Defeat Depression Campaign

Non-compliance and related phenomena

Objective:Review of literature on non-compliance with medication in psychiatric patients.

Method:Computer and manual search of English language literature on non-compliance with drugs, psychiatric disorder, and phenomena which may be related, such as readmission and discharge against medical advice.

Results:The literature is discussed and a tentative checklist of risk factors for non-compliance is offered, as is advice on ways in which the problem may be minimised. It is noted that there is an emphasis on major mental disorders in the published literature.

Conclusion:There is no stereotypical defaulter. A high index of suspicion is essential. As far as possible, the patient should be educated to share in the responsibility for treatment, and concerned relatives and others can often play a pivotal role. More research is required on compliance problems in the minor psychiatric disorders. Close liaison with the general practitioner is vital.

Biopolíticas da depressão nos imigrantes Africanos

Este artigo foca o tema controverso das biopolíticas da depressão em imigrantes, em particular nos originários da África sub-sahariana. Os sintomas depressivos, ligados à ansiedade, são identificados também pela nova e mais importante patologia mental dos imigrantes: a Síndroma de Ulisses, de stress múltiplo e crónico, já definido como "o mal do século vinte e um", e que atinge principalmente os africanos. Não só entre estes imigrantes mas também em África, segundo um estudo conduzido pela OMS, a depressão tornou-se uma das principais patologias mentais. O tratamento farmacológico do sofrimento, entendido como fenómeno orgânico, é considerado o único caminho possível, silenciando os processos históricos, políticos e socioeconómicos que lhe estão na base. A atenção é portanto focada na saúde mental do indivíduo, desviando-a de problemas sociais de difícil resolução, que necessitariam de respostas económicas e políticas.

A Cultural Critique of Community Psychiatry in India

This article is the first comprehensive cultural critique of India's official community mental health policy and program. Data are based on a literature review of published papers, conference proceedings, analyses of official policy and popular media, interviews with key Indian mental health professionals, and fieldwork in Kanpur district, Uttar Pradesh (2004–2006). The authors demonstrate how three influences have shaped community psychiatry in India: a cultural asymmetry between health professionals and the wider society, psychiatry's search for both professional and social legitimacy, and WHO policies that have provided the overall direction to the development of services. Taken together, the consequences are that rural community voices have been edited out. The authors hypothesize that community psychiatry in India is a bureaucratic and culturally incongruent endeavor that increases the divide between psychiatry and local rural communities. Such a claim requires sustained ethnographic fieldwork to reveal the dynamics of the gap between community and professional experiences. The development of culturally sensitive psychiatric theory and clinical services is essential to improve the mental health of rural citizens who place their trust in India's biomedical network.

The cultural origins of western depression

Focusing on the British cultural vocabulary of guilt, fatigue, energy, stress and depression; this paper argues that such vocabularies have their own unique histories and meanings; deeply embedded, in this instance, within "white British and western European" institutions. Predicated on a western epistemology, these constructs developed in response to prevailing concerns at different periods in western history; but are now assumed to be universal natural entities that await further scientific research and investigation. The cross-cultural validity of depression as a universal disorder is therefore dubious and needs an extensive re-examination.