracted through the lens of culture with the result being socially and culturally constructed disorders that have as much to do with the attitudes and knowledge systems of the observer as the lived experience of patients. Hence, expression of psychotic symptoms and disorders represent the result of a negotiated space between individual distress and the values and norms of the wider society. This thematic issue touches on several important points: critical perspectives of high rates of psychosis in migrants, the lack of culturally adapted research and clinical tools in psychosis work, new methods to engage people with psychosis from diverse backgrounds, and cultural issues related to the etiology of psychosis, interpretation of symptoms, and help-seeking. There remain many important topics at the intersection of culture and psychosis not covered by this thematic issue, including stigma and psychosis, delusion formation in cultural context, the history of psychosis concepts, and insight in psychosis. Yet, despite these omissions, the articles in this issue, as a whole, foster recognition of the limits of standard approaches to psychosis and advocate for culturally adapted assessments and interventions, which if implemented from a position of cultural humility, carry the long-term potential of revolutionizing the field.