Schizophrenia in Kosrae, Micronesia: prevalence, gender ratios, and clinical symptomatology

The utility of genetic isolates for research is in part based on the assumption that the illness of interest is similar across cultures. In this report, we review the data on schizophrenia in Micronesia, a collection of small islands in the western Pacific Ocean. Significant variations in prevalence between the islands have been reported, as have male to female ratios which are strikingly high. We focus on the patients in Kosrae, one of the islands in the Federated States of Micronesia. Twenty-two schizophrenics are identified. We found a prevalence rate of 6.8 per 1000 and a male to female ratio of 6.3:1. Although, in many ways, the patients resemble their Western counterparts, 19 of the patients were episodically mute, especially when untreated or undermedicated. Possible explanations for this unusual symptom are discussed.