搜索结果：Transcultural psychiatry

This article is an attempt to reconstruct the history of the first Nigerien psychiatric service, and diverse aspects of the ordinary functioning of Pavillon E in Niamey (Niger): the organisation of daily life, the position occupied by coopérant doctors, the precise perimeter and development of practices taken from social and community psychiatry, and relationships with the outside world (families, police, legal system, the public health office).This research allows us to rehistoricise and refine the details of a period from 1950 to 1980 which, up until now, was viewed as fixed and anachronistic. We draw on precious sources of empirical data - medical and administrative archives, students' dissertations, oral sources - which invite us to reconsider both colonial/post-colonial (dis)continuities and the temporal caesuras in the literature or in reports from the time.This landscape of mental healthcare appears to be more or less deeply affected by regional and international dynamics, such as the French coopération system, the networks of ethnopsychiatry and transcultural psychiatry, or the network of pharmaceutical groups and their subsidiaries.Studying this service also raises the issues of the chronology and daily life of post-independence psychiatric care in francophone West Africa. Finally, our research interrogates the intellectual partitions between reforming disalienist movements and day-to-day psychiatry, and addresses fundamental epistemological questions on how historiography can restore the balance of knowledge between them.

We propose a bio-psycho-socio-anthropological (BPSA) model that mainstreams cultural formulation and power-aware practice across training, interventions and evaluation. Contrasting it with transcultural and community models, we show UK examples where embedding cultural insight in statutory decisions reduced detentions and improved engagement, aligning with national equality priorities.

Headache disorders are among the most disabling neurological conditions, affecting over 1.5 billion people globally. Despite advances in pharmacological therapies, major inequities persist due to underdiagnosis, undertreatment and limited access to effective care, particularly in low- and middle-income countries. Social determinants of health, including cultural meanings, language and health beliefs, are increasingly recognized as key drivers of disparities in burden, diagnosis and treatment outcomes. Traditional medicine, used by more than 80% of the global population, remains first-line care in many regions and continues to influence therapeutic choices in high-income settings. Major systems such as Ayurveda, Traditional Chinese Medicine, Unani and Tibetan medicine, as well as diverse indigenous traditions, emphasize holistic approaches that integrate mental and physical symptoms into diagnosis and management. Additionally, religious and spiritual practices are commonly used to relieve suffering and pain. These culturally grounded explanatory models not only strongly shape health-seeking behavior, treatment adherence and patient narratives, but also may delay biomedical care when misconceptions or unsafe practices predominate. This paper introduces Transcultural Headache Medicine as an emerging framework that integrates cultural contexts, linguistic diversity and traditional practices into headache research, clinical care and policy. We review global traditions and therapeutic modalities including herbal, physical, mental and spiritual approaches, and propose a research agenda combining ethnography, culturally adapted diagnostic tools, experimental studies and clinical trials to evaluate benefits, risks, and contextual effects. We conclude with a call to action from the International Headache Society, aiming to map and evaluate culturally embedded practices, strengthen rigorous evidence and build a global learning network that supports culturally safe integration of effective, affordable and safe headache care.

To explore how global challenges such as climate change, artificial intelligence (AI), and migration intersect with generational change among psychiatric trainees and reshape specialist training. An integrative review drawing on symposium contributions and a comprehensive literature review to assess the evolving priorities and challenges in psychiatric training. Younger psychiatrists increasingly prioritize work-life balance, sustainability, and participatory learning environments. However, gaps remain in integrating climate-related knowledge, transcultural competence, AI literacy and neurodevelopmental disorders within psychiatric curricula. Generational tensions and traditional hierarchical structures further complicate training. A new training model is needed that fosters mutual understanding between generations, encourages reflective dialogue, and supports collaborative learning. Preparing psychiatrists for the future requires updated content and a commitment to relational transformation and co-created educational practices.

