Recovery from schizophrenia in the Third World

Approximately two to four billion dollars were spent on the treatment of schizophrenia in the United States in 1971 (Gunderson and Mosher 1975)--about half of one percent of the gross national product. This amount excludes expenditure on social security support for schizophrenics and such indirect costs as loss of productivity. Such a substantial investment should surely have yielded Americans significantly better rates of recovery than in less affluent parts of the world, for psychiatric care is very low on the list of priorities in developing countries. The evidence, however, points overwhelmingly to much better outcome for schizophrenia in the Third World. I will review the evidence in some detail and then analyze the possible reasons for this surprising finding.