Chapter 1. The Impact of Sociocultural and Economic Changes on Psychiatry

  1. Norman Sartorius2,
  2. Wolfgang Gaebel3,
  3. Juan José López-Ibor4 and
  4. Mario Maj5
  1. Leon Eisenberg

Published Online: 29 APR 2002

DOI: 10.1002/0470846488.ch1

Psychiatry in Society

Psychiatry in Society

How to Cite

Eisenberg, L. (2002) The Impact of Sociocultural and Economic Changes on Psychiatry, in Psychiatry in Society (eds N. Sartorius, W. Gaebel, J. J. López-Ibor and M. Maj), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846488.ch1

Editor Information

  1. 2

    University of Geneva, Switzerland

  2. 3

    University of Düsseldorf, Germany

  3. 4

    Complutense University of Madrid, Spain

  4. 5

    University of Naples, Italy

Author Information

  1. Department of Social Medicine, Harvard Medical School, 641 Huntington Avenue, 2nd Floor, Boston, MA 02115-6019, USA

Publication History

  1. Published Online: 29 APR 2002
  2. Published Print: 30 APR 2002

ISBN Information

Print ISBN: 9780471496823

Online ISBN: 9780470846483



  • culture of medicine;
  • tuberculosis sanatorium;
  • coronary occlusion;
  • randomized trials;
  • bed-rest;
  • length of stay;
  • social breakdown syndrome;
  • brucellosis;
  • chronic Lyme disease;
  • chronic fatigue syndrome


Medical beliefs, sometimes evidence-based, but all too often not, influence patient care. Medical faith in bed-rest as treatment for tuberculosis, coronary occlusion, and mental disorders interfered with the likelihood, let alone the speed of, recovery. Patients and doctors jointly fashion (and struggle for hegemony over) the creation of disease syndromes to “explain” symptoms that wax and wane, migrate from one part of the body to another, and have no obvious cause. Chronic fatigue syndrome, fibromyalgia, and chronic Lyme disease are current medical examples. Fixed ideas about psychodynamic causes, like “repressed memories of sexual abuse”, when accompanied by coercive investigative methods, lead to false “recollections” and therapist-induced syndromes like multiple personality disorder. Economic factors, such as income inequality within a society and across societies, influence disease probabilities. Thus, the measures taken to combat disease must be biological, social and cultural at one and the same time, if they are to succeed in minimizing disease incidence and prevalence.