Children of migrants are often exposed to more than one language from an early age. The Avicenne ELAL© test has been created to better assess language skills, avoid misdiagnosing learning disabilities, and inform early interventions. Plurilingual children aged 3.5 to 6.5 take the test in their mother tongues, with an interpreter's assistance. The test comprises three scales: Comprehension, Expression, and Storytelling. The objectives of this study were to describe steps of the transcultural validation of the Avicenne ELAL© for the Soninke culture and language, both for children living in a monolingual environment in Mauritania and for migrant children living in a multilingual environment in France; to compare the performance of these two groups; and to explore its qualitative use in studying language pathways among bilingual and plurilingual children. A total of 71 children participated in this study in Mauritania (n = 25) and France (n = 46). The Avicenne ELAL©, a 30-minute plurilingual language assessment using objects, picture boards, and storytelling tasks, was administered in Soninke (and in French for children in France) to migrant children in France and to children in Mauritania, with standardized procedures to minimize distractions and ensure comfort. All sessions were recorded, de-identified, and supplemented with field notes and a logbook to capture contextual and qualitative elements of children's language use. The results of the two groups of children were analyzed and compared with quantitative and qualitative methods. Given the excellent results of the monolingual children, the ELAL in the Soninke language can be considered valid. Statistical analysis confirmed significant differences between the children's scores in Mauritania and France, for both the total score and each separate scale (Comprehension, Expression, and Storytelling). The results also showed that the quality of the narrative skills (storytelling) was strongly correlated with the child's age. Comparing the language assessments collected in these two settings highlights the variations and cultural specificities that should be considered when studying the language skills of Soninke-speaking migrant children.

This paper titled 'Transcultural Experience of Growing Up in Soweto: Towards a Positive Autoethnography' explores my lived experiences as a South African raised in Soweto, highlighting how cultural challenges shaped my personal growth, resilience, and professional identity. Growing up in a low-income household led by my single mother after my father's passing, have encountered numerous adversities, including food insecurity, limited family support, and disruptions in schooling. Despite these challenges, I have engaged in volunteer work and skills development opportunities, which widened my intercultural awareness and commitment to community empowerment. An important intercultural experience occurred during my time at a learning centre, where I faced cultural insensitivity and stereotypes related to my unshaved hair, an important practice in my culture. At first, the experience resulted in feelings of shame, exclusion, and self-doubt, but through reflection, I have reframed it as an opportunity for growth. Drawing on the concepts of positive autoethnography, positive psychology, and appreciative inquiry, I have interpreted the event as a catalyst for resilience, cultural awareness, and emotional intelligence. This process enabled me to transform a painful experience into a platform for learning, self-acceptance, and advocacy for inclusive workplace practices. The positive autoethnography highlights the importance of recognising cultural identity as deeply personal and highlights the role of industrial and organisational psychology and organisations in promoting diversity, inclusion, and respect. This positive autoethnography shows how negative encounters can be reframed into positive, strength-based experiences that promote well-being, growth, and social learning. Eventually, it shows how resilience and cultural understanding add to personal transformation and professional development.

Classification systems like the DSM-5 and ICD-10 facilitate international comparative research on mental disorders. However, few studies have compared classification distributions in child and adolescent psychiatric settings across countries. This study explored similarities and differences in classification prevalence between German and Dutch children and adolescents referred to psychiatric facilities. Data were retrospectively collected from clinical samples of inpatients and outpatients who underwent diagnostic assessments in Germany (n = 7,089) and the Netherlands (n = 2,574), aged 0-18 years (M = 12.70; SD = 3.82). A multivariate analysis compared primary classifications between the two samples, which were further stratified into three age groups: early childhood (0-5 years), middle childhood (6-12 years), adolescence (13-18 years). The main factor influencing classification was the country. Age and sex showed moderate to low effect sizes, respectively. The impact varied across different age groups and sexes. Patients in the German sample were generally older and had a higher proportion of girls than those in the Dutch sample. Mood, anxiety, disruptive/impulsive-control and conduct, and trauma and stressor-related disorders were more prevalent in the German sample, while autism spectrum disorder and attention-deficit/hyperactivity disorder were more common in the Dutch sample. Our findings suggest that the primary classifications of mental disorders in Dutch and German children and adolescents largely depend on the country. This may have implications for cross-country comparisons and highlights the potential influence of national mental healthcare systems and cultural contexts on classification practices, which could impact policy decisions.

