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Psychiatry: medicine benefits from cultural and personal insights

Anthropology is a valuable component of the multidisciplinary research effort into psychiatric disorders that is recommended in your Editorial (Nature 463, 9; 2010).

Since the 1920s, anthropologists have helped psychiatrists consider the cultural factors influencing their patients, and psychiatrists have helped anthropologists focus on the individual in their societal studies. Anthropologists have published important ethnographic texts on such topics as the structure and culture of psychiatric hospitals, patients' transition to community life after being deinstitutionalized, and the shifting historical circumstances that contribute to both professional and personal understandings of psychiatric disorders.

Too often dismissed as merely 'anecdotal', anthropology emphasizes the lived experiences of individuals with psychiatric disorders — experiences that rarely figure in research protocols and quantitative data. Elyn Saks, an associate dean and law professor at the University of Southern California, Los Angeles, who has schizophrenia, says that denial of mental illness is not a psychiatric symptom but a defence mechanism against the realization that there is something wrong with the way one perceives the world (E. R. Saks Am. J. Psychiatry 166, 972–973; 2009). By listening to the personal stories of different patients, anthropologists stumble upon observations such as these all the time. Anthropology offers the opportunity to bring individual voices into conversation with the psychiatrists and scientists who are focused on the bigger picture.

Although anthropological research may be limited in scope — the subject population often numbers only in the tens — the perspective of a medical outsider with a different analytical lens can reveal new avenues of inquiry that clinical studies, in their need to conform to the standards of evidence-based medicine, may overlook. Given the limited knowledge of the biology underlying psychiatric disorders, it is time to open up the research agenda to disciplines that think outside the medical box.

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Rubinstein, E. Psychiatry: medicine benefits from cultural and personal insights. Nature 463, 424 (2010).

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