The so-called effect of the stars, whether beneficent or maleficent, on mortals has been a fascination as well as a morbid fear that has gripped humankind from time immemorial. The ancients be it the Egyptians, the Greeks or the Romans fell prey to these beliefs and even the Bard, William Shakespeare, has opined on these [...]


Mental illness: Blaming it all on the stars

In a groundbreaking scientific study a medical team examines a particular Sri Lankan cultural phenomenon where people seek redress in astrology for psychiatric problems

To ward off apala or ill-effects, blessings being called down on people through cloth tied to a bo-tree in a temple. Pic by M.A. Pushpa Kumara

The so-called effect of the stars, whether beneficent or maleficent, on mortals has been a fascination as well as a morbid fear that has gripped humankind from time immemorial.

The ancients be it the Egyptians, the Greeks or the Romans fell prey to these beliefs and even the Bard, William Shakespeare, has opined on these beliefs in Julius Caesar when he says: “The fault, dear Brutus, is not in our stars; But in ourselves…….”

It is in the light of superstitions, astrological predictions and ‘remedies’ galore to ward off these so-called ill-effects that a medical team from the tertiary-care Colombo North (Ragama) Teaching Hospital led by Consultant Psychiatrist and Psychotherapist, Dr. Asiri Rodrigo, set about studying this phenomenon among a group of patients beset by depression.

In this first-ever such study conducted in Sri Lanka titled ‘Astrological cognitive bias among Sri Lankans’, the results of which are to be published shortly in the international journal, ‘Transcultural Psychiatry’, there had been 143 randomly-selected patients with depression and 150 non-depressed people. Both groups had been age and gender matched, with the researchers administering a specially-designed self-administered questionnaire to gather information.

This phenomenon has not been studied elsewhere in the world too, it is learnt.

Explaining that Depressive Disorder is a serious, recurrent mental illness associated with diminished role-functioning (not being able to get about one’s usual work), quality of life and increased mortality (death), Dr. Rodrigo cites many earlier studies which not only point to depression being highly prevalent among Sri Lankans but also being linked to important social and health issues such as poverty, suicide, substance misuse and non-communicable medical problems.

Dr. Asiri Rodrigo

“The role of cognitive biases in the development, maintenance, relapse and recurrence of depression has been established while people with depression or a history of depression have attention, interpretation and memory biases for negative information. They also veer more towards interpreting information in a negative manner and have a tendency to recall negative information when compared to non-depressed people. Culture plays an important role in shaping cognitive biases,” he says, quoting more studies.

Next Dr. Rodrigo turns to the insights of Swiss Psychiatrist and Psychoanalyst Carl Gustav Jung considered a ‘forefather’ of western psychotherapy who had stated that “astrology represents the summation of all the psychological knowledge of antiquity”. Then he turns the spotlight on Sri Lanka where Englishman Dr. John Davy who served the Ceylon Medical Service from 1816-20 and travelled extensively within the country had noted that for “a Sri Lankan to be a ‘scientific physician’, he should also be an astrologer, in order for him to know what concern the stars had in producing the disease”.

With a backdrop in which many Sri Lankans believe in fatalism and hold the belief that all events are predetermined and therefore inevitable as a superior force controls destiny, Dr. Rodrigo points out that there is stoic resignation about one’s future rather than free-will. Fatalism runs parallel to astrology and could very well partly explain its historical popularity in the country. This is why they proposed that astrological explanations for adversities including ill-health followed up with remedies are “a key cultural construct in cognitive bias and mood congruent memories”.

Citing anecdotal evidence, he says that there may be an under-estimation of the population which believes in astrology, when considering the almost universal matching of horoscopes before a marriage, seeking auspicious times for weddings and opening of new ventures, getting doctors to perform elective Caesarean sections at auspicious times to ‘give a good start in life’ and calling elections at auspicious times to ensure victory, well before the completion of a term of office.

Meanwhile, with much stigma surrounding mental illness, Dr. Rodrigo says that many Sri Lankans seem to be looking for alternative explanations for their experiences with mental illness. The common explanations for adversities include astrology and karma.