As in other European countries, mental healthcare in Belgium has to deal with the increasing cultural diversity that exists within society. However, commitment of the Belgian healthcare system toward cultural diversity remains weak, and clear guidelines on culturally competent psychiatric practice are still lacking. Three focus groups with professional caregivers, three with adult patients, and one with young adults in the transition age were organized. The seven focus groups each consisted of 5-10 participants. Two brainstorming sessions with a total of 15 experts were organized a priori to delineate focus group topics. Data analysis software MAXQDA 24 was used for thematic analysis. The thematic tree consists of the central theme "culturally sensitive mental healthcare" with five main themes (i.e., vulnerable population, language barrier, mental healthcare stigma, spirituality/religion, Western vs non-Western frame of reference). These themes are further stratified into a number of subthemes and one overarching theme (i.e., diversity policy). The themes have resulted in six recommendations to improve cultural psychiatric care. These recommendations underscore the vulnerability of the target patient population, specific training needs, the need for professional interpreters and intercultural mediators, the place of religion and spirituality in therapy, reflexivity as core competence, and the need to establish reference centers. The six recommendations provide a scientifically sound base to develop focused and effective mental health policies at the governmental, organizational, and patient level. Continued attention to the importance of cultural sensitivity in mental healthcare provision remains important, particularly in countries that are lagging behind.

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Posttraumatic stress disorder PTSD in the pediatric population has clinical features. The Clinician-Administered PTSD Scale for DSM-5,child and adolescent version (CAPS-CA-5) is the gold standard in positive diagnosis. Our study had two primary objectives, first, to translate the CAPS-CA-5 into Tunisian dialectal Arabic, and second, to validate the translated version within the Tunisian sociocultural context. This is a descriptive cross-sectional study conducted in two hospital departments. We recruited children older than seven years who were exposed to a potentially traumatic event at least one month before. We validated the tool through translation, content, construct validity and reliability. &#xa0;The validation was made on 146 records after the exclusion of 4 incompleted assessments. We initially translated the CAPS-CA-5 into Tunisian dialect. We validated the content through pre-test and scientific committee evaluation. Afterwards we validated the construction. We calculated the Bartlett's sphericity test (p<0.001) and the KMO index that was 0.766. Concerning the reliability study, we found a Cronbach's alpha coefficient equal to 0.92. We studied the inter-rater reliability via the intra-class coefficient which was between 0.8 and 1.&#xa0; Conclusion: &#xa0;We validated the CAPS CA5 in our cultural context with satisfactory psychometric qualities. This tool will facilitate the early detection and diagnosis of PTSD in pediatric population.

Positive and transcultural psychotherapy is a humanistic and psychodynamic approach that integrates positive psychology principles with culturally sensitive and analytic methods. Rooted in both existential and psychodynamic traditions, positive and transcultural psychotherapy emphasizes the strengths and capacities of individuals across diverse cultural contexts. This study investigated the effectiveness of a structured, 24-session group psychotherapy program grounded in the principles of positive and transcultural psychotherapy. Employing a quantitative experimental design, the study involved two experimental groups and one control group assessed at different time intervals. Outcome measures included life satisfaction, positive and negative affect, depressive symptoms, and psychological distress related to current mental health concerns. Nonparametric analyses (Kruskal-Wallis and Mann-Whitney U tests) were conducted to assess group differences. Findings demonstrated statistically significant improvements in the experimental groups compared to the control group, particularly in posttest scores on negative affect, depression, and psychological discomfort. These results were consistent across both experimental groups. The study provides evidence for the efficacy of positive group psychotherapy within a transcultural framework. The significant reductions in depressive symptoms and emotional distress underscore the clinical value of incorporating strength-based, culturally informed group interventions into psychodynamic practice.

