EDITORS' INTRODUCTION

Schizophrenia has a special place in the field of psychiatry in general and cultural psychiatry in particular. This was the first psychiatric condition which was studied across cultures under the aegis of the World Health Organisation (WHO). The two studies – the International Pilot Study of Schizophrenia and Determinants of Outcome of Severe Mental Disorders – set the benchmark for comparing illnesses across cultures. While welcomed by the epidemiologists that similar epidemiological methods can be employed across cultures, the critique by anthropologists and social scientists claimed that these studies looked at commonalities and ignored the differences. There is also some evidence that the outcome of schizophrenia appears to be better in low-income countries, although these findings have been challenged.

Jablensky, as one of the original scientists involved in the WHO studies, provides an overview of schizophrenia research across cultures. He gives a brief introduction to the epidemiology but focuses on phenotypic comparability of schizophrenia across populations. This is an important point if one is to deal with the question of misdiagnosis, which is sometimes seen as conflating the rates of schizophrenia. He emphasises that schizophrenic disorders in non-Western populations can be reliably distinguished from the acute transient psychoses and other disorders such as affective disorders, although he acknowledges that there may be some symptomatic overlap between affective disorders and schizophrenia. Jablensky cautions that a good deal of the variation may be attributed to methodological difficulties, including study design, sample size, diagnostic patterns and methods of data analysis. The real variation noted in these rates is possibly related to the multifactorial nature of the illness.