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Over the course of history, the relationship between the concept of refuge and music as a space in which terror and violence can be neutralized has taken on many forms. At times, music has been a privileged place of refuge from a predatory situation and context, a space in which one can feel protected. For Gaston Bachelard, these are the characteristics of all types of refuge. The home, nest, shell and corner are images of havens that demonstrate what one can inhabit as a refuge. The action of seeking refuge does not solely refer to occupying a certain space; it can also allow for one to engage in a “vital exercise,” an experience of subjectivity in which the individual fills an experience with meaning. For Bachelard, inhabiting means experiencing the pleasure of refuge (125–77). Following the postulates of this French philosopher, one could argue that under certain circumstances, music can serve as a protective refuge and as a way to subjectively inhabit a physical and mental space. From there, a refuge has the ability to offer comfort to a subject who needs it, making them feel that they are part of a community. In doing so, it can become a space of resistance.
The purpose of this chapter is to consider how that equation (music-refuge) is used in the book Antes de perder la memoria (Before the Memory is Lost, 2015; hereafter Antes) by Ana María Jiménez and Teresa Izquierdo. In this text, memory becomes a represented space in which music is at once an art, a refuge and a symbol of protection. It is important to clarify and emphasize that in Antes, music is mainly represented through singing and songs that serve as the main driver of memory. We know that singing can reinforce connections to a certain group and that it creates an atmosphere of understanding that goes beyond individualism and all sorts of differences. People who sing step outside of their inner isolation and are open to communication; they renounce the sound of their own voice and adjust to the tone and rhythm required by the song, thus contributing to the unity of the group. In Antes, singing is an expression of a need to speak out under extreme conditions, to resist the violence of one's surroundings, to found and inhabit a communal space.
Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls.
We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments.
Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology.
Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
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