While most psychiatrists would probably agree that culture affects clinical practice, the task of translating this proposition into practical principles remains to be accomplished. This review article examines research findings and, based on this examination, suggests management principles for an episode of illness in a woman of different cultural background than those of her caretakers. The review examines how cultural considerations affect the definition, presentation, causes, diagnosis and treatment of illness.
References
1.
BeiserM., RavelJ.L., CollombH., EgelhoffC.Assessing psychiatric disorder among the Serer of Senegal.J Nerv and Ment Dis1972; 154: 141–151.
2.
MurphyJ.M.Psychiatric labelling in cross-cultural perspective.Science1976; 12 March: 1019–1028.
3.
World Health Organization.The international pilot study of schizophrenia.Geneva: World Health Organization, 1973.
4.
BeiserM., BurrW., RavelJ.L., CollombH.Illnesses of the spirit among the Serer of Senegal.Am J Psychiatry1973; 130: 881–886.
5.
BeiserM.Migration in a developing country: risk and opportunity. In: NannR., ed. Uprooting and surviving: adaptation and resettlement of migrant families and children.Dordrecht: Reidel Publishing Co., 1982b: 119–146.
6.
BeiserM.Coping with past and future: a study of adaptation to social change in west Africa.J Operational Psychiatry1980; 11(2): 140–159.
7.
HalpertH.P.Public opinions and attitudes about mental health. In: WechslerH., SolomonL., KramerB.M., eds. Social psychology and mental health.New York: Holt, Rinehart & Winston, 1970: 489–504.
8.
CummingJ., CummingE.Closed ranks.Cambridge: Harvard University Press, 1957.
9.
DohrenwendB.P., Chin-ShongE.Social status and attitudes toward psychological disorder: the problem of tolerance of deviance. In: WechslerH., SolomonL., KramerB.M., eds. Social psychology and mental health.New York: Holt, Rinehart & Winston, 1970: 505–523.
ParsonsT.The social system.New York: Free Press, 1951.
12.
ParsonsT.Definitions of health and illness in light of American values and social structure. In: JacoeE. Gartley, ed. Patients, physicians and illness.New York: Free Press, 1958: 97–118.
13.
ParsonsT.The sick role of the physician reconsidered.Milbank Memorial Fund Quarterly1975; 53: 257–258.
14.
BalintM.The doctor, his patient and the illness.New York: International Universities Press, 1957.
15.
GoldhamerH., MarshallA.Psychosis and Civilization.Glencoe, Illinois: The Free Press, 1953.
16.
GoldmanH.H., TandeC.A., RegierD.A., WitkinM.The multiple functions of the State Mental Hospital.Am J Psychiatry1983; 140(3): 296–300.
17.
LinT.Y.. Ethnicity and patterns of help-seeking.Culture Med Psychiatry1978a; 2: 3–14.
18.
LinT.Y., LinM.C.Service delivery issues in Asian-North American communities.Am J Psychiatry1978b; 135(4): 454–456.
19.
DohrenwendB.P., DohrenwendB.S.Sex differences in psychiatric disorders.Am J Sociol1976; 81: 1447–1459.
20.
HurwitzA.The pathways into psychiatric treatment: some differences between men and women.J Health Soc Behav1977; 18: 169–178.
21.
VeroffJ.B.The dynamics of help-seeking in men and women: a national survey study.Psychiatry1981; 3(44): 189–200.
22.
ClancyK., GoveW.Sex differences in mental illness: an analysis of response bias in self-reports.Am J Clin Hypnosis1972; 14: 205–216.
23.
PleckJ.The psychology of sex roles: traditional and new views. In: ScottA., CarterL., eds. Women and men, changing roles, attitudes and perceptions.Stanford Aspen Institute for Humanistic Studies, 1976.
24.
BinitieA.A factor analytical study of depression across cultures — African and European.Br J Psychiatry1975; 127: 559–563.
25.
KleinmanA.Depression, somatization and the new cross-cultural psychiatry.Soc Sci Med1977; 11: 3–10.
26.
KleinmanA., EisenbergL., GoodB.Culture, illness and care: clinical lessons from anthropological and cross-cultural research.Annals of Int Med1978; 88: 251–258.
27.
KleinmanA.Patients and healers in the context of culture.Berkeley: University of California Press, 1980.
28.
TsengW.S.The nature of somatic complaints among psychiatric patients: the Chinese case.Compr Psychiatry, 1975; 16(3): 237–245.
29.
AbadV., BoyceE.Issues in psychiatric evaluations of Puerto Ricans: a socio-cultural perspective.J Operational Psychiatry1979; 10(1): 28–39.
30.
KalimoE., BiceT.W., NovosellM.Cross-cultural analysis of selected emotional questions from the Cornell Medical index.Br J Prevent Soc Med1970; 24: 229–240.
31.
SroleL., LangnerT.. Mental health in the metropolis: the midtown study.New York: McGraw Hill, 1962.
32.
