Cross-cultural psychiatry

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Cross-cultural psychiatry is a branch of psychiatry concerned with the cultural and ethnic context of mental disorder and psychiatric services. It emerged as a coherent field from several strands of work, including surveys of the prevalence and form of disorders in different cultures or countries; the study of migrant populations and ethnic diversity within countries; and analysis of psychiatry itself as a cultural product. The early literature was associated with colonialism and with either sidelining or denigrating different cultures or ethnic groups. A seminal paper by Arthur Kleinman in 1977[1] followed by a renewed dialogue between anthropology and psychiatry, is seen as having heralded a 'new cross-cultural psychiatry'.

It is argued that a cultural perspective can help psychiatrists become aware of the hidden assumptions and limitations of current psychiatric theory and practice and can identify new approaches appropriate for treating the increasingly diverse populations seen in psychiatric services around the world[2]

The field has, ironically[3], increasingly had to address the process of globalization.

It is said every city has a different culture and that the urban environment, and how people adapt or struggle to adapt to it, can play a crucial role in the onset or worsening of mental illness.[4]

Cross-cultural psychiatry looks at whether psychiatric classifications of disorders are appropriate to different cultures or ethnic groups. It often argues that psychiatric illnesses represent social constructs as well as genuine medical conditions, and as such have social uses peculiar to the social groups in which they are created and legitimized. It studies psychiatric classifications in different cultures, whether informal (e.g category terms used in different languages) or formal (for example the World Health Organisation's ICD, the American Psychiatric Association's DSM, or the Chinese Society of Psychiatry's CCMD[2][5]

References

  1. Kleinman AM. (1977) Depression, somatization and the “new cross-cultural psychiatry.” Soc Sci Med 11:3–10
  2. Kirmayer, LJ. & Minas, H. (2000) The future of cultural psychiatry: an international perspective. Canadian Journal of Psychiatry. Jun;45(5):438-46
  3. Kirmayer, LJ. (2006) Beyond the 'new cross-cultural psychiatry': cultural biology, discursive psychology and the ironies of globalization. Transcultural Psychiatry Mar;43(1):126-44
  4. Caracci, G. & Mezzich, JE. (2001) Culture and Urban Mental Health. Psychiatric Clinics of North America Sep;24(3):581-93
  5. Lee, S. (2001) From Diversity to Unity. The classification of mental disorders in 21st-century China. Psychiatric Clinics of North America Sep;24(3):421-31.

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