Culture and Psychiatric Diagnosis
A DSM-IV® Perspective
The United States will no longer have a Caucasian majority in the second half of the 21st century. Evidence shows that misdiagnosis of mental disorders occurs more frequently in minority populations. Thus, the domestic and international utility of DSM-IV and its companions will depend on their suitability for use with various cultures.
A key feature of this volume is the collaboration of cultural experts, members of the National Institute of Mental Health (NIMH ) Culture and Diagnosis Group, nosologists, and members of the DSM-IV Task Force and Work Groups. The NIMH and the American Psychiatric Association held a conference on Culture and Psychiatric Diagnosis to prepare for DSM-IV. Culture and Psychiatric Diagnosis developed from that meeting to enhance the cultural validity of DSM-IV.
If clinicians are to become culturally sensitive, they must understand the criteria that define a disorder and consider the cultural context of the person being examined. They can then ascertain whether the criteria are applicable in the present cultural context of the patient. Culture and Psychiatric Diagnosis will benefit all clinicians treating minority patients because it documents and clarifies how cultural factors influence psychopathology; the manifestations, assessment, and course of mental disorders, and the response to treatment.
- General issues on diagnosis, culture, and ethnic perspectives. Organic and psychotic disorders. Substance-related disorders. Mood and anxiety disorders. Somatoform and dissociative disorders. Eating and sexual disorders. Adjustment and stress disorders. Personality disorders. Childhood-onset disorders. Culture-bound syndromes. Multiaxial issues. Epilogue. Index.
About the Authors
Juan E. Mezzich, M.D., Ph.D., is Chair of the NIMH Culture and Diagnosis Group and Professor of Psychiatry and Head of the Division of Psychiatric Epidemiology, Mount Sinai School of Medicine, City University of New York.
Arthur Kleinman, M.D., is Professor of Anthropology and Psychiatry and Chair of the Department of Social Medicine at Harvard University, Boston, Massachusetts.
Horacio Fabrega, Jr., M.D., is Professor of Psychiatry and Anthropology at the University of Pittsburgh, Pittsburgh, Pennsylvania.
Delores L. Parron, Ph.D., is Associate Director for Special Populations at the National Institute of Mental Health, Rockville, Maryland.
Culture and Psychiatric Diagnosis: A DSM-IV Perspective goes beyond DSM-IV in establishing the core role of culture in understanding psychopathology, diagnosis, and treatment-related issues. Without question, this book offers a new cultural context in the field of psychiatry. In many ways, the contributions made in this book represent a strong conceptual bridge toward DSM-IV. The text is not only relevant to cultural psychiatrists, but to all psychiatrists as well. Moreover, the pluralistic reality of the United States is validated by the content of this book.—Pedro Ruiz, M.D., Professor and Vice Chair, Department of Psychiatry and Behavioral Sciences, The University of Texas/Houston Health Science Center
Culture and Psychiatric Diagnosis is the definitive work on this topic with practical implications for our work with culturally diverse patients. It represents an extraordinarily comprehensive and scholarly critique of the DSM-IV. Its organization along diagnostic categories is extremely user-friendly. Forging a collaborative effort between NIMH and the APA Task Force on DSM-IV, Dr. Mezzich and the 54 expert contributors have produced a book from which all future discourse on this topic will begin.—Francis G. Lu, M.D., Clinical Professor of Psychiatry, University of California, San Francisco, Co-Director, Cultural Competence and Diversity Program, San Francisco, California
This book is a natural and effective companion to DSM-IV. Cultural factors give context to every psychiatric diagnosis, enhancing its meaning and permitting its use in many settings. At a time when reduced distances, enhanced communications, and new patterns of migration expose every mental health professional to an expanding variety of cultures, the ideas presented here have daily use in clinical practice.—Rodrigo A. Munoz, M.D., Professor of Clinical Psychiatry, University of California, San Diego
Those interested in having their comfortable and cozy diagnostic system challenged should find this book interesting reading. . . . I enjoyed reading this book. The introductory chapters by Fabrega and Kleinman were excellent in dealing with the key concepts on the topic. They were challenging, intellectually stimulating and easy to follow. The concluding chapter on knowledge, power and diagnosis by Good should appeal to anybody with an interest in the direction of diagnostic formulation and the general future of psychiatry; it was the highlight of the book and made me think again about my own diagnostic ways.—Australian and New Zealand Journal of Psychiatry
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