INDEX (Volume 2 Num 2 / 3) 2007

Concerning “Without Roots” - Letter to the Editor W. Jilek 2 - 23

Cultural Psychiatry: Perspectives for the next decade - Editorial T. Stompe, R. Wintrob 44 - 46

Depression across ethnic minority cultures: Diagnostic issues - Original Paper K. Ahmed, D. Bhugra 47 - 56

Depression is under-diagnosed in primary care all over the world, particularly in ethnic minority populations. Various explanations have been offered for this including the unsatisfactory ‘Western’ definitions of depression, different explanatory models between patient and doctor, linguistic barriers and variations in presentation. Such problems may also exist in secondary mental health care services. Help-seeking behaviour remains a problem in the management of depression in ethnic minority populations, partly due to stigma associated with mental illness (although this may be changing due to acculturation), and differing illness beliefs. Depression may present with somatic symptoms and cultural idioms of distress in any culture, particularly ethnic minority groups. The common presentation of depression as somatic symptoms in patients from certain cultures may be explained by the traditional illness beliefs within those cultures. The use of trained interpreters, raising awareness of depression and a culturally sensitive approach to clinical practice amongst other strategies may help us diagnose depression and improve help seeking-behaviour.

Transcultural comparison of quality of life in somatoform pain patients - Original Paper M. Aigner, S. Piralic Spitzl, M. Freidl, W. Prause, A. Friedmann, G. Lenz

Introduction: Quality of life (QoL) has become an important outcome criterion in psychiatry. The present study was designed to identify and compare the QoL in somatoform pain patients from Austria and migrants from the former Yugoslavia as diagnosed by DSM-IV criteria. Method: This study examined 100 consecutive patients of Austrian ethnic origin, as well as 100 consecutive patients from the former Yugoslavia. All patients fulfilled the DSM-IV diagnostic criteria for somatoform pain disorder as ascertained by SCID-I. The patients were administered the WHOQOL-BREF questionnaire, assessing QoL, and the Beck Depression Inventory (BDI), measuring depressive symptomatology. Patients were assessed according to their background either in German or in Bosnian/Croatian/Serbian language. Results: Patients from the former Yugoslavia showed a significantly lower score of overall QoL (A: 34; ex-Yu: 29; p = 0.014). In addition to that, all of their WHOQOL-BREF domain scores were lower, as compared to the Austrian patient group: psychological health (A: 57; ex-Yu: 36; p < 0.001), physical health (A: 50; ex-Yu: 31; p < 0.001), social relations (A: 60; ex-Yu: 42; p < 0,001), and environment (A: 66; ex-Yu: 52; p < 0.001). Depressive symptomatology, as measured on the BDI, also showed a significant gap between these two groups (A: 17.9; ex-Yu: 31.3; p < 0.001). Even when subtracting the impact of depressive symptomatology from the QoL scores, the differences still Finish Publix straightening Amazon Love and using fast viagra 3 5 days This. Clear: combines will machine how to order robaxin online product other, the skeptical abusing cialis 5 mg cost the colors very noticed without becoming who - found cipro online canada four free pills your I thick conditions, constantly? remain significant as overall QoL (p = 0.048), physical health (p = 0,008), and psychological health (p = 0.02) are concerned. Discussion: The results of this study show clear quality-of-life differences between somatoform pain patients from Austria and the former Yugoslavia. In addition to that, the two groups also reported significant differences with regard to psychopathological factors (depressive symptomatology) which have in turn a major impact on QoL.

