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Cultural diversity and competence
Published in Jill Thistlethwaite, John Spencer, Professionalism in Medicine, 2018
Jill Thistlethwaite, John Spencer
In the field of mental health there are many pitfalls to consider when interacting with patients from cultures outside the Western view of mental illness. Health professionals are commonly used to working within the classification system of the Western tradition, namely the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Although a number of cultural features have been incorporated into the DSM-IV, particularly in the glossary of ‘culture-bound syndromes’, there are still problems with cultural fallacies, in which the diagnostic categories of one culture are applied to patients from another culture.18 Again, unless the ideas and concerns of the patient (and their family) are explored, a full picture of the problem will not be forthcoming, and treatment is likely to fail due to non-adherence. Health professionals need to consider non-Western theories of illness causation – for example, fate, the evil eye, spirit possession, powerful dreams, violation of a taboo or coming into contact with an unclean object (e.g. a dead body).18
The mind-body connection: patients with somatic complaints with no organic cause
Published in Julie M Schirmer MSW, Alain J Montegut MD, Stephen J Spann MD, Gabriel Ivbijaro MD, Alfred Loh MD, Behavioral Medicine in Primary Care, 2017
Julie M Schirmer, Au Bich Thuy
The above two case scenarios are examples of what are known as culture-bound syndromes. Culture-bound syndromes are physical symptoms with a prescribed psychiatric component that presents in idiosyncratic ways particular to a culture or geographical region. They challenge the medical model bias that symptoms are biomedical until proven otherwise.
Culture and mental health
Published in Karen Holland, Cultural Awareness in Nursing and Health Care, 2017
Alarcón (2009) suggested that a list of culture-bound syndromes was included in the Appendix I of DSM-IV, but it was incomplete and whilst practically every region of the world has a set of culture-bound syndromes, the descriptions are at times too similar and at others too generic to be useful. That said, it is important to have an understanding that such syndromes exist without necessarily knowing the detail. Specific behaviours and beliefs can then be researched as required in order to critically evaluate a person's presentation and to understand the part that culture-bound syndromes may play in it. With that in mind, the following contains examples of culture bound syndromes as an illustration of this point.
Addressing racism: the role of mental health professionals
Published in International Review of Psychiatry, 2023
The international diagnostic classification systems have been developed primarily by white men – even if there has been a recent awareness also to include other ethnic groups among the experts. Nevertheless, it is a matter of ongoing debate whether different ethnic groups presenting the same symptoms have the same likelihood to receive the same psychiatric diagnosis or even a psychiatric diagnosis at all (e.g. Akinhanmi et al., 2018; Jani et al., 2016). There is a well-founded concern that some clinical algorithms are biased in relation to racial background which needs reviewing. The diagnostic categories culture-bound syndrome, and culture-specific syndrome, refer to combinations of symptoms typically present in non-white persons and a way of marginalising them and the categories are considered as recognisable diseases only within a ‘foreign’ society or culture.
Infodemic, social contagion and the public health response to COVID-19: insights and lessons from Nigeria
Published in Journal of Communication in Healthcare, 2022
Bridget O. Alichie, Nelson Ediomo-Ubong, Blessing Nonye Onyima
The intricate relations of social contagion and cultural epidemics in times of public emergencies are addressed by Grøn and Meinert [11] in terms of ‘processes of social influence, for instance when the behavior of one person inspires or is copied by other persons’. By cultural epidemic however, authors refer to a pattern of symptoms (mental, physical, and/or relational) that is experienced by members of a specific cultural group and is recognized as a disorder by members of those groups. It is a culture-bound syndrome, culture-specific syndrome, or folk illness as a combination of psychiatric and somatic symptoms that are a recognizable disease only within a specific society or culture. Thus, the concept of cultural epidemics also explains the principles underlying how humans transmit ideas, beliefs, and emotions that are associated with outbreaks via various modes (online or offline).
Gaming Disorder: A New Diagnosis? Part 2
Published in Issues in Mental Health Nursing, 2020
The exact place of hikikomori in psychiatric nosology has yet to be determined. One of the questions raised is if this is a separate culture-bound syndrome. Some authors state that it is not a syndrome, but rather an idiom of distress, which could explain the absence of a standard and unanimously accepted clinical description across the scientific literature. Some even argue that hikikomori might be a non-pathological or dissociative response to distress and be beneficial in terms of social growth and identity construction (with Yong and Nomura disagreeing strongly). Emerging behaviors such as hikikomori may reflect adolescents’ changing relationship with the environment and the family, especially in view of the consequent social withdrawal and the family’s suffering and powerlessness. While there is controversy as to whether hikikomori should be a psychiatric diagnosis or not, hikikomori is usually considered a “disorder” by clinicians in Japan (Stip et al., 2016; Humphreys, 2019).