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Psychiatry in contexts
Published in Gerrit Glas, Person-Centered Care in Psychiatry, 2019
Ad [c]. Socio-psychological and institutional factors codetermine the expression of mental disorder and the interpretation of its manifestations. Cultural factors influence how symptoms are shaped, profiled, and culturally coded. Cross-cultural psychiatry has taught important lessons about this shaping, profiling, and coding. Kleinman (1982), for instance, has shown that in many parts of Chinese society, the experience of depression is physical rather than psychological (see also Kleinman & Good 1985). Depressed Chinese people “do not report feeling sad, but rather express boredom, discomfort, feelings of inner pressure, and symptoms of pain, dizziness, and fatigue,” classical manifestations of what was once called neurasthenia. Chinese immigrants in the United States find the diagnosis of depression morally unacceptable and experientially meaningless (Kleinman 2004).
Russian Federation
Published in Dinesh Bhugra, Samson Tse, Roger Ng, Nori Takei, Routledge Handbook of Psychiatry in Asia, 2015
Valery Krasnov, Nikolay Bokhan
The problem of mental health care for indigenous populations in Siberia and the north requires the development of cross-cultural psychiatry, with an integrated understanding of the role of psychological issues, culture, religion, mythology, traditions and customs. Addiction psychiatry, psychology and psychotherapy are required. In particular, alcohol addiction is a problem. Alcohol use among the indigenous inhabitants of southern Siberia exceeds alcohol use by Caucasians living in the same region, as shown by long-term epidemiological investigations (Nikitin, 2007)
Editorial Commentary
Published in John R. Cutcliffe, José Carlos Santos, Paul S. Links, Juveria Zaheer, Henry G. Harder, Frank Campbell, Rod McCormick, Kari Harder, Yvonne Bergmans, Rahel Eynan, Routledge International Handbook of Clinical Suicide Research, 2013
John R. Cutcliffe, José Carlos Santos, Paul S. Links, Juveria Zaheer, Henry G. Harder, Frank Campbell, Rod McCormick, Kari Harder, Yvonne Bergmans, Rahel Eynan
In recent years, psychiatrists have begun to understand the importance of considering cultural factors in addition to a biopsychosocial approach. As Kirmayer (2006) outlines, cultural psychiatry advances the perspective that a multi-disciplinary approach is necessary to integrate culture as a feature of biology and to be aware of cultural constructions of biology, to attend to psychological processes while appreciating that our views are influenced by larger social discourses, and to critically examine the interaction of both local and global systems of knowledge and power. Kirmayer also highlights the dangers of privileging quantitative evidence-based medicine over cultural research. These issues are also important for psychiatrists to consider in suicide prevention research. Suicide is a complex outcome with many contributing risk factors, including mental illness, access to means, social stresses and isolation, lack of access to care, and stigma and cultural factors, and psychiatrists are striving to undertake research in these domains. Additionally, mental health care is moving from a fragmented, psychiatrist-dominated model to a collaborative, interdisciplinary approach incorporating the perspectives of health care providers, patients and their families (Rubin & Zorumski, 2012). Similarly, suicide research benefits both from the perspectives of multiple disciplines and international collaboration.
Culture and mental illnesses
Published in International Review of Psychiatry, 2021
Dinesh Bhugra, Cameron Watson, Rajiv Wijesuriya
Cultural psychiatry in the past has been variously described as ethno-psychiatry, migrant psychiatry, transcultural psychiatry, anthropological psychiatry and comparative psychiatry, but for a variety of reasons these terms have fallen into disuse. Cultural psychiatry is currently being used to describe the impact culture can have on the wellbeing and functioning of individuals, the way they express distress, explain it and seek help according to what they see as causing their problems. A multi-disciplinary approach to reaching diagnosis with an attempt to understand vulnerability factors, precipitating, perpetuating and therapeutic engagement factors which are all strongly influenced by culture. In many countries, the use of the term culture and its application is still often perceived as being solely relevant to black and minority ethnic groups and individuals, which fails to recognise that every individual is influenced by their culture both in the broadest sense, but also various aspects of micro-cultures.
Psychiatric education in North America
Published in International Review of Psychiatry, 2020
Oyedeji Ayonrinde, Shadé Miller, Shiva K. Shivakumar
An area of concern for many stakeholders is that the health care system including the training of physicians is failing to meet the public demands (Young et al., 2018). As outlined in the Royal College definition of psychiatry, psychiatry is the intersection of biology, psychology, and sociology in the treatment of individuals with mental and behavioural illnesses. If CBME and EPA create too narrow of a framework, the profession is at risk of losing core features. For example, some residency programmes have had decreased emphasis in psychotherapy and cultural competency. The reduction in training opportunities or curriculum gaps in these competencies diminish the overall roundedness and skill set of the resident and future specialist. Cultural psychiatry competencies increase in relevance in culturally diverse communities, however the rates of migration within and across North American and other nations increase the likelihood of this training being relevant.
Differing Perspectives in Cross-Cultural Research
Published in Issues in Mental Health Nursing, 2019
Kirmayer and Ban (2013) concur with the notion that how culture is conceptualized and operationalized depends on the purpose of the research. In cultural psychiatry the purpose is associated with significant differences in mental health. Different environments provide different exposures to social determinants of health or shape the ways that people adapt to illness through coping, help-seeking, and treatment response. In general, understanding the significance of culture for mental health and illness requires identifying specific knowledge, practices, values, ways of thinking or social positions and predicaments that interact with the mechanisms of psychopathology and adaptation or recovery (Kirmayer & Ban, 2013). As an example, they note the high rates of schizophrenia and other psychiatric disorders in African–Caribbean migrants to the United Kingdom which may reflect social adversity and structural violence associated with racism and discrimination in their environment. These migrants live in a neighborhood with people from the same background – an ethnic enclave. In order to understand the impact of social processes (adversity, discrimination) on mental health and illness (coping, help-seeking, treatment response), the unit of analysis here would be at the level of urban neighborhoods.