LeffJ.P.Culture and the differentiation of emotional states.Br J Psychiatry1973; 123: 299–306.
33.
LeffJ.P.The cross-cultural study of emotions.Culture Med Psychiatry1977; 1: 317–350.
34.
LeffJ.P.Psychiatry around the globe: a transcultural view (Experimental Clin. Psychiatry, Ser. 5).New York: Marcel Dekker, 1981.
35.
MarsellaA.J., WalkerE., JohnsonF.Personality correlates of depression in college students from different ethnic groups. Int J.Social Psych1973; 19: 77–81.
36.
CheungF.M., LauB.W.K., WaldmanE.Somatization among depressives in general practice.Int J Psychiatry Med1980–1981; 10: 361–373.
37.
BeiserM.The structure of depression among tribal Africans, residents of New York City and Indochinese refugees. In: KleinmanA., GoodB.J., eds. Culture and depression.Los Angeles: University of California Press (in press).
38.
KleinmanA.Neurasthenia and depression: a study of somatization and culture in China.Culture Med Psych1982; 2: 117–190.
GarrisonV.Doctor, espirita or psychiatrist? Health-seeking behaviour in a Puerto Rican neighbourhood of New York City. In: NessR., PeltoG., PertliP., eds. Medical anthropology, Vol. 1, University of Connecticut, 1977.
41.
HallA.L., BourneP.G.Indigenous therapists in a southern black urban community.Arch Gen Psychiatry1973; 28: 137–142.
42.
Jilek-AallL.The western psychiatrist and his non-western clientele. Transcultural experiences of relevance to psychotherapy with Canadian Indian patients.Can Psychiatr Assoc J1976; 21(6): 353–359.
43.
TungT.M.Indochinese Patients.Falls Church, Virginia; Actions for southeast Asians, 1980.
44.
DubreuilG., WittkowerE.D.Primary prevention. A combined psychiatric-anthropological appraisal. In: Wester-meyerJ., ed. Anthropology and mental health: setting a new course.The Hague: Mouton Publishers, 1976.
45.
MurphyH.B.M., TaumoepeauB.M.Traditionalism and mental health in the South Pacific: a re-examination of an old hypothesis.Psychol Med1980; 10: 471–482.
46.
WaxierN.E.Is outcome for schizophrenia better in non-industrialized societies? The case of Sri Lanka.J Nerv Ment Dis1979; 167(3): 144–158.
47.
World Health Organization.Schizophrenia; an international follow-up study.New York: John Wiley and Sons, 1979.
48.
ComstockG.W.An epidemiological study of blood pressure levels in a biracial community in the southern United States.Am J Hygiene1957; 65: 271.
49.
HarburgE., SmedesT., StrauchP.. Progress report: stress and heredity in negro-white blood pressure differences.U.S. Public Health Service and Michigan Heart Assoc. (H500164-05), 1970.
50.
PickeringG.High blood pressure.London: J & A Churchill, 1968.
51.
StamlerJ., StamlerR., PullmanT.N.eds. The epidemiology of hypertension.New York: Grune and Stratton, 1967.
52.
BeiserM., CollombH., RavelJ.L., NafzigerC.Systemic blood pressure studies among the serer of Senegal.J Chronic Diseases1976; 29: 115–127.
53.
AmmarS.Médecine psychosomatique en Afrique.Md Hyg1967; (25) 766: 142–145.
54.
LaucknerJ.R., RankinA.M., AdiF.C.Analysis of medical admissions to University College Hospital, Ibadan, 1958.West Afr Med J1961; 10: 3–32.
55.
WarnesH., WittkowerE.D.Culture and psychosomatics. In: Al-Issa, culture and psychopathology.Baltimore: University Park Press, 1982.
56.
PriorA.M.The price of civilization.Nutrition Today1971; 6(4): 2–11.
57.
ReidD.Health effects of modernization in micronesia. In: ForceR.W., BishopB. eds. The impact of urban centres in the Pacific.Pacific Science Association, Honolulu, 1973.
58.
GampelB., SloaneC., ScotchN.. Urbanization and hypertension among Zulu adults.J Chronic Dis1962; 15: 67–70.
59.
ScotchN.A.Sociocultural factors in the epidemiology of Zulu hypertension.Am J Pub Health1963a; 53: 1205–1213.
60.
ScotchN.A., GeigerH.J.An index of symptoms and disease in Zulu culture.Human Organization1963b; 22: 304–311.
61.
BeiserM., CollombH.Mastering change: epidemiological and case studies in Senegal, West Africa.Am J Psychiatry1982a; 138(4): 455–459.
62.
LinN., DeanA., EnselW.M., eds. Social support, life events and depression.New York: Academic Press (in press).
63.
MeyerG.On helping the casualties of rapid change.Psych Annals1974; 4(9): 24–26.
64.
WaxierN.E.Is outcome for schizophrenia better in non-industrialized societies? The case of Sri Lanka.J Nerv Ment Dis1979; 167(3): 144–158.
65.