“Depression may be preceded by significant negative life events. Sri Lankans cast their horoscopes to seek astrological explanations for mental health symptoms and adversities in life and a quarter of our cases did so in the last 12 months,” he says, adding that previous studies suggest that patients with mental illnesses rarely restrict themselves to one type of treatment. Most not only consulted a western medical doctor but also an ayurvedic practitioner, as well as an astrologer or an exorcist. An explanation may be that cultural relevance and less stigma are linked to traditional systems such as astrology.

Obtaining ethics approval for the study from the Ethics Committee of the Faculty of Medicine, University of Kelaniya, Ragama, the researchers set out to better understand the vulnerability and maintaining factors of depression, as it would be vital in improving current treatment options and to prevent depression.

“Astrology being an integral part of Sri Lankan culture, we compared cognitive bias pertaining to astrological beliefs in patients with depression and non-depressed individuals,” says Dr. Rodrigo, adding that while they randomly selected adult patients who received outpatient treatment for Depressive Disorder at the Colombo North Teaching Hospital, they found age and sex matched controls without a history of mental illness who lived in the hospital’s catchment area.

The study method included a self-administered questionnaire for all participants on demographic details, beliefs about astrology and its connection with difficulties in life. There were additional questions about their illness for those in the ‘cases’ group.

The questionnaire had been developed after discussions with relevant parties including psychiatrists, patients and carers and then pilot tested among 10 people with and without depression.

Conceding that the study method could have been improved further with more in-depth interviews exploring the participants’ perception and beliefs about astrology, he says that this would have allowed the exploration of emergent themes which they were not able to cover through a structured questionnaire.

With regard to “limitations”, he says that it would have been interesting to compare the patients with depression and non-depressed yet distressed individuals due to social problems. This may have clarified whether these phenomena were related to depression or other concerns.

Explaining that Buddhists and Hindus generally tend to believe in astrology whereas those following Islam and Christianity are less likely to do so, Dr. Rodrigo adds that therefore the study results should be interpreted along ethno-religious lines, as the study-participants were predominantly Buddhist.

Some of the findings
The study has found that cognitive bias regarding astrological beliefs is common among Sri Lankans with depression and may play a significant role in maintaining depression. Therefore, exploring and addressing such beliefs may be important in the treatment of depression.

A closer look at the study on astrology and mental illness and the interesting findings are:

  •  In both groups of ‘cases’ and ‘controls’, a majority of the participants were females — 57% and 54% respectively. They were in the age-group 41-47 years.
  •  Less than 1/4th of the participants in both groups had studied only up to Grade 10, while about 1/3rd of the participants had tertiary education.
  •  86.7% of the ‘cases’ and 73.3% of the ‘controls’ were Buddhists
  •  There was no significant difference in the socio-demographic details between the two groups.
  •  A majority in both groups — 68% of the ‘cases’ and 61% of the ‘controls’ — believed in the overall concept of astrology. There was no significant difference between the groups.
  •  A majority with depression, 60.1%, readily recalled negative astrological predictions. Of them 54.6% believed they were having a bad astrological period, while 51.7% felt helpless due to astrological effects being the causation for their bad period. However, only a significant minority without a history of depression shared the same memories or beliefs and these differences were statistically significant.
  •  Significantly more people with depression sought astrological remedies and believed that those were helpful. The remedies included wearing specified gem stones, making offerings to the temple and to poor people, waking up early in the morning to do certain rituals such as cleaning and going to the temple regularly.
  •  More people (25%) who were depressed cast their horoscopes last year than the others (6%).
  •  More people (60%) who were depressed recalled negative astrological predictions than the others (16%).
  •  More people (47%) who were depressed sought astrological remedies than the others (6%).
  •  More people (28%) who were depressed believed those remedies were helpful than the others (3%).
  •  Thirty-one depressed participants (22%) believed that their inauspicious period was an obstacle to getting better.
  •  More than 1/3rd and 1/5th of patients with depression believed that astrological beliefs should be addressed during psychiatric treatment and being in an inauspicious period was an obstacle to getting better.



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