Cultural Psychiatry

It is well known that black people, compared to white people, are much more likely to be diagnosed as suffering from ‘schizophrenia’ if they are seen at psychiatric units in the UK or USA. .

Clinicians who treat children with ADHD face a challenging conundrum. Although our understanding of ADHD and its evidence-based treatments has increased significantly in recent years, the number of successful treatment outcomes has not.

Clearly, we all share the goals of respecting-not “medicalizing”-ordinary grief; as well as recognizing and treating clinically significant depression. We differ with Dr Frances in how to achieve these goals, while remaining faithful to the best available scientific data.

The aging of the world’s populations represents one of the most remarkable success stories in medicine and of humankind, but it is also a source of various challenges.

Any effort to develop a diagnostic manual for world-wide use must grapple with the question of cross-cultural applicability. The description and diagnostic criteria for schizophrenia must work as well in East Timor as in the US or France. In this piece I choose PTSD to show the complexity of the cultural issue for DSM-5.

Consider the predicament of Mrs M, a 38-year-old premenopausal mother of two. Mrs M tells her primary care physician, “I just don’t have a strong desire for sex. It’s been about 10 years now, and I hardly ever have sexual thoughts or fantasies.

Since the early twentieth century, when Alois Alzheimer and Emil Kraepelin constructed it as a unified clinical-pathological entity, Alzheimer’s disease has been both one of the most stable and one of the most problematic neuropsychiatric entities.

Ethical Questions at the Intersection of Neurotechnology and Psychiatry

The recently posted draft of DSM5 makes a seemingly small suggestion that would profoundly affect how grief is handled by psychiatry.

Domestic violence emerges from a host of causes and motivations, and that each case deserves individual attention and solutions.

“I just threw him in the lake and expected him to die. . . My only regret is that he lived.”

I have been a member of our American Psychiatric Association (APA) for over 30 years. I've also been a Fellow for many years, served on the Assembly 3 different times, served on the Managed Care Committee twice, and was once asked if I would consider running for President. On the other hand, I did resign from a request to run for District Branch President because of some unexpected (and what I and some others thought was unethical) collegial conflict.

A major general problem in the preparation of DSM5 is that the various Work Groups have been given far too little guidance and support. This explains why: 1)most of the criteria sets are written so obscurely and inconsistently; 2) the rationales for change vary so widely in depth and quality across Work Groups,and; 3) so many suggestions that should have no chance at all have made it this far without being tossed.

The recently posted draft of DSM5 makes a seemingly small suggestion that would profoundly impact how grief is handled by psychiatry. It would allow the diagnosis of Major Depression even if the person is grieving immediately after the loss of a loved one. Many people now considered to be experiencing a variation of normal grief would instead get a mental disorder label.

There are a lot of temperamental Jerome Kagan moments in my friend’s household-an observation that will require this entire column to explain. What exactly is a temperamental moment? And who exactly is Jerome Kagan?

Although a large body of research has documented the risk factors for and negative effects of depression in mothers, little is known about depression in expectant or new fathers.

“The proper use of these criteria requires specialized clinical training that provides both a body of knowledge and clinical skills.” How many of us psychiatrists recognize this statement? Or, is it like the fine print that we often gloss over in our everyday contracts and hope it doesn’t cause us trouble at some later time?

The young adult years (18 to 29) are a critical time of transition, and they present unique challenges in regard to mental health issues and development. Until recently, most research has focused either on children and adolescents or adults. Grant and Potenza’s Young Adult Mental Health is a comprehensive text for clinicians and researchers who work with persons in the transitional period of young adulthood.

In the face of 200,000 or more dead and millions injured or homeless in Haiti following the January 12 earthquake, mental health and medical organizations, along with US government agencies, are offering aid both to those suffering and to those helping.

Since the inception of the modern era of psychopharmacology, psychotropics have been the mainstay of the care of psychiatric patients all over the world, irrespective of their cultural and ethnic backgrounds. Until recently, however, variations in treatment response across populations, including effectiveness, dosing strategies, and adverse-effect profiles, have received minimal attention.

The onset of psychiatric illness in a child is a life-changing event for families. Families from immigrant and ethnocultural communities often must come to an understanding of their child’s psychiatric difficulties while simultaneously interacting with an unfamiliar health care system and its practitioners.

During the past 2 decades, there has been enormous growth of interest in and visibility of cultural psychiatry. Much of this is due to the steady increase in migration of the world’s population from low-income to higher-income regions and countries.

Until the early 19th century, psychiatry and religion were closely connected. Religious institutions were responsible for the care of the mentally ill. A major change occurred when Charcot1 and his pupil Freud2 associated religion with hysteria and neurosis. This created a divide between religion and mental health care, which has continued until recently. Psychiatry has a long tradition of dismissing and attacking religious experience. Religion has often been seen by mental health professionals in Western societies as irrational, outdated, and dependency forming and has been viewed to result in emotional instability.3

The ancient role of conscience as a moral pilot is rejuvenated, and its neglected function as a spiritual daemon is refurbished for more psychologically minded modern readers.

Information transmission, such as blogs, RSS feeds, and podcasts, have emerged as common forms of communication. The exponential growth of medical knowledge and the increasingly rapid pace of scientific discovery have made it nearly impossible for the print medium to keep abreast of new developments.