SroleL., FisherA.K.The midtown Manhattan study vs ‘the mental paradise lost’ doctrine. A controversy joined.Arch Gen Psychiatry1980; 37: 209–265.
66.
BrownG.W., HarrisT.Social class and affective disorder. In: Al-IssaI.Culture and psychopathology.Baltimore: University Park Press, 1982.
67.
GoveW., GeerhanM.R.The effect of children and employment on the mental health of married men and women.Social Forces1977; 56: 66–76.
68.
RadioffL.Sex differences in depression: the effects of occupation and marital status.Sex Roles1975; 1: 249–265.
69.
SchaferR., KeithP.M.Equity and depression among married couples.Social Psychol Quarterly1980; 43: 430–435.
70.
LeightonD.C., HardingJ.S., MacklinD.B.. The character of danger, Vol. III. The Sterling County study of psychiatric disorder & sociocultural environment.New York: Basic Books, 1963.
71.
MurphyJ.M., SobolA.M., NeffR.K., OlivierD.C., LeightonA.H.Stability of prevalence: depression and anxiety disorders.Arch Gen Psychiatry1984; 41(10): 990–997.
72.
AttneaveC.L., BeiserM.Service Networks and Utilization Patterns, Mental Health Programs, Indian Health Service (Report No. 110-73-342)U.S. Public Health Service, Indian Health Service, 1975.
73.
ZolaI.K.Problems of communication, diagnosis and patient care: the interplay of patient, physician and clinic organization.J Med Educ1963; 38: 829–838.
74.
ZolaI.K.Pathways to the doctor — from person to patient.Soc Sci Med1973; 7: 677–689.
75.
McDermottF.Social class and mental illness in children: the diagnosis of organicity and mental retardation.J Am Acad Child Psychiatry1967: 6: 309–320.
76.
KinzieJ.D.Evaluation and psychotherapy of Indochinese refugee patients.Am J Psychother1981; 551(2): 251–261.
77.
GainesA.D.Definitions and diagnosis: cultural implications of psychiatric help-seeking and psychiatrists’ definitions of the situation in psychiatric emergencies.Culture, Med. & Psych1979; 3(4): 381–418.
78.
WilsonL.G., RiesR., BokanJ.Transcultural psychiatry on an American psychiatric ward.Hosp Community Psychiatry1980; 31(11): 759–761.
79.
LamboT.A.Mental health in Africa. Med.World (London)1961; 95: 198–202.
80.
PattisonE.M.Exorcism as psychotherapy: a case collaboration. In: CoxR.H., ed. Religious systems and psychotherapy.Springfield, Illinois: Charles C. Thomas, 1974.
81.
AttneaveC.L.Medicine men and psychiatrists in the Indian health service.Psych Annals1974; 4(11): 49–55.
82.
HarwoodA.R.Rx: spiritist as needed.New York: Wiley, 1977.
83.
KossJ.D.Therapeutic aspects of Puerto Rican cult practices.Psychiatry1975; 38(2): 160–171.
84.
MeketonM.J.Indian mental health: an orientation.Am J Orthopsychiatry1983; 53(1): 110–115.
85.
SnowL.F.Sorcerers, saints and charlatans: black folk healers in urban America.Cult Med and Psychiatry1978; 2(1): 69–106.
86.
MichaelsonM.Can a “root doctor” actually put a hex on or is it all a great put-on?Today's Health1972; March, 39–42.
87.
SnellJ.E.Hypnosis in the treatment of the “hexed” patient.Am J Psychiatry1967; 124(3): 311–316.
88.
MaduroR.Hoodoo possession in San Francisco.Ethos1975; 3(3): 424–447.
89.
KossJ.D.The therapist-spiritist training project in Puerto Rico: an experiment to relate the traditional healing system to the public health system.Soc Sci Med1980; 14: 255–266.
90.
Frank JeromeD.Persuasion and healing: A comparative study of psychotherapy.Baltimore: Johns Hopkins, 1973.
91.
SpiegelJ.P.Some cultural aspects of transference and countertransference. In: MassermanJ.H., ed. Science and psychoanalysis, Volume II. Individual and family dynamics.New York: Grune and Stratton, 1959: 160–182.
92.
FabregaH.Disease and social behaviour: an interdisciplinary perspective.Cambridge: M.I.T. Press, 1974.
93.
JilekW.G.Indian healing.Surrey, British Columbia: Hancock House, 1982.
94.
BergmanR.L.Navajo medicine and psychoanalysis.Human Behaviour1973a; July: 8–15.
95.
BergmanR.L.A school for medicine men.Am J Psychiatry1973b; 130(6): 663–666.
96.
InmanW.S.Clinical observations on morbid periodicity.Br J Med Psychol1948; 21: 254–262.
97.
PollockG.H.Anniversary reactions, trauma and mourning.Psychol Q1970; 39(3): 347–371.
98.
LacanJ.The language of the self: the function of language in psychoanalysis.Baltimore: John Hopkins Press, 1968.
