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Eight - The Evolution of Community Epidemiological Studies in India: A Subaltern Critique
- Edited by Anne M. Lovell, Institut national de la santé et de la recherche médicale, Paris, Gerald M. Oppenheimer, City University of New York and Columbia University, New York
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- Book:
- Reimagining Psychiatric Epidemiology in a Global Frame
- Published by:
- Boydell & Brewer
- Published online:
- 15 February 2024
- Print publication:
- 03 June 2022, pp 250-282
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- Chapter
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Summary
A Subaltern Framework for Psychiatric Epidemiology in India
The World Health Organization (WHO) international program on the epidemiology of mental disorders began in the 1950s. By the 1960s, ground rules had been established for what was becoming the scientific discipline of psychiatric epidemiology and for facilitating its expansion throughout the world. Non-Western countries like India soon initiated studies in this area within their own constraints. By the 1960s, psychiatric epidemiology articles first appeared in the Indian Journal of Psychiatry. They borrowed methods and tools from the Western epidemiological canon but for different purposes and with markedly different results than those produced in wealthier countries. In retrospect, dissimilarities between findings in India and in Western countries tended to be attributed to methodological rather than contextual factors.
This chapter explores the specificity and evolution of the epidemiology of mental disorders in India and their social, cultural, and political significance. Numerous scholars claim that the history of psychiatry in India began in a period of Indian subalternity to British colonizers, who represented the diversity of “Indian” pasts through a homogenizing narrative of transition from a “medieval” period to “modernity.” We argue that psychiatric epidemiology in post-Independent India also exists in a position of subalternity but to a globalized psychiatry that has developed in the global North. This chapter further addresses subalternity within India by focusing on the mental health of lower castes, slum-dwellers, and other subpopulations that exist in a subaltern relation to social groups in their own country.
The “subaltern,” as we use the term, stands in an ambiguous relation to power, subordinate to it without fully consenting to its rule. Nor does it accept the point of view or vocabulary of dominant powers as a valid expression of its own subaltern identity. The Italian Marxist Antonio Gramsci (1981–1937) used the term subaltern to designate social groups subjected to the hegemonic power of a society's ruling class. In the 1980s, the Subaltern Studies Group, a collective of radical historians from the Indian subcontinent, re-conceptualized the term, focusing their attention on the disenfranchised peoples of India. “Subaltern studies” came to signify a “history from below.” Proponents of subaltern studies have produced counter-discourses that contest the dominant colonial, postcolonial, and post-imperial narratives, with the hope of connecting their analytic work to acts of resistance by oppressed peoples themselves.
Meditation-induced psychosis: a narrative review and individual patient data analysis
- Pawan Sharma, Ananya Mahapatra, Rishab Gupta
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- Journal:
- Irish Journal of Psychological Medicine / Volume 39 / Issue 4 / December 2022
- Published online by Cambridge University Press:
- 31 October 2019, pp. 391-397
- Print publication:
- December 2022
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- Article
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Background:
Meditation is associated with health benefits; however, there are reports that it may trigger or exacerbate psychotic states. In this review, we aim to collate case reports of psychotic disorders occurring in association with meditative practice and to discuss the relationship between psychosis and meditation.
Methodology:We performed case-based analysis of all the existing studies published in English language using PubMed, PsycINFO, Cochrane, Scopus, EMBASE, CINAHL and Google Scholar with the search terms; ‘Psychosis’ OR ‘Psychotic Symptoms’ OR ‘Schizophrenia’ AND ‘Meditation.’
Results:A total of 19 studies and 28 cases were included in the review. The patients described had an age range of 18–57 years; there was equal distribution of males and females. The diagnoses included acute psychosis in 14 cases, schizophrenia in 7 cases, mania with psychotic symptoms in 3 cases, and schizoaffective disorder in 1 case. The types of meditation described were Transcendent, Mindfulness, Buddhist Meditation like Qigong, Zen, and Theraveda, and others like Bikram yoga, Pranic Healing, and Hindustan Type meditation. Of the 28 cases reported, 14 patients had certain precipitating factors like insomnia, lack of food intake, history of mental illness, stress, and psychoactive substance use.
Conclusion:There are case reports of psychotic disorder arising in association with meditative practice; however, it is difficult to attribute a causal relationship between the two. At the same time, there is a body of research describing the beneficial effect of meditative practice in clinical settings for patients with psychotic disorders. Appropriately designed studies are needed to further investigate the relationship between meditative practice and psychosis.