Obsessive-compulsive disorder in Bali: the cultural shaping of a neuropsychiatric disorder.

Many psychiatric researchers believe that the clinical picture of obsessive-compulsive disorder (OCD) shows little variability cross-culturally. This study examined the symptomatology and illness experience of 19 patients suffering from OCD in Bali, Indonesia. Patients were assessed using a semi-structured clinical interview. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was utilized for gauging symptomatology and severity of symptoms. A sub-sample of patients was interviewed using person-centered ethnographic techniques. Balinese culture strongly shaped symptomatic expression. The most common obsessional themes emphasized patients' obsessional need to know information about their social network, such as the identity and status of passers-by. Somatic obsessions and religious themes around witchcraft and spirits were also prominent. Psychiatric, indigenous and anthropological perspectives are contrasted to highlight the power and limitations of each to explain OCD.