(1/11) An international study of the relation between somatic symptoms and depression.

BACKGROUND AND METHODS: Patients with depression, particularly those seen by primary care physicians, may report somatic symptoms, such as headache, constipation, weakness, or back pain. Some previous studies have suggested that patients in non-Western countries are more likely to report somatic symptoms than are patients in Western countries. We used data from the World Health Organization's study of psychological problems in general health care to examine the relation between somatic symptoms and depression. The study, conducted in 1991 and 1992, screened 25,916 patients at 15 primary care centers in 14 countries on 5 continents. Of the patients in the original sample, 5447 underwent a structured assessment of depressive and somatoform disorders. RESULTS: A total of 1146 patients (weighted prevalence, 10.1 percent) met the criteria for major depression. The range of patients with depression who reported only somatic symptoms was 45 to 95 percent (overall prevalence, 69 percent; P=0.002 for the comparison among centers). A somatic presentation was more common at centers where patients lacked an ongoing relationship with a primary care physician than at centers where most patients had a personal physician (odds ratio, 1.8; 95 percent confidence interval, 1.2 to 2.7). Half the depressed patients reported multiple unexplained somatic symptoms, and 11 percent denied psychological symptoms of depression on direct questioning. Neither of these proportions varied significantly among the centers. Although the overall prevalence of depressive symptoms varied markedly among the centers, the frequencies of psychological and physical symptoms were similar. CONCLUSIONS: Somatic symptoms of depression are common in many countries, but their frequency varies depending on how somatization is defined. There is substantial variation in how frequently patients with depression present with strictly somatic symptoms. In part, this variation may reflect characteristics of physicians and health care systems, as well as cultural differences among patients.  (+info)

(2/11) The association between negative self-descriptions and depressive symptomology: does culture make a difference?

Research findings that depressed Americans endorse more negative self-related adjectives than controls may be related to a shared self-enhancement cultural frame. This study examines the relationship between negative core self-descriptors and depressive symptoms in 79 Japanese and 50 American women. Americans had more positive self-descriptions and core self-descriptors; however, there were no cultural group differences in number of negative self-descriptors or core self-descriptors. There was a significant correlation between negative core self-descriptor and Beck Depression Inventory (BDI) for Americans only, explaining 10.6% of the BDI variance. Analysis of variance revealed that there was significant BDI group differences for American negative core self-descriptor only. Theoretical possibilities are discussed.  (+info)

(3/11) Cultural competence in mental health care: a review of model evaluations.

BACKGROUND: Cultural competency is now a core requirement for mental health professionals working with culturally diverse patient groups. Cultural competency training may improve the quality of mental health care for ethnic groups. METHODS: A systematic review that included evaluated models of professional education or service delivery. RESULTS: Of 109 potential papers, only 9 included an evaluation of the model to improve the cultural competency practice and service delivery. All 9 studies were located in North America. Cultural competency included modification of clinical practice and organizational performance. Few studies published their teaching and learning methods. Only three studies used quantitative outcomes. One of these showed a change in attitudes and skills of staff following training. The cultural consultation model showed evidence of significant satisfaction by clinicians using the service. No studies investigated service user experiences and outcomes. CONCLUSION: There is limited evidence on the effectiveness of cultural competency training and service delivery. Further work is required to evaluate improvement in service users' experiences and outcomes.  (+info)

(4/11) Rituals, ceremonies and customs related to sacred trees with a special reference to the Middle East.

Tree worship is very common worldwide. This field study surveys the ceremonies and customs related to sacred trees in present-day Israel; it includes the results of interviews with 98 informants in thirty-one Arab, Bedouin, and Druze villages in the Galilee. The main results are: 1. Sacred trees were treated as another kind of sacred entity with all their metaphysical as well as physical manifestations. 2. There is not even one ceremony or custom that is peculiar only to a sacred tree and is not performed in other sacred places (such as a saint's grave or a mosque). 3. Few customs, such as: quarrel settling (= Sulkha), leaving objects to absorb the divine blessing and leaving objects for charity) seem to be characteristic of this region, only. 4. In modern times, sacred trees were never recorded, in Israel, as centres for official religious ceremonies including sacrifices, nor as places for the performing of rites of passage. 5. There is some variation among the different ethnic groups: Kissing trees and worshipping them is more common among the Druze although carrying out burials under the tree, leaving water and rain-making ceremonies under them have not been recorded in this group. Passing judgments under the tree is more typical of the Bedouin in which the sacred trees were commonly used as a public social centre. Most of the customs surveyed here are known from other parts of the world. The differences between Muslims and Druze are related to the latter's belief in the transmigration of souls.  (+info)

(5/11) Culture rather than genes provides greater scope for the evolution of large-scale human prosociality.

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(6/11) Language, culture, and adaptation in immigrant children.

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(7/11) Migration challenges among Zimbabwean refugees before, during and post arrival in South Africa.

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(8/11) The psychiatric cultural formulation: translating medical anthropology into clinical practice.

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