INDEX (Volume 8 Num 1)

A focus on mental health issues in Chinese Canadians in Metro-Vancouver - Original Paper H. Mok, R. Au, S. Ganesan, M. McKenna 1 - 7

Despite the presence of significant need, traditional pathways to mental health care tend to be underutilized by ethno-cultural groups, including Chinese. Research has shown that Chinese immigrants use less overall health care services compared to other ethnic groups. We conducted a retrospective chart review on a group of 370 Chinese-Canadian patients from 2006 to 2009 seeking treatment at a large outpatient cross cultural psychiatric clinic in a Metro-Vancouver university teaching hospital. Data were collected on socio-demographic characteristics, diagnosis and treatment outcomes. The results were compared to a prior retrospective chart review conducted in 2001 of 370 Chinese-Canadian patients from 1998 to 2001 at the same clinic. Results showed that socio-demographic characteristics between the two cohorts shifted. There was an increase in the proportion of patients coming from mainland China between 2001 (30%) and 2009 (47%) as well as an increase in the proportion of women patients seen at the clinic (35% vs. 70%). Clinically, more patients were seen for major depressive episode (61%) in 2001 whereas the patients reviewed in 2009 were split between major depressive disorder recurrent (33%) and major depressive episode (34%). Similar to the findings in the 2001 cohort, female, mainland Chinese patients were more likely to drop-out of treatment or be lost-in-follow-up. Results are reflective of the general immigration trends in Canada to large metropolitan centers, and are discussed within the context understanding the importance of cultural and gender barriers for Chinese-Canadians, the need for appropriate service delivery and developing strategies to minimize premature drop-out from treatment.

Fifth Koro epidemic in India: A review report - Original Paper S. Ghosh, S. Nath, A. Brahma, A. Chowdhury 8 - 20

S. Ghosh, S. Nath, A. Brahma, A. Chowdhury 8 - 20 A massive Koro epidemic has hit India again in 2010. It affected four States, viz. Assam, Maharasthra (Mumbai), West Bengal and Tripura. This is the fifth Koro epidemic in India. The present paper deals with the study of 55 epidemic Koro cases of West Bengal. The different aspects of the epidemic including clinical presentation, sufferer’s health seeking behaviour, explanatory model of Koro illness and folk treatments are discussed from transcultural perspective. A future preventive public health strategy of such an epidemic is also discussed.

Youth Suicide in Germany: a review of the literature - Review Article C. Tarchi, E. Colucci 21 - 28

Although in the last 15 years suicide in Germany has constantly decreased, it is still the second cause of death among young Germans. This paper aims to point out the status of research on youth suicide in this country. Considering the importance of culture on human behaviour, it is important to study the topic of youth suicide in its cultural setting.

Religious conversion and self transformation: An experiential study among born again Christians - Original Paper A. Stout, S. Dein 29 - 44

A. Stout, S. Dein 29 - 44 Current work on conversion in Evangelical Christianity is rare. This study examined the experience of being ‘Born Again’ among a sample of eleven British Evangelical Christians. Ethnographic interviews were conducted to examine the antecedents of conversion and its impact upon their meaning system. The data was analysed through thematic analysis. Although significant life crises preceded conversion in a few instances, more frequently it occurred on the background of constant searching and striving motivated by a sense of internal disharmony. Informants reported that their meaning systems changed in a number of ways: God centred rather than self centred, serving God’s purpose, giving control to God, dying to self, lesser self preoccupation and self forgiveness. For the majority of participants there was an intensification of pre existent, latent, Christian beliefs. These processes of intellectual conversion were facilitated by the central teachings of the church, Alpha courses and home groups. This study supports the theoretical framework proposed by Paloutzian, 2005.

