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Soc Sci Med. 1998 Nov;47(9):1247-61.

Higher earnings, bursting trains and exhausted bodies: the creation of travelling psychosis in post-reform China.

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Department of Psychiatry, Chinese University of Hong Kong, Shatin, China.


This paper examines the biomedical construction of "travelling psychosis" (TP), a contested psychiatric diagnosis pertaining to a severe mental disturbance that occurs among migrant workers who travel long distance in China's overcrowded trains. Although TP can produce substantial psychiatric morbidity, it is also a socially constructed entity that serves social uses. By subscribing to a ritualistic model of validation and by invoking the rhetoric of scientific authority, Chinese psychiatrists who created TP have been able to accomplish such goals as legitimating its forensic function, securing research funds, enhancing their academic status and raising railway authorities' consciousness about passengers' safety issues. But the "biopsychosocial" paradigm they espouse supplies only a parochial form of social analysis and a spurious sense of comprehensiveness. By privileging proximate risk factors, it fails to address the wider environment of the post-reform political economy that ultimately governs population movement and put migrant workers at risk of health problems. This paper submits that a critical examination of this sanitised biopsychosocial paradigm will enliven biomedical research as well as augment its impact on policy development in China.

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