Differences in voice-hearing experiences of people with psychosis in the U.S.A., India and Ghana: interview-based study.

BACKGROUND: We still know little about whether and how the auditory hallucinations associated with serious psychotic disorder shift across cultural boundaries. AIMS: To compare auditory hallucinations across three different cultures, by means of an interview-based study. METHOD: An anthropologist and several psychiatrists interviewed participants from the USA, India and Ghana, each sample comprising 20 persons who heard voices and met the inclusion criteria of schizophrenia, about their experience of voices. RESULTS: Participants in the U.S.A. were more likely to use diagnostic labels and to report violent commands than those in India and Ghana, who were more likely than the Americans to report rich relationships with their voices and less likely to describe the voices as the sign of a violated mind. CONCLUSIONS: These observations suggest that the voice-hearing experiences of people with serious psychotic disorder are shaped by local culture. These differences may have clinical implications.

A cross-sectional comparison of drinking patterns, alcohol use and related medical morbidities in a secondary versus tertiary setting.

BACKGROUND: Alcohol Dependence exists in different spectrums at different settings and associated with various medical morbidities, disability and health care utilization costs. OBJECTIVES: To study the drinking patterns, alcohol use disorders and alcohol related medical morbidities in patients diagnosed with Alcohol Dependence Syndrome (ADS) and attending out / in-patient psychiatry services at secondary and tertiary care centre. METHODS: A cross-sectional comparative study was done among the patients diagnosed with ADS attending psychiatry services at District hospital, Udupi and Kasturba Hospital, Manipal. Serial sampling was done. Patients having any other psychiatric illnesses were excluded. The two groups were compared in relation to socio-demographic variables, drinking related variables, patterns of drinking and alcohol related medical morbidities identified. RESULTS: Significant differences in some socio-demographic parameters among the patients from the two different treatment centers were found with secondary level hospital (N=50) having more illiterate, laborers and below the poverty line population in comparison to the tertiary level hospital (N=75). Maximum frequency of gastrointestinal morbidities was seen in both the hospital population, irrespective of the patterns of drinking. CONCLUSION: Alcohol use disorders and alcohol related medical morbidities show some variations in their presentations in the different treatment centers.