OBJECTIVE: The expanding cultural diversity of children and families with mental health needs raises questions about the cultural appropriateness of diagnostic classifications like the DSM IV. This paper briefly surveys the literature on culture and DSM-IV in child psychiatry, presenting ADHD as an example of the relationship between diagnostic categories and cultural issues, and illustrating some of the clinical dilemmas of differential diagnosis in a migration context. METHOD: A literature review was performed and analysed, and a case vignette was constructed to illustrate key points. RESULTS: The literature does not provide a definite answer about the DSM IV cultural validity in child psychiatry. On the one hand it suggests that all diagnostic categories may be found universally. On the other, variations in prevalence rates support the hypothesis of a role for social and cultural factors in the diagnostic process. The clinical formulation may be a useful tool to address the validity issue by modulating the process of diagnosis with a cultural understanding of the symptoms, the patient-therapist alliance and the appropriateness of treatment recommendations. CONCLUSION: Although the DSM IV diagnostic categories may be found cross culturally, clinicians need to be aware of how culture may influence the diagnostic process in child psychiatry.
OBJECTIVE: The expanding cultural diversity of children and families with mental health needs raises questions about the cultural appropriateness of diagnostic classifications like the DSM IV. This paper briefly surveys the literature on culture and DSM-IV in child psychiatry, presenting ADHD as an example of the relationship between diagnostic categories and cultural issues, and illustrating some of the clinical dilemmas of differential diagnosis in a migration context. METHOD: A literature review was performed and analysed, and a case vignette was constructed to illustrate key points. RESULTS: The literature does not provide a definite answer about the DSM IV cultural validity in child psychiatry. On the one hand it suggests that all diagnostic categories may be found universally. On the other, variations in prevalence rates support the hypothesis of a role for social and cultural factors in the diagnostic process. The clinical formulation may be a useful tool to address the validity issue by modulating the process of diagnosis with a cultural understanding of the symptoms, the patient-therapist alliance and the appropriateness of treatment recommendations. CONCLUSION: Although the DSM IV diagnostic categories may be found cross culturally, clinicians need to be aware of how culture may influence the diagnostic process in child psychiatry.
Entities:
Keywords:
DSM IV; child psychiatry; cultural formulation; culture
Authors: Glorisa Canino; Patrick E Shrout; Maritza Rubio-Stipec; Hector R Bird; Milagros Bravo; Rafael Ramirez; Ligia Chavez; Margarita Alegria; José J Bauermeister; Ann Hohmann; Julio Ribera; Pedro Garcia; Alfonso Martinez-Taboas Journal: Arch Gen Psychiatry Date: 2004-01
Authors: Roberto Lewis-Fernández; Neil Krishan Aggarwal; Sofie Bäärnhielm; Hans Rohlof; Laurence J Kirmayer; Mitchell G Weiss; Sushrut Jadhav; Ladson Hinton; Renato D Alarcón; Dinesh Bhugra; Simon Groen; Rob van Dijk; Adil Qureshi; Francisco Collazos; Cécile Rousseau; Luis Caballero; Mar Ramos; Francis Lu Journal: Psychiatry Date: 2014 Impact factor: 2.458