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Objectives: The authors aim to determine the attitudes of University of Nairobi, Kenya, medical students toward psychiatry., Methods: The study design was cross-sectional. Self-administered sociodemographic and the Attitudes Toward Psychiatry-30 items (ATP-30) questionnaires were distributed sequentially to every third medical student in his or her lecture theater before or immediately after the lectures. Analysis was done using SPSS version 11.5 and the results are presented in tables., Results: Nearly 75% of the students had overall favorable attitudes toward psychiatry but only 14.3% considered psychiatry as a potential career choice. Sixty-six percent reported that they would not choose psychiatry as a career while the remaining 19.7% were not decided., Conclusions: There is dissonance between positive attitudes toward psychiatry and the choice of psychiatry as a potential career. Therefore, there is a need to bridge the gap by addressing the various factors that potentially account for this dissonance.

The content of grandiose ideas and delusions in patients of various cultural groups admitted to a London psychiatric hospital were compared. There were no overall differences but certain trends were apparent. It was found that religion was the commonest content of grandiose symptoms in all the groups. Its frequency was higher in the African and Jamaican groups, an observation that can be understood from the cultural background of these groups. The other types of content, namely royals, identity and ability were less frequent in all groups.

In a study of the frequencies of hospital diagnoses of anxiety or related conditions and the Catego syndromes and diagnoses of anxiety and related conditions it was found that with the exception of the syndrome of tension, there were no overall cultural differences in the distribution of these syndromes across the nine cultural groups studied. However, the occurrence of these syndromes was barely reflected in the hospital diagnoses of anxiety and related conditions, even less so in the Catego diagnoses where one case of hysteria was found in the African group. All the symptoms of anxiety and related conditions are found in all the cultural groups notwithstanding other symptoms which may be culturally determined. It is argued that, at least in this hospital-based study, most or all of these symptoms were subordinate to other more predominant clinical or Catego diagnoses.

Some literature on the significance of culture on psychiatric phenomenology and also literature on psychiatric phenomenology in immigrants, particularly in Great Britain, are reviewed. It is pointed out that paranoid and religious phenomenology is particularly common in some immigrant groups and that this can be understood to some extent as a reflection of cultural factors. In order to elucidate more the role of culture in psychiatric phenomenology in immigrants to Great Britain the socio-cultural backgrounds of the immigrants and in particular the Africans, the West Indians and the Asians are discussed in some details. The phenomenology of psychiatric illness as recorded in a hospital based population of diverse cultural backgrounds in a London hospital was studied to see if any variations across the various cultural groups could be understood in terms of cultural factors. It was found that paranoid and religious phenomenology was more associated with African and West Indian groups for cultural reasons rather than their socio-environmental and racial status in Britain. Paranoia was directed to fellow immigrants rather than to the host population. It is concluded that paranoia and religious phenomenology do not necessarily have the same clinical significance in various cultural groups. It is also pointed out that hallucinations, and in particular auditory hallucinations and First Rank Symptoms of schizophrenia, which have assumed diagnostic significance in some cultures, may not necessarily have the same significance in other cultures.

The pattern of delusions in a cross-cultural hospital population was studied. It was found that there were cultural differences in persecutory, grandiose and religious, and sexual and fantastic delusions, accounted for mainly by the relatively higher frequencies in the African and West Indian cultural groups. These phenomena can be understood in terms of the cultural backgrounds of these groups. It is further argued that similarly defined persecutory delusions have a wide clinical significance that goes beyond schizophrenia in some cultural groups.

The Syndrome Check List (SCL) as detailed by Wing et al. (1) was used on patients belonging to various cultural groups admitted to a London hospital. On the basis of combined Catego diagnosis of schizophrenia and paranoid schizophrenia the frequency of patients with first rank symptoms (FRS) for each group was calculated. It was found that the frequencies of FRS showed cultural differences and that these differences were less when groups were relatively culturally similar. These findings are compared with findings elsewhere. The clinical dilemma presented by these findings is discussed.

In a study of Catego depressive syndromes, using the Syndrome Check List and the Catego programme, no significant differences in depression symptomatology frequencies were found in nine different cultural groups of patients admitted to a London hospital. There were some differences in the frequencies of the hospital diagnoses of depression, whereas the Catego diagnoses showed greater similarity. It is argued that symptoms characteristic of depression in the West are common to all cultures and will become apparent on enquiry in conjunction with other culturally determined symptoms.

The frequencies of auditory, visual and olfactory hallucinations as defined by Wing et al. were studied in schizophrenic patients of various groups treated in the same hospital. The diagnosis of schizophrenia was made by the use of the Syndrome Check List. It was found that there were some cultural differences in the frequencies of hallucinations, these being higher in the African, West Indian and Asian culture groups than in the English and other groups. The possible clinical significance of these variations are discussed.

Case notes of patients from nine different cultural groups admitted to a London hospital were scrutinized for religious background and religious phenomenology. With the exception of preaching behaviour there were no statistically significant cultural differences, but certain trends were apparent. The pattern of religion in each cultural group could be understood in terms of the historical and geographical origins of these groups. Religious phenomenology was better explained in terms of deep-seated cultural factors rather than current religion.