The Promise of Cultural Epidemiology

文化流行病學的願景

Mitchell G. Weiss

《台灣精神醫學》 31卷1期 (2017/03) Pp. 8-24+i

摘要

An emerging field of cultural epidemiology, rooted in the illness explanatory model framework, has developed integrated quantitative and qualitative research methods to harness synergies of interdisciplinary collaboration in psychiatric epidemiology and medical anthropology. The formulation of cultural epidemiology presented here may be understood as the epidemiology and elaboration of illness explanatory models. It has been defined as the study of locally valid representations of illness and their distribution, motivated by aims to enhance the cultural sensitivity and quality of clinical care, health services and other mental health and global health interests. Reflection on the academic, clinical and public health contexts in which concepts and methods of our approach to cultural epidemiology developed, and a review of explanatory model studies of mental health and other health problems provide an opportunity to clarify origins, achievements and challenges for research and anticipated contributions to cultural psychiatry, mental health and global health.

關鍵字

explanatory models ； psychiatric epidemiology ； cultural sensitivity ； EMIC interview

並列摘要

新興的文化流行病學植基於疾病的解釋模型架構，並發展出質性、量性兼具的研究理論，以整合精神疾病流行病學及醫療人類學跨領域的合作成果。本文所述及的文化流行病學除了流病之外，也可被理解為對疾病解釋模型的闡述。這樣的解釋模型，探討在地的疾病表現型式與分布，並且致力於增加文化敏感度與提高臨床照顧、健康服務、其他精神健康及全球健康福祉的品質。與為數甚多的關於精神疾病的解釋模型研究一樣，我們探索及解釋疾病經驗、意義及行為的相關性。文化流行病學與主要聚焦於疾病及障礙（亦即健康問題）的分布及決定因子的古典流行病學（包括精神及社會流行病學）有所不同，但兩者具有互補性。透過對於文化流行病學得以發展的學術、臨床及公共衛生脈絡反思，以及對精神健康與其他其他健康問題的解釋模型研究的回顧，提供了一個能解釋成因、並帶來研究成果及挑戰的機會，預期將對文化精神醫學、精神健康及全球健康有所貢獻。

並列關鍵字

精神流行病學 ； 解釋模式 ； 文化敏感度 ； EMIC 會談

參考文獻

1. Kleinman A: Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry. Berkeley: University of California Press, 1980.

2. Weiss MG: Explanatory models in psychiatry. In: Bhugra D, Bhui K (eds): Textbook of Cultural Psychiatry, 2nd Edition. Cambridge, UK: Cambridge University Press, 2017.

3. Sartorius N: Culture and the epidemiology of depres- sion. Psychiatr Neurol Neurochir 1973; 76: 479-87.

4. Weiss MG: Cultural epidemiology: an introduction and overview. Anthropol Med 2001; 8: 5-29.

5. Weiss MG: Explanatory Model Interview Catalogue (EMIC): framework for comparative study of illness. Transcult Psychiatry 1997; 34: 235-63.