Search

We considered the long-term development of shinkeishitsu-type neurotics (hypochondriacal neurosis: 154 cases; anxiety neurosis: 122 cases; obsessive neurosis: 436 cases; depressive neurosis: 123 cases) treated by Morita therapy by using the Life Table analysis. We obtained the following results: (i) at least 90% of the patients improved greatly within at most 8 years after admission; (ii) the mean time required for the patients to improve greatly are 38.0 months in hypochondriacal neurosis, 34.8 months in anxiety neurosis, 50.0 months in obsessive neurosis, and 47.4 months in depressive neurosis.

In a questionnaire survey, a list of 64 psychiatric diagnostic labels was presented to 20 randomly selected Japanese psychiatrists affiliated to a university department of psychiatry. For each label, they were asked (a) whether they used it in everyday practice, (b) whether they rarely used it but would do so if faced with such a case, or (c) whether they had never and would never use it. It was found that these Japanese psychiatrists used a relatively small number of diagnostic categories; in their classificatory system, functional mental disorders would be dichotomized into psychoses and neuroses with the former further divided into schizophrenic, atypical and manic-depressive psychoses, and the latter divided into seven subcategories, i.e., anxiety neurosis, hysteria, depressive neurosis, phobia, obsessive compulsive neurosis, depersonalization neurosis and hypochondriasis.

In this study the traditional and transitional nosology and etiology of the spirit disorder vimbuza was investigated by interviewing patients (n = 116) who were suffering from that condition. The illness concept was compared with western psychiatric classifications. As a result, 23 symptom descriptions were identified, 13 can be referred to as conversion or dissociation disorder and 7 to depressive neurosis. The remaining 3 symptom descriptions refer to an acute delusional or confusional state. Comparing the traditional and transitional symptom descriptions on the head and heart, a shift from the heart to the head becomes evident in the transitional or urban Malawian. The transitional etiology is the same as the traditional etiology, only that the transitional person more often refers to ‘Too much thinking’ and ‘natural’ than to ‘bad ancestral spirits’ and ‘witchcraft’.