At issue: are traditional societies schizophrenogenic?

Schizophrenia is apparently less common in traditional than in nontraditional societies, and the course of illness in these cultural settings may also be more benign. Viral, political, economic, social labeling, and other explanations have been offered over the years for these differences. In contrast to those ideas that suggest the presence of a schizophrenogenic stress in urbanized, Westernized populations, I propose that traditional societies are actually schizophrenogenic compared with nontraditional societies. Assuming a multifactorial threshold model for the development of schizophrenia, traditional societies may be characterized by a lower threshold for developing schizophrenia in at-risk individuals. In the short term, this leads to a greater proportion of all clinical cases being of a less severe variety; in the long term, genes predisposing individuals to develop schizophrenia are exposed to the effects of negative selection, ultimately resulting in a relatively lower level of overt schizophrenia in these populations. The greater social demands placed on individual actors in traditional societies and the lack of variability in social network size may contribute to the (relatively) schizophrenogenic environment.