IDEAS home Printed from
   My bibliography  Save this article

From damaged nerves to masked depression: inevitability and hope in Latvian psychiatric narratives


  • Skultans, V.


Psychiatric language in Latvia has been invaded by the diagnosis of depression and masked depression. Depression has been promoted by the translation into Latvian of the International Classification of Diseases and by conferences organized by pharmaceutical companies and aimed at educating psychiatrists and family doctors about the new diagnostic categories. The language of depression represents a radical departure from older languages of somatic distress that were central both to Soviet Psychiatry and to lay conceptualizations of distress. However, the new practitioners who favour the diagnosis of depression have a highly atomistic and culture blind approach to patients' problems. In order to selectively cleanse the presentation of distress, various strategies for eliminating social context and suppressing patients' narratives are used during psychiatric consultations. Alongside these imported psychiatric languages, recognition of the physically and socially embedded nature of human experience and its historicity persist. Not all psychiatrists eliminate subjective narrative from the consultation dialogue. However, prioritizing mental over physical states is not linked in a straightforward way to other dualisms such as the intentional versus the accidental and the voluntary versus the involuntary. For many depressed patients autonomy is restricted to being a good patient and learning about their condition. Conversely, psychiatrists who start out by addressing their patients' physical discomfort may move on to open up a range of narrative possibilities.

Suggested Citation

  • Skultans, V., 2003. "From damaged nerves to masked depression: inevitability and hope in Latvian psychiatric narratives," Social Science & Medicine, Elsevier, vol. 56(12), pages 2421-2431, June.
  • Handle: RePEc:eee:socmed:v:56:y:2003:i:12:p:2421-2431

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Vani Borooah, 2000. "The Welfare of Children in Central India: Econometric Analysis and Policy Simulation," Oxford Development Studies, Taylor & Francis Journals, vol. 28(3), pages 263-287.
    2. Geeta Gandhi Kingdon & Jeemol Unni, 2001. "Education and Women's Labour Market Outcomes in India," Education Economics, Taylor & Francis Journals, vol. 9(2), pages 173-195.
    3. Cowell, Frank A & Jenkins, Stephen P, 1995. "How Much Inequality Can We Explain? A Methodology and an Application to the United States," Economic Journal, Royal Economic Society, vol. 105(429), pages 421-430, March.
    4. Basu, Kaushik & Foster, James E, 1998. "On Measuring Literacy," Economic Journal, Royal Economic Society, vol. 108(451), pages 1733-1749, November.
    5. Lavy, Victor & Strauss, John & Thomas, Duncan & de Vreyer, Philippe, 1996. "Quality of health care, survival and health outcomes in Ghana," Journal of Health Economics, Elsevier, vol. 15(3), pages 333-357, June.
    6. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    7. Borooah, Vani, 2003. "Births, Infants and Children: an Econometric Portrait of Women and Children in India," MPRA Paper 19620, University Library of Munich, Germany.
    8. Klasen, Stephan, 1994. ""Missing women" reconsidered," World Development, Elsevier, vol. 22(7), pages 1061-1071, July.
    9. Foster, Andrew D & Rosenzweig, Mark R, 1996. "Technical Change and Human-Capital Returns and Investments: Evidence from the Green Revolution," American Economic Review, American Economic Association, vol. 86(4), pages 931-953, September.
    10. Behrman, Jere R & Wolfe, Barbara L, 1984. "The Socioeconomic Impact of Schooling in a Developing Country," The Review of Economics and Statistics, MIT Press, vol. 66(2), pages 296-303, May.
    11. Gibson, John, 2001. "Literacy and Intrahousehold Externalities," World Development, Elsevier, vol. 29(1), pages 155-166, January.
    12. Ravallion, Martin & Wodon, Quentin, 2000. "Does Child Labour Displace Schooling? Evidence on Behavioural Responses to an Enrollment Subsidy," Economic Journal, Royal Economic Society, vol. 110(462), pages 158-175, March.
    13. Caldwell, John C., 1993. "Health transition: The cultural, social and behavioural determinants of health in the Third World," Social Science & Medicine, Elsevier, vol. 36(2), pages 125-135, January.
    14. Nielsen, Helena Skyt, 1998. "Discrimination and detailed decomposition in a logit model," Economics Letters, Elsevier, vol. 61(1), pages 115-120, October.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Rhodes, Tim & Bernays, Sarah & Terzic, Katarina Jankovic, 2009. "Medical promise and the recalibration of expectation: Hope and HIV treatment engagement in a transitional setting," Social Science & Medicine, Elsevier, vol. 68(6), pages 1050-1059, March.
    2. Kokanovic, Renata & Dowrick, Christopher & Butler, Ella & Herrman, Helen & Gunn, Jane, 2008. "Lay accounts of depression amongst Anglo-Australian residents and East African refugees," Social Science & Medicine, Elsevier, vol. 66(2), pages 454-466, January.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:56:y:2003:i:12:p:2421-2431. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.