Epidemiological and sociocultural factors in the etiology of duodenal ulcer

Negotiation of the illness experience: Ayurvedic therapy and the psychosocial dimension of illness

The negotiation of the illness experience by ayurvedic vaidya and South Kanarese patients suffering from specific sources of psychosocial distress is examined in light of the cultural patterning of illness and communication within the clinical context. The negotiation process is initiated by the posing of rhetorical questions about somatic and affective states and structured by a conceptual framework which relegates such states to humoral interrelationships. By establishing a humoral explanatory model for an illness episode or affective state which takes into account environmental and constitutional factors over which one has little control, responsibility is mollified and dialogue about personal problems eased. A comparison of the interaction between ayurvedic practitioners and patients and astrologers and clients is made in this regard. The socially integrative and adaptive consequences of ayurvedic therapy is considered vis a vis a portrayal of a popular vaidya therapy for a number of illnesses associated with the somatization of psychosocial stress.

Migration, culture and mental health

The former belief that immigrants always suffer from an excess of mental disorder is no longer valid, and the old rivalry between social selection and social causation hypotheses has lost much of its relevance. The mental health of a migrant group is determined by factors relating to the society of origin, factors relating to the migration itself, and factors operating in the society of resettlement; and all three sets need to be considered if one seeks to reduce or merely to understand the level of mental disorder in any immigrant group. Illustrations from each set of factors are presented, with indications of whether they appear to have general relevance or be related to specific mental disorders.