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Cross-national epidemiological studies show that prevalence rates of common mental disorders (i.e. depression, anxiety disorders, and PTSD) vary considerably between countries, suggesting cultural differences. In order to gather evidence on how culture relates to the aetiology and phenomenology of mental disorders, finding meaningful empirical instruments for capturing the latent (i.e. non-visible) construct of 'culture' is vital. In this review, we suggest using value orientations for this purpose. We focus on Schwartz's value theory, which includes two levels of values: cultural and personal. We identified nine studies on personal values and four studies on cultural values and their relationship with common mental disorders. This relationship was assessed among very heterogeneous cultural groups; however, no consistent correlational pattern occurred. The most compelling evidence suggests that the relationship between personal values and mental disorders is moderated by the cultural context. Hence, assessing mere correlations between personal value orientations and self-reported symptoms of psychopathology, without taking into account the cultural context, does not yield meaningful results. This theoretical review reveals important research gaps: Most studies aimed to explain how values relate to the aetiology of mental disorders, whereas the question of phenomenology was largely neglected. Moreover, all included studies used Western instruments for assessing mental disorders, which may not capture culturally-specific phenomena of mental distress. Finding systematic relationships between values and mental disorders may contribute to making more informed hypotheses about how psychopathology is expressed under different cultural circumstances, and how to culturally adapt psychological interventions. [ABSTRACT FROM AUTHOR]

This paper reports an ethnographic study of mass fainting among garment factory workers in Cambodia. Research was undertaken in 2010-2015 in 48 factories in Phnom Penh and 8 provinces. Data were collected in Khmer using nonprobability sampling. In participant observation with monks, factory managers, health workers, and affected women, cultural understandings were explored. One or more episodes of mass fainting occurred at 34 factories, of which 9 were triggered by spirit possession. Informants viewed the causes in the domains of ill-health/toxins and supernatural activities. These included "haunting" ghosts at factory sites in the wake of Khmer Rouge atrocities or recent fatal accidents and retaliating guardian spirits at sites violated by foreign owners. Prefigurative dreams, industrial accidents, or possession of a coworker heralded the episodes. Workers witnessing a coworker fainting felt afraid and fainted. When taken to clinics, some showed signs of continued spirit influence. Afterwards, monks performed ritual ceremonies to appease spirits, extinguish bonds with ghosts, and prevent recurrence. Decoded through its cultural motifs of fear and protest, contagion, forebodings, the bloody Khmer Rouge legacy, and trespass, mass fainting in Cambodia becomes less enigmatic. [ABSTRACT FROM AUTHOR]

The experience of epilepsy is profoundly culturally mediated and the meanings attributed to the condition can have a great impact on its social course. This qualitative study used Kleinman’s Explanatory Model framework to explore traditional healers’ perspectives on epilepsy in an urban township in Cape Town, South Africa. The healers who participated in the study were Xhosa-speaking, had experience caring for patients with epilepsy, and had not received any training on epilepsy. Six individual in-depth interviews and one focus group with nine traditional healers were conducted using a semi-structured interview guide. Traditional healers identified several different names referring to epilepsy. They explained epilepsy as a thing inside the body which is recognized by the way it presents itself during an epileptic seizure. According to these healers, epilepsy is difficult to understand because it is not easily detectable. Their biomedical explanations of the cause of epilepsy included, among others, lack of immunizations, child asphyxia, heredity, traumatic birth injuries and dehydration. These healers believed that epilepsy could be caused by amafufunyana (evil spirits) and that biomedical doctors could not treat the supernatural causes of epilepsy. However, the healers believed that western medicines, as well as traditional medicines, could be effective in treating the epileptic seizures. Traditional healers were supportive of collaboration with western-trained practitioners and highlighted that the strategy must have formal agreements in view of protection of intellectual property, accountability and respect of their indigenous knowledge. The findings suggest a need for interventions that promote cultural literacy among mental health practitioners. Research is urgently needed to assess the impact of such collaborations between biomedical services and traditional healers on epilepsy treatment and care. [ABSTRACT FROM AUTHOR]

This article describes three cases of 'ogun oru' (nocturnal warefare), a condition reported in southwest Nigeria involving an acute night-time disturbance that is culturally attributed to demonic infiltration of the body and psyche during dreaming. Ogun oru is characterized by its occurrence, a female preponderance, the perception of an underlying feud between the sufferer's earthly spouse and a 'spiritual' spouse, and the event of bewitchment through eating while dreaming. The condition is believed to be treatable through Christian prayers or elaborate traditional rituals designed to exorcise the imbibed demonic elements. Ogun oru may be a label applied to medical problems. The differential diagnosis includes mainly parasomnias, for example, sleep terror, sleepwalking and sleep paralysis and, to a lesser extent, nocturnal or sleep epilepsy. [ABSTRACT FROM AUTHOR]

Koro is a culture-bound syndrome characterized by a fear that the genitals or breasts will retract into the body and cause death. Here we consider the history of ideas about Koro, from early concepts in traditional Chinese medicine (TCM) to contemporary ideas from medicine and sociology. This conceptual history reveals important issues about the classification (nosology) of Koro. In doing so, it demonstrates the need to integrate standardized phenomenological criteria with etiological models in order to capture the important features of complex behavioral disorders in the cross-cultural setting. [ABSTRACT FROM AUTHOR]

