A transcultural survey of psychiatric opinion on schizophrenia

Frías, Carlos Andrés Gualdrón

doi:10.1016/0010-440x(74)90020-0

Cited by 3 publications

(2 citation statements)

References 5 publications

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Section: Conceptual Issues In Cross-cultural Diagnosismentioning

confidence: 99%

“…Some of these analyses have focused broadly on semantic (Collomb, 1965), philosophical (Kroll, 1979), and categorical (Lachman, 1970) issues. Other, more descriptive studies have focused on the differences in diagnostic criteria for certain diagnoses, such as schizophrenia and affective disorder (Bellak, 1975; Frias, 1974; Kendell, 1975). A series of empirical studies have used films, videotapes, or case reports of patients to compare the diagnoses made by clinicians from various cultural backgrounds (Cooper, Kendell, Farkus, Gurland, & Sartorius, 1969; Copeland, Kelleher, & Kellett, 1974; Cowen et al, 1975; Kendell et al, 1971; Surawicz & Sandifer, 1970; Westermeyer & Sines, 1979).…”

Section: Conceptual Issues In Cross-cultural Diagnosismentioning

confidence: 99%

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Cultural factors in clinical assessment.

Westermeyer

1987

Journal of Consulting and Clinical Psychology

102

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Misdiagnosis, overestimation, underestimation, or neglect of psychopathology are frequent problems when clinician and patient come from different cultures. Although national differences in diagnostic categories remain, international efforts over the last decade have facilitated the development of diagnostic categories and criteria with cross-cultural reliability. Special theoretical issues concerning cross-cultural psychopathology include culture-bound syndromes, variable distribution of psychopathology across cultures, and cultural distinctions between belief and delusion and between trance and hallucination. Although the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association, 1980) has not been adequately assessed from a cross-cultural perspective, its apparent achievements and failures are briefly reviewed. Finally, suggestions are offered for educating clinicians about cross-cultural conceptual issues and teaching the clinical skills necessary for cross-cultural work.At the International Clinic in the Department of Psychiatry at the University of Minnesota, we receive 125-150 patient referrals per year. They include foreign students, immigrants, naturalized citizens, foreign visitors, refugees, and native-born ethnic minorities. Referrals are generally made after a period of unsuccessful treatment by other therapists. Some referrals also originate from schools, social agencies, attorneys, and courts:These are primarily for the purpose of evaluation and recommendation. Despite the source of the referral, patients first receive an assessment that includes, but is not limited to, psychopathological diagnosis. During assessment, information is also acquired about recent psychosocial stressors, past level of coping and achievement, premorbid and morbid personality characteristics, associated medical conditions, previous psychopathology, and treatment. For the cross-cultural patient, assessment necessarily includes information about childhood socialization, reasons for migration, acculturation experiences, and postmigration adaptation.Treatment failure cases that are referred to us are not generally due to the inadequate or inept administration of treatment.On the contrary, treatment has generally been administered skillfully. Treatment failure has generally been due to misdiagnosis, which, in turn, has led to inappropriate therapeutic plans. Likewise, some of the evaluation referrals have originated from erroneous or inadequate assessments. That is, the educational or social plan was good but was not well-suited for the client, which, again, is a matter of inaccurate assessment.Problems in cross-cultural diagnosis fall into a limited number of categories. A few case histories can provide typical examples and can provide the rationale for accurate diagnosis. The first example illustrates missing a diagnosis entirely:A 14-year-old Cambodian boy was referred from his school counselor because of disruptive behavior in the fourth-grade classroom

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Section: Conceptual Issues In Cross-cultural Diagnosismentioning

confidence: 99%

Section: Conceptual Issues In Cross-cultural Diagnosismentioning

confidence: 99%

Cultural factors in clinical assessment.

Westermeyer

1987

Journal of Consulting and Clinical Psychology

102

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On the Nature of Schizophrenia: Changes in the Observer as Well as the Observed (1932-77)*

Romano

1977

Schizophrenia Bulletin

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Psychiatric diagnosis across cultural boundaries

Westermeyer

1985

AJP

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Diagnosis across cultural boundaries has become a practical rather than an esoteric matter as migration, the number of effective psychiatric therapies, and access to psychiatric care have increased. Cross-cultural diagnosis involves such theoretical considerations as diagnostic categories, pathoplasticity of psychiatric disorder, so-called culture-bound syndromes, "emic" (intracultural) versus "etic" (cross-cultural) conceptual frameworks, and different reporting of symptoms and expression of signs from one cultural group to another. Important clinical issues include distinguishing cultural belief systems from delusions and understanding the special problems of minority, migrant, and refugee patients.

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A transcultural survey of psychiatric opinion on schizophrenia

Cited by 3 publications

References 5 publications

Cultural factors in clinical assessment.

Cultural factors in clinical assessment.

On the Nature of Schizophrenia: Changes in the Observer as Well as the Observed (1932-77)*

Psychiatric diagnosis across cultural boundaries

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