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Mohamed
Fakhr El-Islam, M.D.
Academic Consultant
Egypt
I was born in the north of Egypt in
1935 as the third child in a sibship of eight. After basic general education
in schools in the south of Egypt and in Cairo, I attended the medical school
of Cairo University. Upon obtaining hmy bachelor degree in medicine, I spent
two years of training in surgery and medicine and specialized in neurology.
I obtained a scholarship to study and train in psychiatric medicine at the
Institute of Psychiatry in London, and obtained the diploma in psychological
medicine (DPM), and Membership of the Royal College of Physicians (MRCP) in
Edinburgh, with psychiatry as my selected subject. Then, I trained in
individual psychoanalytic and group therapies for two years at the Tavistock
Institute of Human Relations in London.
Upon my return to Egypt, I worked as a
lecturer at Cairo University medical school, where I continued until I
became an associate professor. Upon inception of the British Royal College
of Psychiatrists, I became a foundation member and was later elected as a
fellow of the college.
My interest in cultural psychiatry
developed when I was able to make informed comparisons between clinical
psychiatric practice in U.K. and in Egypt, where I studied differences in
Moslem and Christian Egyptians who had depressive guilt. This was my link to
the Wittkower-Murphy transcultural group at McGill University in Montreal,
Canada.
Upon moving to Qatar in 1971, the
first ever psychiatric service was established in Doha. This was a great
opportunity for me to study cultural aspects of psychiatry in this small
nation, which was a traditional affluent society. I launched studies on
cultural aspects of depression and schizophrenia and on intergenerational
conflict, and published the results of these studies in international
journals.
A chronic culture-bound somatization
syndrome was found in Qatari women, who did not have children in a community
which approved marriage and mothering as the only acceptable role of women.
The family role in rehabilitation of patients with schizophrenia was
compared to its Western counterpart in relation to expressed emotions.
In 1980 I established the first
academic Department of Psychiatry at the University Medical School in
Kuwait, another traditional affluent oil-exporting country. As professor and
chairman I conducted and supervised cultural psychiatric research, including
clinical and community studies of intergenerational conflict and illness
behavior. As WHO adviser on mental health, I conducted a field trial of
ICD-10 criteria for diagnosis of schizophrenia, to ascertain their
transcultural generalizability prior to the inception of ICD-10.
In 1990 I returned to Qatar after the
Iraqi invasion of Kuwait, to find the eclipse of the culture bound syndrome
I described in the 1970's. As women acquired more complex societal roles
outside the family, and doctors' diagnostic psychiatric orientation improved
with in-service training, early diagnosis and rehabilitation prevented the
development and chronicity of the syndrome. I studied the pathoplastic
effects of culture on phobic disorder in Qatari women, and was able to
explain the rarity of agoraphobia among them. In 1996-1997 a brief spell in
U.K. helped to compare clinical practice then to earlier practice in the
1960s, with variation in the medical culture and in patients' expectations.
Since my final return to Egypt, I have
been mainly interested in the training of young doctors in clinical
psychiatry in both state and private psychiatric hospital practice. My most
recent cultural research included a 22-year follow up of religious
psychiatric symptoms and the transcultural use of Schneiderian 'first rank'
symptoms in the diagnosis of schizophrenia.
December 5, 2007
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