An editorial in Nature argues that funding is meager for research on psychiatric diseases compared to that for other major diseases. Focusing just on schizophrenia, new directions for the upcoming decade include: considering why the efficacy of medications has not improved other than reducing side effects; changing the focus on diagnosis and drugs in late stages of the disease to identifying biomarkers and environmental factors that put people at risk; devoting more research to deeper understanding of the underlying biology; devoting more research to “environmental” (socio-cultural) factors; bringing together knowledge in various disciplines; deepening the exposure of psychiatrists to biology.
This blogger adds that a deepened exposure of psychiatrists to medical anthropology and its attention to environmental factors including illness labeling, stigma, and non-medical treatment options is even more important than more biology. If it is in fact true that, as the editorial claims, about 80% of the pattern of schizophrenia in populations “seems to be determined by genetics” with an unknown share of that percentage “susceptible” to environmental influences, and if the other 20% is directly determined by “environmental factors,” then the proportion that is purely or directly biological alone may be more like 60%…and the other 40% either directly or indirectly shaped by environmental factors. Who knows – these percentages all “seem” to be guesswork, but even the crudest guesswork leaves a lot of room for social/cultural factors. And it just may be easier to deal with/change/prevent such social/cultural factors than it is to mess around with someone’s genes.
The next decade for psychiatry should be the decade of cultural psychiatry.
Image: “Brains” by Flickr user Curious Expeditions, licensed by Creative Commons.
anthropologyworks 
I appreciate your comments. I have an article under review with Culture, Medicine and Psychiatry that promotes just this kind of work. I am also hoping to present similar ideas at the Adler Professional School of Psychology’s Conference in June 2010 on the Social Determinants of Mental Health. There is a good body of anthropological literature on social and cultural factors that influence schizophrenia, which my chapter outlines (as does my dissertation), but there is a great need to consider the framework of psychoneuroimmunology which utilizes biomarkers of social distress and promises to give us a platform for understanding how social stress creates psychiatric symptoms and how teaching people nonmedical methods for mediating that stress — like meditation, yoga, etc. — may help people heal. My current postdoc with the Center for the Study of Complementary Therapies at the University of Virginia, I hope, will allow me to look into this further.
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Neely, Thanks so much for sharing this information about your work. I look forward to seeing your article in CMP. All the best, Barbara
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