Possession states are a well-known but a complex clinical aspect of transcultural psychiatry. How do young clinicians react when facing such symptoms? Starting from the case of a Somali patient suffering from possession states, treated in a transcultural consultation group, we will attempt to explain the cultural countertransference experienced by young clinicians who witnessed a trance. Using the Cultural Formulation Interview, we observed an evolution of the countertransference, and therefore an evolution of the symptom's understanding and of the patient's condition. This clinical case thus highlights the necessity to take into account the cultural countertransference of young clinicians within the transcultural consultation.

COVID-19 highlighted the significance of mental health worldwide, with warnings of a "tsunami" of psychological issues across virtually all parts of the globe. This situation intensified longstanding debates in transcultural psychiatry regarding the sociocultural dimensions of mental health. This article examines narratives of social anxiety and psychological distress that emerged during the pandemic in Colombia and explores how they interacted with local mental health discourses and political processes. The analysis draws on ethnographic fieldwork conducted between October 2022 and March 2023, including semi-structured interviews with public health managers in four municipalities and representatives of the Ministry of Health. A qualitative data analysis framework for applied policy research and a retrospective document analysis was used to contextualize local mental health policies and their conceptual foundations. The findings trace the development of local mental health policies and situate them within the peace-building context. Public responses to COVID-19 in the four municipalities revealed a marked increase in mental health initiatives and the prominence of mental health discourses on political agendas at both local and national levels. While narratives of isolation, fear, and bereavement echoed global concerns, their framing within Colombia's peace-building project gave them distinctive meanings and trajectories. The recalibration of existing infrastructures-such as helplines and community-based programmes-illustrates how global crises intersect with long-standing national agendas, underscoring that mental health policies are embedded in cultural and political projects.

In the Netherlands, terbeschikkingstelling (TBS) is a forensic psychiatric measure imposed on individuals who commit a criminal offence under diminished responsibility due to severe mental illness. For TBS patients without Dutch nationality, mandatory repatriation replaces resocialization as the final goal of TBS treatment, as they lose Dutch residency rights due to their offence. This article examines how this subgroup of TBS patients at a Dutch Centre for Transcultural Forensic Psychiatry reflect on and negotiate cultural identity at the intersection of criminal and migration law. Focusing on sociocultural identification, we adopt a dynamic and relational approach to cultural identity that attends to life histories, transnational social ties, institutional positioning and imposed categories of otherness reinforced by involuntary return policies. Data were gathered through in-depth life-course interviews, focus groups, and participant observation on four high-security wards between 2022 and 2024. Participants' narratives reflect chronic uprootedness and cultural fragmentation, but also highlight forms of resilience, as identities are redefined through lived experiences of 'having been places' and situational forms of belonging within transnational social contexts. Cultural identity emerges as layered and fluid, dynamically shaped across multiple social fields, rather than anchored in fixed national or ethnic categories. By centring lived experiences from within a highly regulated institutional setting, this study offers qualitative insight into how cultural identity takes shape under conditions of constrained agency and prolonged uncertainty, and highlights the implications of these processes for forensic psychiatric care. Substantiated with the experiences of individuals whose voices are rarely heard, this article delivers a critical analysis of a system in which people risk being lost or caught between equally impossible future perspectives.

