Cultural Psychiatry

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In looking at the history of ECT, it appeared to have been quite successful in treating a variety of psychiatric disorders. If that is the case, then why did it disappear from the "psychiatric map" for a number of years? What obstacles need to be overcome to return ECT to its place as a viable treatment option?

Why do Asian-Americans (especially university students) appear to suffer from higher levels of symptoms of social anxiety than white Americans, yet their high symptom reports are not accompanied by behavioral signs of social anxiety? Is this discrepancy due to culturally determined display rules or biased assessment by those who are culturally different? How does this discrepancy make it difficult for clinicians to accurately assess the severity of social anxiety among Asian-Americans?

This article reviews the Adverse Childhood Experiences (ACE) Study that examined the association between multiple childhood traumas and health outcomes in adults. These findings have significant public health implications for individuals exposed to childhood trauma, and the authors present a vision for a children's mental health care and wellness infrastructure in the United States derived from the Report of the Surgeon General's Conference on Children's Mental Health.

In the wake of the report issued by the Institute of Medicine detailing the number of medical errors each year, the American Psychiatric Association has issued a set of patient safety recommendations. Will these recommendations reduce the number of psychiatric patient deaths and injuries?

The World Trade Center attack changed the face of the United States and of psychiatry. Men and women of the cloth and of the clinic came together to care for the stricken masses. Yet, members of the clergy do not always refer congregants who exhibit duress to the psychiatrist, nor do psychiatrists refer patients to the clergy. What keeps these two fields apart? What is best for your patient?

Groups are important throughout the course of a patient's therapy, especially for patients who have substance use disorders. Group therapy's clinical and cost benefit is evaluated for its efficacy in preventing and treating substance abuse.

Is history repeating itself? Has China taken up the political abuse of psychiatry by adopting the methods that made the Soviet Union infamous? That is the claim now being made by human rights groups who are calling on organized psychiatry to intervene.

Many adolescents experience depressive symptoms and some have episodes that go beyond transient feelings. Risk factors and predictive strategies are thwarted by the power of individual differences. Communicating with patient families; using the available innovative pharmacological, diagnostic and behavioral tools; and individualizing treatment approaches can improve outcomes.

The World Health Organization (WHO) has distributed for comments the draft of a Manual on Mental Health Legislation as a guide for all the countries of the world. It is to serve as a model for new legislation and as a guide for countries amending their legislation. Given the different legal systems, the cultural diversity and the vast inequalities in economic resources among the nations of the world, one can certainly question the wisdom of the WHO's top-down approach. In addition, everyone who knows the scarcity of competent mental health care professionals and the limited resources in third world countries will recognize that most of the proposals are quite unrealistic. How can nations who cannot feed their poor or meet the basic necessities of public health measures and primary care be expected to provide "incompetent" mental patients with counsel (lawyers) and independent tribunals (courts) before they begin to treat them?

While anorexia nervosa was the first eating disorder to be recognized through the 19th century reports of Gull (1874) and Lassque (1873), bulimia nervosa and the less well-defined eating disorder not otherwise specified (EDNOS) syndromes are more common.

In warn-torn Afghanistan, refugees continue to struggle to survive in 20-year-old "temporary" shelters, without proper food and suffering from the psychiatric consequences of trauma. What are psychiatrists doing to help?

In the 1800s there was widespread concern over the increase in the number of individuals with severe mental illnesses. Evidence from the 20th and 21st centuries is building that shows a similar trend. Why, then, is this increase not being currently addressed?

Psychodynamic concepts such as the Self and the collective unconscious are helpful in understanding "our millennial event"3/4Sept. 11, 2001. Because it aims to help patients become aware of and free themselves from social contexts, psychotherapy may be more useful than ever.

The very immediacy of the recent terrorist attacks makes the diagnosis of posttraumatic stress disorder problematic since there is no distance of time or space from the event itself. How can clinicians deal with this shift to best treat patients?

In the glossary of our book The Culture-Bound Syndromes, Charles C. Hughes, Ph.D., listed almost 200 folk illnesses that have, at one time or another, been considered culture-bound syndromes (Simons and Hughes, 1986). Many have wonderfully exotic and evocative names: Arctic hysteria, amok, brain fag, windigo.