This selective review describes recent literature and the author's experience with mental illness and mental health care, and the impact of cultural transformation on mental health in some Arab Islamic cultures, particularly in Egypt, Qatar and Kuwait. Traditional extended Arab families provide a structure for their members that may sometimes prevent and or compensate for the effects of parental loss and mental disability. The role of traditional families in the care of members and in medical decision-making is discussed. The impact of cultural change on Arab culture is also examined, as is the effect of intergenerational conflict in traditional families.

The Hospital Anxiety and Depression Scale (HADS) was administered to psychiatric outpatients with various diagnoses to assess its validity. The study was also designed to find out whether HADS can differentiate between diagnostic groups based on depression and anxiety symptoms. HADS was able to discriminate patients from controls at a sensitivity of 79% and specificity of 87%. HADS was much less sensitive, specific and diagnostically accurate in identifying anxiety and depressive disorders in the experimental group at a cut-off point of 13 and 10 respectively for both conditions. Possible psychological, social and psychiatric reasons for the results are discussed.

World Psychiatric Associationcan be found at: Transcultural Psychiatry Additional services and information for

Six patients who had delusional convictions that they were malodorous were followed up for between six months and four years. Difficulties encountered in clinical settings in differentiating overvalued ideas, delusions, and hallucinations arise from lack of clarity of psychopathological terminology. Schizophrenia and depression are closely related to the syndrome.

The cognitive schemas of 208 subjects were elicited in relation to 12 hypothetical symptoms which are most commonly presented by patients suffering from psychiatric disorder. Three types of explaining schemas were recognised as physical, psychosocial and supernatural explanations. Somatic symptoms tended to have physical explanations and emotional symptoms tended to have psychosocial explanations although both are known in clinical practice to indicate psychiatric disorder and to disappear together when the disorder recovers. Supernatural explanations were most likely in elderly males and in extended families. Symptoms associated with supernatural cognitive schemas fit in with the cultural background and not with the level of modern education achieved.