In this paper, I discuss the issues related to schizophrenia as a `transforming' and `milder manifestation' of the disorder from a perspective of cultural psychiatry. In the first half, I examine the discussions on schizophrenia as a `moving target', including the writings of Shin Tarumi, J. E. D. Esquirol, Hisao Nakai, Georges Devereux, Ian Hacking, and Kunio Yanagita.
The concept of schizophrenia has been considered from 1908 until now to hold an unshakeable position of `universal syndrome' (Nakai) observed worldwide. However, recent findings of `milder manifestations' of this disorder revealed important aspects of its plasticity according to its historical and cultural background.
In the second half, I explore two main approaches to this issue; one emphasizes the aspect of `matter (Mono)' and the other emphasizes an `event (Koto)'. The former emphasizes the medical and scientific aspect of `substance' or `entity', and the latter emphasizes `occurrence' and `relationship' in human science.
In the 21st century, attitudes toward disabilities are apt to bridge the gap between normal and abnormal, but the viewpoints from psychiatry often stress the clear boundary between the two. This apparent contradiction is widening.
For the future normalization of symptoms, it is necessary to understand schizophrenia as a malleable disease concept in the context of triadic interaction among patient, doctor, and diagnostic criteria.
Author's abstract
Schizophrenia: From a Viewpoint of Cultural Psychiatry
Tokyo Musashino Hospital, Department of Psychiatry
Psychiatria et Neurologia Japonica
123: 583-591, 2021
<Keywords:schizophrenia (milder manifestation), cultural psychiatry, ethnopsychiatry (Devereux), indifferent/interactive kinds (Hacking), culture-bound syndrome>