Devrai: Story of a Schizophrenic

#26

About Schizophrenia in general,there is nothing in black and white terms accept 3 factors, as my teacher Dr. Kulhara(who was student of Dr. Goldberg, and worked with T.J.Crow for some time) used to say:
1. there is somehing known as schizophrenia
2. antipsychotics work
3. there are some biochemical/anatomical abnormalities in their brains.

But, then lot os studies have delineated some facors at least which are corelated with different aspects of schizophrenia. Stable family and positive inter-personal reltions and family ensuring that patient takes medication, taking the patient to doctor and monitoring his treatment anad progress are among such factors, which are still present in abundance in our society.
How India copes with pressures of Industrialization, is good research subject for the next generation professionals(if they themselves survive the temptations of corporate sector entering into mental health practice)
Howver, What we have observed and reported in our studies on drug dependence,particularly opioids, is that patints from rural sector have better outcomes as compared to their urban counterparts,though their are some differences on socio-demographic and drug related/clinical variables s well.

Re: # 23
But Dr Lokraj, there still is no absolute explanation. Even the CTP doesn`t explain what exactly it is about less developed countries. I do think though, that you are right about denial that poor countries are getting something right. I think it should be interesting to see if Indians with schizophrenia start to fare worse as society becomes more industrialised and there is more globalisation. Mohan Agashe was my examiner some years ago,btw.

#24
Thats about the coping patterns at societal/cultural level.

drlokraj:

hehehe...good observation!

achcha lagay haathouN #19 ka jawab bhee day daiN, meherbani hogi

``No one knows as yet what the answer is, why does this happens?``

temporal ,that is not the case for the whole world.Let Australia keep teaching that to its students.Comprehensive Text Book of Psychiatry outlines some very clear factors associated with better outcome.
Also,PGI,Chandigarh and Agra were two centres in north India in the WHO study on course and outcome of Schizophrenia, which reprted the findings.
Some people may be finding it difficult to accept that even so called backward countries can be ``better`` in some aspect. Temporal bhai,this is example of denial and I am resting my case here.

nb #21:

No one knows as yet what the answer is, why does this happens?

thanks...i hear you and lokraj

Re: # 14
t-bhai,
It is a fact that people in developed countries do show less re-integartion and less recovery than those in developed countries, and not just desis-this applies equally to Latin America,China, and most countries in Africa.
No one knows as yet what the answer is, why does this happens?A well known Australian researcher said to me in all earnestness that he thought people in the subcontinent,at least, developed a milder form of schizophrenia. I`m sure it`s not that. Nor is it, like some other textbooks say, because societies in developed socieities are `simpler`. I genuinely believe that annoying as desi society can be, those closest to us do not abandon us because we are of no use to them any more-not usually, anyway.

Despite the flaws (pointed out gleefully by the usual suspects!), a nice enough review, left me wanting to see the movie. Marathi parallel cinema has always been highly underrated (``Shwaas`` last year about a blind boy and his grandafther, I think, was another like this one). Will definitely take a dekko and post my own review....

drlokraj #18:

yes mine was on an individual level!

... will you clarify if the assertion in your second paragraph pertains to societal or individual levels?

#14
Temporal

you are talking of ego defence at individual level.At societal level, the defences are different and there is difference between defence mechanisms and coping strategies.As I said earlier, more discussion will digress fro the topic on board.

The claim about Eastern societies fairing better than West on this front(outcome of psychiatric disorders) is not mine, it is the result of perhaps the most robust multi-centric transcultural study by WHO on the outcome and prognosis of Schizophrenia coducted so far and is a point of reference on the subject all over the world. In India, there are several Govt. and non govt. organizations working very hard on this subject, like SCARF at Chennai and NIMHANS at Bangalore,Rationalists Society of India, besides many organizatios at Bombay.Dr. Mohan Agashe, the well known actor of Marathi and Hindi films and Marathi theatre,is himself a leading psychiatrist of Pune and is active in the field of psycho-education as well.I have done a small bit on my part by publishing several articles in Dainik Bhaaskar(most widely published Indian News Paper),Punjabi Tribune and several magazines, on mental disorders including schizophrenia, and delivering talks on mental health and related issues in public gatherings organized by NGOs.

Devrai is indeed a brilliant movie. I liked Sonali`s performance more than Atul Kulkarni, because the role of a diffident woman with a brother who has that disease gave less scope for excelling than the role of a schizophrenic itself. Yet she has excelled. I know it might be sacrilege to say this, but Sonali Kulkarni is THE best Indian actress ever, with a range and expertise that surpasses even Shabana and Smita Patil.

Another decent Marathi movie about this disease......or rather about MPD is Ratra-Aarambh. It is less educative, more of a thriller-cum-tear-jerker, and has far inferior production values. But worth a watch anyway. Splendid performance by Dilip Prabhavalkar. Will be tough to get a subtitled copy of it though.

i would have preferred a title something like ``Twisted Realities`` for the same. while filing the article it didn`t occur to me. And left it to the discretion of the editors.

i would have preferred a title something like ``Twisted Realities`` for the same. while filing the article it didn`t occur to me. And left it to the discretion of the editors.

#13:

janab:

What you are refering to is not denial, it is lack of education. Denial is refusal to accept something while knowing fully about it.

in my mind we are in a grey area...here is a definition i’d lean more to:

“denial, in psychology, an ego defense mechanism that operates unconsciously to resolve emotional conflict, and to allay anxiety by refusing to perceive the more unpleasant aspects of external reality.”

and this:

…inspite of lack of resources and lack of awareness about scientific knowledge about the causation of mental disorders, the eastern countries are much better off in this aspect.............be it psychosis, neurosis,personality disorders or drug and alcohol dependence..........and the difference is because of the family system and the relationships, and values and the culture…

ok!…let me say it is not denial ( as I say) in the east but lack of education (as you put it)…even then i would find this claim of yours a little hard to digest…

…in the east more of these conditions are swept under the rug or mis-diagnosed and mistreated…(based on personal and anecodtal narrations)

...but then you are the expert in the field!

rgds

t

#12, thanks for the mail.

I am not going to explain these factors in detail here, because thats a subject of Psychiatry and taught to post graduate students.

What you are refering to is not denial, it is lack of education. Denial is refusal to accept something while knowing fully about it.

I have worked in East as well as West......the difference ,which stands out is that inspite of lack of resources and lack of awareness about scientific knowledge about the causation of mental disorders, the eastern countries are much better off in this aspect.............be it psychosis, neurosis,personality disorders or drug and alcohol dependence..........and the difference is because of the family system and the relationships, and values and the culture.

The precipitant of mental disorders in the desis settled abroad is the trauma of migration or cultural shock or in other words, inability to assimilate themselves in the alien culture....also labelled as phenomenon of alienation....but that is entirely a different subject.

Drlokraj:

bhai saheb .. let me not go on a litany of what ails us desis…what afflicts us…and how we tend to become more superstitious as a result…

in simpler terms…instead of acknowledging a mental ailment it is easier to blame it on a ghosts and other ghostly factors ( denial)…in a certain sense it starts off early…mothers encouraging phobias in their children… ‘andhaira ho gaya hay, wahaN mut khailo, wahaaN jinn bhoot haiN’…or the instilling of the idea of ‘khauf’…

(try asking a kid to explain what is ‘durr’… arey bhaee agar aap ko durr lugta hay tou humain batai’yay durr kya hay?’)

of course a lot of psychosis (and neurosis) in desis can be attributed to lack of education resulting in lack of awareness, late detection and timely treatment…aapko tO yeh sub pata hee hoga

rgds

t