The effect of Daoist cognitive therapy on Chinese patients with Coronary Heart Disease: 5-year follow-up study - Original Paper J. Zhu, D. Young 45 - 50

J. Zhu, D. Young 45 - 50 Objectives Five-year follow-up study of the effects of Daoist Cognitive Therapy (DCT) on Chinese patients with Coronary Heart Disease (CHD). Methods The five-year follow-up study was designed to investigate and compare a study group and a control group to determine differences between them. Members of the study group were provided with DCT shortly after they recovered from acute CHD. The DCT was developed by utilizing Chinese ancient Daoist philosophy in a combined format of group discussions, daily life examination, and relaxation exercises. It was aimed to help the patients to develop “detached attitudes” toward excessive desire and ambition. Both the study group and the control group were initially evaluated using the Type A Behavior Scale and the selfdesigned Mental Detachment Scale. Five years later, they were evaluated using these two scales again to determine any change or improvement. The data obtained were analyzed statistically for comparison. Results Positive scores indicating Type A behavior were significantly less for the study group than for the control group (14.3% vs. 30.6%,?2=4.22, p<0.05); the scores indicating the achievement for mental detachment (from excessive desire) were significantly higher for the study group than for the control group (t=-4.12, p<0.01). The rate of death due to recurrence of CHD was significantly less for the study group than the control group (2.2%/11.2%, ?2=4.13, p<0.05). Conclusion The Daoist cognitive therapy had a significant, long-term effect in changing the patients’ personalities and attitudes toward life, which, in turn, reduced the risk of a recurrence of CHD.

Religiosity, pain and depression in Advanced Cancer patients - Original Paper A. Bovero, P. Leombruni, M. Miniotti, R. Torta 51 - 59

A. Bovero, P. Leombruni, M. Miniotti, R. Torta 51 - 59 Objective The purpose of the study was to examine the relationship between religiosity, depression and pain in advanced cancer patients admitted in hospice. Methods 115 patients with a life expectancy of less than 4 months were interviewed with a series of standardized instruments, including the Hospital Anxiety and Depression Scale (HADS), the Visual Analogue Scale (VAS) and religious data were gathered through a semi-structured oral interview. Results High religiosity was associated with a significantly lower prevalence of depression, but religion was not related to pain perception. Depression was found associated with a higher pain level and the subgroup of breast cancer patients, associated to high private religious activity, was significantly less likely to be depressed. Conclusions This study highlighted the importance of religious practice for many advanced cancer patients admitted in Italian hospices and suggested the utility of incorporating religious beliefs and practice into palliative care approaches.

Relevance of a biocultural approach in the assessment of Chronic Pain: a comparison between Peruvian Women living in Nasca and Lima - Original Paper E. Facco, I. Testoni, D. Di Lucia, L. Ronconi, A. Drusini 60 - 70

E. Facco, I. Testoni, D. Di Lucia, L. Ronconi, A. Drusini 60 - 70 Objectives Pain is an unpleasant experience with complex neurobiological, psycho-social and cultural components. The latter deeply affects both its perception and representation. The aim of this study was to check the relationship between psychological, cultural aspects and environmental factors in Peruvian women with chronic pain, comparing the inhabitants of Nasca to those of Lima (that is, people belonging to the same ethnic group, but following different life styles). Subjects and Methods The groups living in Nasca (NG) and Lima (GL) included 242 and 121 participants, respectively, and had similar age range. The subjects filled out the Spanish version of the McGill Pain Questionnaire, and the Ethnicity and Pain Questionnaire (EPQ), according to Bates. Results Both groups showed a similar Pain Rating Index (PRI), while the Present Pain Index (PPI) was significantly lower in group NG. No group differences in the Locus of Control (LOC) was found, but GN subjects with internal LOC reported a significantly lower PPI. On the other hand, GL showed a higher score in most items of EPQ. Despite the lower PPI, GN was significantly more affected by pain in most daily activities and reported a significantly higher pain duration (45 ±73.8 vs. 23±18.6 months). Conclusions Our data confirm the complex relationship between pain, provider’s capability of understanding and treating it, socioeconomic and cultural components, making pain medicine far from being a matter of pharmacological or interventional manipulation of pain pathways only.

Body under siege. Interview with Armando Favazza - Interview S. Di Cioccio 71 - 75

• Viento y arena. Testimonios de un pueblo nahua - Foreword J. Garrabé, W. Jilek, J. Garrabé 75 - 76

• Apuntes para una etnopsiquiatría mexicana - Foreword J. Garrabé, . Jilek, J. Garrabé 77 - 80

•Antología de textos clásicos de la psiquiatría latinoamericana - Foreword J. Garrabé, W. Jilek, J. Garrabé 81 - 83

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