A biocultural approach to psychiatric illnesses

Psychopharmacology (Berl). 2019 Oct;236(10):2923-2936. doi: 10.1007/s00213-019-5178-7. Epub 2019 Feb 5.

Abstract

Rationale: As a species, humans are vulnerable to numerous mental disorders, including depression and schizophrenia. This susceptibility may be due to the evolution of our large, complex brains, or perhaps because these illnesses counterintuitively confer some adaptive advantage. Additionally, cultural and biological factors may contribute to susceptibility and variation in mental illness experience and expression. Taking a holistic perspective could strengthen our understanding of these illnesses in diverse cultural contexts.

Objectives: This paper reviews some of these potential factors and contextualizes mental disorders within a biocultural framework.

Results: There is growing evidence that suggests cultural norms may influence inflammation, neurotransmitters, and neurobiology, as well as the illness experience. Specific examples include variation in schizophrenia delusions between countries, differences in links between inflammation and emotion between the United States and Japan, and differences in brain activity between Caucasian and Asian participants indicating that cultural values may moderate cognitive processes related to social cognition and interoception.

Conclusions: Research agendas that are grounded in an appreciation of biocultural diversity as it relates to psychiatric illness represent key areas for truly interdisciplinary research that can result in culturally sensitive treatments and highlight possible biological variation affecting medical treatment.

Keywords: Biocultural; Culture; Depression; Evolutionary medicine; Neuroinflammation; Schizophrenia.

Publication types

  • Review

MeSH terms

  • Cross-Cultural Comparison*
  • Depressive Disorder / ethnology
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy
  • Humans
  • Japan / ethnology
  • Mental Disorders / ethnology*
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Schizophrenia / ethnology
  • Schizophrenia / therapy
  • Schizophrenic Psychology
  • United States / ethnology
  • White People / ethnology
  • White People / psychology