Gyroscopic Investing

The World Health Organization conducted two long-term follow-up studies involving more than 2,000 people suffering from schizophrenia in different countries. These studies found patients have much better long-term outcomes in developing countries (India, Colombia and Nigeria) than in developed countries (USA, UK, Ireland, Denmark, Czech Republic, Slovakia, Japan, and Russia),[40] despite the fact that antipsychotic drugs are typically not widely available in poorer countries, raising questions about the effectiveness of such drug-based treatments.

In many non-Western societies, schizophrenia may only be treated with more informal, community-led methods. Multiple international surveys by the World Health Organization over several decades have indicated that the outcome for people diagnosed with schizophrenia in non-Western countries is on average better there than for people in the West.[41] Many clinicians and researchers hypothesize that this difference is due to relative levels of social connectedness and acceptance,[42] although further cross-cultural studies are seeking to clarify the findings.

Several factors are associated with a better prognosis: female gender, acute (vs. insidious) onset of symptoms, older age of first episode, predominantly positive (rather than negative) symptoms, presence of mood symptoms and good premorbid functioning.[23][24] Most studies done on this subject, however, are correlational in nature, and a clear cause-and-effect relationship is difficult to establish. Evidence is also consistent that negative attitudes towards individuals with schizophrenia can have a significant adverse impact, especially within the individual's family. Family members' critical comments, hostility, authoritarian and intrusive or controlling attitudes (termed high 'expressed emotion' or 'EE' by researchers) have been found to correlate with a higher risk of relapse in schizophrenia across cultures.[25]

INTREPID is a programme of research designed to: a) develop robust, comparable methods for the study of schizophrenia and other psychoses in diverse settings (Phase 1); and b) implement these in a three-country study of the epidemiology, phenomenology, aetiology and outcome of psychoses (Phase 2).  INTREPID is being conducted in defined catchment areas in three countries: Chengalpet talk (near Chennai), India; Ibadan South East and Ona Ara, Ibadan, Nigeria; and Tunapuna-Piarco, Trinidad.

TennPaGa wrote: Watters has two main explicit insights. First: People in every culture experience trauma and stress, but they find different ways of expressing and understanding their suffering—lending it meaning by embedding it in a narrative—based on the “symptom pools”? provided to them by their cultures. When a new disorder enters the cultural “symptom pool,”? people in distress will begin to manifest the symptoms of that disorder, whether it’s the day blindness of Victorian hysterics or the body dysmorphia of (some) American anorexics. Shifts in cultural narratives will shift the symptom pool, and thereby change the ways people manifest their suffering. Importantly, cultural narratives also shift how people relieve suffering, if and when they do relieve it. When it comes to mental illness, not only the diseases but the cures are culturally-conditioned.