Is schizophrenia universal? An open question

Abstract

What conclusions can be drawn from the survey of studies of schizophrenia in less developed areas? The following points should be considered: There are three early anthropological observations that schizophrenia did not exist among people with little or no contact with Western technology. The single field study in a minimally developed area (northern Gold Coast) found nine cases of schizophrenia which, according to the author, could also have been diagnosed as trypanosomiasis (Tooth 1950). The prevalence of schizophrenia in developing areas appears to be roughly correlated with the degree of Western acculturation. If mentally ill individuals who live 'in the bush' present as cases of classic schizophrenia, some psychiatrists say that they may not have schizophrenia at all but rather organic brain disease (Lambo 1965 and Tooth 1950). The studies which report cases of schizophrenia among true 'bush' individuals are cases of 'reactive' and not 'process' schizophrenia. The 'reactive' variety is seen commonly among soldiers under fire, prisoners, immigrants, and Peace Corps volunteers. In any case, none of the studies reported 'process' schizophrenia among individuals who had not had significant exposure to Western technology. In light of the above observations, it seems unwarranted to conclude that schizophrenia is universal.