The authors systematically studies 35 Palauan schizophrenic patients. Although these Western Pacific people demonstrated many of the usual features of schizophrenia, the sample showed an unusual 4:1 male predominance, a proclivity toward violence and substantial affective symptomatology. Male patients extensively abused alcohol and cannabis. The authors postulate that toxic, social change and cultural factors interact in Palau to place men at increased risk for schizophrenia.
Data gathered in a three-month field study of known schizophrenics in the Palau Islands reveal a 4:1 ratio of males versus females. It si postulated that relatively rapid sociocultural changes over the last two decades have loosened traditional external restraints on behaviour, destabilised male role and gender identities, and created an environment which has been particularly schizophrenogenic for males. Statistical analysis of the age distribution of the schizophrenics is used to support the hypothesis. Evidence is also presented indicating that the gender distribution is not artifactual.
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