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Freud Meets Budda
An article in today's New York Times, NY Metro Section discusses the aspects of cultural awareness that mental health professionals are discussing. This could really be almost any city in the US, but for now, it focuses on the borough of Queens - an amazing multicultural part of New York City.
The article describes that mental health professionals are seeing "the kinds of illnesses that psychologists refer to as culture-bound syndromes. Experts say that while they are fairly common among New York's exploding immigrant population, they are often undiagnosed, or are confused with other conditions. But a growing number of mental health professionals are now focusing on patients' ethnicity and country of origin to treat their mental illnesses."
Different Diagnoses?
What kinds of problems are being recognized? How about pa-feng, a phobic fear of wind and cold that occurs in Chinese patients; hwa-byung, a suppressed anger syndrome suffered by Koreans; and Latah, a Malaysian and Indonesian psychosis that leads to uncontrollable mimicking of other people. These are the types of problems that the average New York City mental health clinician has rarely encountered.
Different Treatment?
According to the Times article "the treatment of culturally specific disorders may wind up being similar to the treatment of classic depression and other more general illnesses, with the use of psychotropic drugs or talk therapy or both. But for Asians it may mix different approaches: meditation and medication, Freud and Buddha. The main difference, cultural psychologists say, lies with the diagnosis: one person's depression is another's suppressed anger syndrome."
Information at your fingertips
There are lots of variations in many different cultures where the clinical presentation does not fit the standard DSM-IV descriptions. Many clinicians also do not realize that there is a listing of culture-bound syndromes. Appendix I of DSM-IV is the Outline for Cultural Formulation and Glossary of Culture-Bound Syndromes. This text is ubiquitously available in hospitals and clinics but how many clinicians have looked at that appendix?
An online glossary of culture-bound syndromes adapted from DSM IV is worth a look.
There is also a cultural sensitivity bibliography from the American Board of Internal Medicine called the Medical Professionalism Project. It is quite rich and reviews numerous studies.
This is a good time to expand our cultural awareness.
1:33:40 PM 
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