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Culture and psychiatric epidemiology

Culture refers to values, beliefs, knowledge, norms, and practices and the notion that these are shared among a specific set of people. Culture shapes the meaning and social experience of mental illness; influences the types of exposures to factors that cause mental illness; and moderates the relationship between risks and mental health outcomes. Cultural differences in models of causality and labelling of mental illnesses contribute to degree of family support, use of religious and traditional healing, and engagement with biomedical care systems. Cultural variations in describing, disclosing, and categorizing suffering are also sources of potential bias in epidemiological research. Instruments developed in one culture may be used in others, but greater emphasis must be placed on their adaptation to ensure equivalence. Use of cultural frameworks is crucial to optimize utilization and outcomes of culturally adapted psychological treatments and other mental health interventions.