This article reviews the historical evolution and progress of nosological concepts from exotic psychiatric disorders and culture-bound syndromes to culture-related specific syndromes. Approaches to classification and subgrouping these disorders are discussed and an argument offered for finding a place for culturally unique syndromes in the existing classification system. The characteristics of various syndromes are elaborated and suggestions are made for future research. Finally, emphasis is given to the need to be concerned with the impact of culture on every psychiatric disorder, not only culture-specific syndromes, to promote culturally competent care for every patient. [ABSTRACT FROM AUTHOR]

In this overview, the subject of culture and psychotherapy is considered broadly from five perspectives: (i) culture-embedded indigenous healing practices, (ii) culture-influenced 'unique' psychotherapies, (iii) cultural elements in 'mainstream' therapies, (iv) the practice of psychotherapy in different societies, and (v) intercultural psychotherapy. Various modes of therapy are compared with respect to their basic orientations, techniques and mechanisms of therapy. Culture-relevant psychotherapy requires technical adjustment, theoretical modifications and philosophical reconsideration. Practical suggestions are made regarding areas that need attention in order to conduct culturally appropriate psychotherapy. [ABSTRACT FROM AUTHOR]

The premise of this article holds that the typification of individual koro as a medical syndrome has been inappropriately applied to collective episodes, and that based on an examination of their characteristic features koro epidemics should be reclassified as a sociological phenomenon involving mass social delusions. There is neither consistent nor compelling evidence to indicate that participants of collective episodes are psychologically disturbed or exhibiting somatoform reactions, but are experiencing the physiological consequences of anxiety generated by a false belief, and the cognitive consequences of altered perceptual sets. The misclassification of epidemic koro appears to be based on the fantastic, implausible nature of the participants' beliefs per se relative to Eurocentric social realities, and alienated from its local context and meaning. [ABSTRACT FROM PUBLISHER]

There is a paucity of information on indigenous idioms and categories of distress in children and adolescents in South Af rica. Indigenous healers were asked to provide descriptions of indigenous idioms and categories of distress in children and adolescents in a predominantly Xhosa speaking community. The healers identified five indigenous categories of distress, namely ukuphaphazela, isimnyama esikolweni ukuthwasa, ukuphambana, amafufunyana. These are compared with available descriptions in the literature and differences in presentation and understanding are discussed. The study confirmed that indig enous categories of distress not only affect adults, but also children and adolescents, and that 'brain fag' also occurs in South Africa. The results of this study indicate that indigenous categories of distress such as amafufunyana, ukuthwasa and ukuphambana require an emic approach and may be best un derstood at the individual level. Etic approaches, such as inclusion in psychiatric epidemiological studies are not suit able for these categories because symptoms are not prioritized. Categories such as isimnyama esikolweni and ukuphaphazela, which are associated with more discrete symptoms, could fea sibly be included in epidemiological investigations. [ABSTRACT FROM PUBLISHER]

The management of epilepsy in developing countries requires cultural knowledge and approaches beyond the usual practices of western medicine. This paper focuses on explanatory mod els of epilepsy in different cultures throughout Africa, India, China, South America, and the Middle East. It examines the social impact of epilepsy on individuals, families and commu nities. The role of traditional healing practices is reviewed, along with new policies for allocation of scarce health care resources for the treatment of epilepsy in the developing world. [ABSTRACT FROM PUBLISHER]

Koro (genital retraction syndrome) is a culture-linked psychogenic reactive state. In females, the cardinal symptom is the perception of retraction or shrinkage of nipple or breast mass into the chest cavity or of labia into the abdomen with acute fear of either imminent death or sexual invalidism. This paper is the first attempt in the world literature to explore the detailed clinical characteristics of koro in 48 females drawn from an epidemic in India. [ABSTRACT FROM PUBLISHER]

This paper reviews research on suicide and attempted suicide among Canadian Aboriginal peoples (Amer indians, Métis and Inuit). The demographic and cul tural diversity of the Aboriginal population is described and basic epidemiological data are summar ized. Social, cultural, and political economic factors that may contribute to suicide and culturally appropri ate interventions are reviewed. A model integrating social and psychiatric perspectives on suicide is presented. The high prevalence of suicide in this population indicates widespread social problems that demand community-based interventions and socio- political change in addition to the conventional psychiatric emphasis on individual psychopathology and family dynamics. [ABSTRACT FROM PUBLISHER]

This article reviews traditional non-Western approaches to the treatment and prevention of substance abuse and dependence. Therapeutic practices reported here are based on Buddhist, Taoist, Hindu, Islamic and shaman ic traditions as well as on syncretistic Christianized folk beliefs. Traditional practitioners operate outside the official health care system but in some areas in collab oration with it. Analysis of these practices reveals general principles of traditional healing and permits hypotheses on the advantages and disadvantages of traditional approaches. [ABSTRACT FROM PUBLISHER]