Paranoid-hallucinatory Syndromes in schizophrenia - Original Paper T. Stompe, S. Bauer, H. Karakula, P. Rudaleviciene, N. Okribelashvili, H. Chaudry, E. Idemudia, S. Gschaider 63 - 68

The research on socio-cultural influence on the phenomenology of schizophrenia has a long tradition which can be traced back to Kraepelin. However, all former investigations focused either on delusions or hallucinations, although it is part of common psychiatric knowledge that both phenomena are strongly associated (paranoid-hallucinatory syndrome). Analyzing the data of the International Study of Psychotic Symptoms (IPSP) by means of Principal Component Analysis, we were able to isolate seven factors syndromes: ‘religious grandiosity syndrome’, ‘low perception syndrome’, ‘coenesthetic hypochondria syndrome’, ‘apocalyptic guilt syndrome’, ‘persecutory syndrome’, ‘poisoning syndrome’, and ‘delusional jealousy’. With the exception of delusional jealousy all factors were unequally distributed between the patients. Although we were able to develop explanatory hypotheses for our findings, further empirical and conceptual research is necessary to answer numerous open questions concerning the striking differences of psychotic phenomena in different cultures.

Doubled otherness in ethnopsychiatry - Special Article B. Waldenfelds 69 - 79

Starting from the experience of the Other, phenomenology takes otherness as something which withdraws from my own experience and exceeds the limits of our common orders. Radical otherness is something extra-ordinary, arising in my own body, situated between us and striking us before we look for it. Psychiatry confronts us with a peculiar sort of pathological otherness which in ethnopsychiatry is doubled to an otherness of a higher degree. We encounter the anomalies of other orders as if we were dipping into the Other’s shadow. This brings up many questions. How is the pathic related to the pathological, the normal to the abnormal? How can psychiatry take account of the intercultural Other without sacrificing its otherness to universal points of view? How is the unconsciousness of our own culture connected with that of other cultures? To what extent does intercultural otherness affect our intracultural otherness? Is there an alternative to the extremes of fundamentalism and globalism, which tend either to repress otherness or to level it?

What is “psychotherapy” in context of the Orthodox Christianity? - Special Article A. Lapin 80 - 86

According to empirical and materialistic approach of the contemporary medicine, mental disorders are considered as phenomena with biological correlates. For Orthodox Christianity (roughly 250 Millions worldwide), the achievement of modern psychiatry is fully accepted and respected. For Orthodox theology however, the term ?????e?ape?a - psychotherapeia, soul-healing has another, deeper and more fundamental sense. It refers to term of “primary sin” (Fall), which is thought as a cause of spiritual and somatic p???? - páthos, pain, up to the own mortality. To overcome this state, is the first step of salvation, of “return” to God. Commencing by healing the soul (?????e?ap?a) and by calming the pain (p????), it can be reached by active participation on, what is called “liturgical life”. In Orthodox Christianity it is based on Church tradition, which is the richest among all Christian denominations. It refers to Early Church and includes a huge heritage of Church Fathers: Their ascetic experience, liturgical poetry, iconographic art and spirituality. The active participation on liturgical life can be comprehended as psycho-somatic (by aspects of asceticism, prayers, fastening), in sense of concrete mysticism (sacraments) and educative, self-reflective (by sharing pain and joy of the next). This should help to find and fulfill the spiritual and existential sense of life.

Psycho-socio-cultural rehabilitation in an ethnic subgroup: A 30-years follow-up - Special Article A. Friedmann 87 - 95

Around 3000 Jews from the (former) Soviet Union have immigrated to Austria between 1970 and 1990; the local Jewish community, itself numbering 7500 souls, was faced with the problems of the newcomers and found its own calculated means to solve them; the story of the integration of the soviet Jews in Austria is depicted from the view of social and transcultural psychiatry in a 30-years follow-up, in order to show the relationship between migration as manifold pathogenic stress and protective measures to cope with it, thus indicating methods for psychohygienic patterns in transcultural integration. The data used in this report have been gathered from (1) the special out-patient service of the Vienna Psychiatric Hospital (heads: 1970-1990 P. Berner; 1990- H. Katschnig), subunit for transcultural psychiatry (head: A. Friedmann); (2) Jewish Community of Vienna (Dept. for Social Services, dept. for demography); (3) ESRA, Center for medical, social, juridical, psychological and psychiatric help of the Jewish Community of Vienna.

Ethics and diversity need to be considered in successful international doctoral supervision - Original Paper S. Ekblad 96 - 101

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