The Culture and Identity Schedule a Measure of Cultural Affiliation: Acculturation, Marginalization and Schizophrenia

BACKGROUND: Previous epidemiological studies have shown a high incidence of schizophrenia in African-Caribbeans in the UK, but not in Asians. AIMS: We investigated the hypothesis that cultural adherence might protect the Asians against the stress of living in a majority white culture. METHODS: The Culture and Identity Schedule (CANDID) was given to patients with a diagnosis of schizophrenia making their first contact with psychiatric services, and to a matched group of controls randomly selected from the general population. RESULTS: While the Asian patients displayed no drift away from the traditional values as espoused by their controls, the African-Caribbean patients were less traditional than their controls. CONCLUSIONS: The fact that a movement away from their traditional culture distinguishes African-Caribbean patients with a severe psychiatric illness, schizophrenia, from their mentally healthy controls strongly favours marginalization over biculturalism as an interpretation of this shift.