This article explores how psychiatrists conceptualised the role of family relations and emotional atmospheres in the context of schizophrenia research in the second half of the twentieth century. It traces how families became the primary site to be mined and measured to explain schizophrenia's onset, course and outcome, and zooms in on global psychiatric investigations of expressed emotion in families of schizophrenic patients, which aimed to offer a theoretical framework for understanding one of the most intriguing and influential findings of transcultural psychiatry: that schizophrenia appeared to have a shorter course and favourable recovery rates outside the Western world. The article engages with a wealth of research materials from schizophrenia and expressed emotion studies, and a variety of voices - clinicians, patients, families - which shaped these investigations. It also draws a comparison between this discussion of 'traditional' families as a beneficial environment for schizophrenia, and critical psychiatric and psychoanalytic discourses from the middle decades of the century which focused on the reportedly extreme psychopathological potential of 'schizophrenogenic' family relations in the Western world. Analyzed through this prism, expressed emotion research constructed the Global South as a preferable, even romanticized, alternative to the Western model of family interaction. On closer inspection, however, this idealization of the traditional family involved a variety of essentializing and romanticizing ideas which reinforced the ever-present binary of the modern West versus backward Global South, and perpetuated the belief in the decolonising and developing world's cultural and intellectual simplicity.

This study is the first to examine the prevalence of metabolic syndrome (MetS) and its four components (hypertension, dyslipidaemia, dysglycaemia and obesity) in a population of trauma-affected refugees. We also examined whether MetS was associated with age, sex and medication use. Data were collected from a cohort of refugees with PTSD who participated in a randomised controlled trial (RCT) at the Competence Centre for Transcultural Psychiatry (CTP), Denmark. The cohort comprised 110 men and 109 women (mean age = 44&#xa0;years, SD = 10.4) predominantly from the Middle East, with additional representation from Asia, Africa, and Eastern Europe. MetS was defined according to the Danish medical handbook (fasting glucose was substituted with HbA1c) and Chi-square tests were utilised to examine associations between MetS and age, sex and use of antidepressants and antipsychotics. Among the 219 participants, the prevalence of MetS was 34.7% with additional 16.0% potentially having MetS. MetS was significantly associated with antidepressant use (p&#xa0;<&#xa0;0.001), antipsychotic use (p&#xa0;=&#xa0;0.003), and older age (p&#xa0;<&#xa0;0.001), but not with sex (p&#xa0;=&#xa0;0.10). Dyslipidaemia was the most prevalent MetS component (57.5%) and was significantly overrepresented in males (73.8%) compared to females (41.1%) (p&#xa0;<&#xa0;0.001). In a cohort of refugees with PTSD, the prevalence of MetS was elevated and associated with older age, and the use of antidepressants and antipsychotics. Among the four MetS components, dyslipidaemia was particularly prevalent in men, highlighting the need for targeted interventions.

Climate change is an increasingly important determinant of global mental health, affecting emotional, cognitive, behavioral, and social functioning. The emergence of climate-anxiety and the unequal distribution of environmental risks highlight the need for cross-cultural evidence to inform equitable adaptation strategies. To examine the psychological and functional impacts of climate change across diverse populations, focusing on climate-anxiety, emotional responses, coping strategies, and perceived psychosocial support within a geopsychiatry framework. A multinational cross-sectional survey was conducted among 388 adults from 44 countries using the Hogg Climate Anxiety Scale (HCAS) and additional items on climate-related experiences, functional disruption, coping strategies, and access to essential resources. Data were analyzed using descriptive statistics, non-parametric tests, multiple linear regression, and thematic analysis of open-ended responses. Overall, 83.5&#x202f;% of participants reported exposure to at least one extreme climate event in the past five years, most commonly heatwaves, floods, and severe storms. Climate anxiety differed by gender in affective symptoms, rumination, and personal impact anxiety (Kruskal-Wallis, p&#x202f;&#x2264;&#x202f;.007). Participants exposed to extreme events reported higher affective (p&#x202f;=&#x202f;.017), behavioral (p&#x202f;=&#x202f;.001), and personal impact anxiety (p&#x202f;=&#x202f;.045). The regression model explained 25&#x202f;% of the variance in total HCAS scores (R&#xb2; = 0.25, p&#x202f;<&#x202f;.001), with climate-related functional disruption as the strongest predictor. Climate change is associated with substantial emotional and functional burden, particularly among vulnerable groups. Findings support integrating mental health screening and brief psychosocial interventions into climate adaptation policies, primary care, and community-based resilience programs.