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