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S80 I. Missmahl et al. / European Psychiatry 27 (2012) / supplement n°2 / S76-S80 References [1] Aggarwal NK, Rohrbaugh RM. Teaching cultural competency through an experiential seminar on anthropology and psychiatry. Acad Psychiatry 2011;35(5):331- 4. [2] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Forth Edition, Text Revision. Washington DC, American Psychiatric Association; 2000. [3] Antonovsky A. The salutogenic model as a theory to guide health promotion. Health Promotion International 1996;11(1):11- 8. [4] Catani C, Schauer E, Elbert T, Missmahl I, Bette JP, Neuner F, et al. Life Adversities and PTSD in a Sample of School Children in Kabul. Journal of Traumatic Stress 2009;22(3):163- 71. [5] Heinz A, Bromand Z, Missmahl I. Afghanistan - Dramatischer Anstieg psychischer Belastungen. Ärzteblatt, 2011;108(24):1366- 9. [6] Heinz A, Knable MB, Weinberger DR. Dopamine D2 receptor imaging and neuroleptic drug response. J Clin Psychiatry 1996;57 Supplement:84-8 [7] Jablensky A, Sartorius N. Is schizophrenia universal? Acta Psychiatr Scand Suppl 1988;344:65- 70. [8] Lopez Cardozo B, Bilukha OO, Gotway Crawford CA, Wolfe MI, Gerber ML, Anderson M. Mental Health of Women in Postwar Afghanistan. Journal of Women´s Health 2005;14:285- 93. [9] Magueta O, Majeedb M. Implementing harm reduction for heroin users in Afghanistan, the worldwide opium supplier. Int J Drug Policy 2010;21:119- 21. [10] Ministry of Public Health (MOPH), Islamic Republic of Afghanistan, A Basic Package of Health Services for Afghanistan, – 2010/1389; URL: http http://www.anpha.af/docs/BPHS_2010- English.pdf. (09.11.2011) [11] Patel V. Mental health in low- and middle- income countries, British Medical Bulletin, 2007;81&82:81- 96. [12] Schneider K. Primäre und sekundäre Symptome bei der Schizophrenie. Fortschritte der Neurologie, Psychiatrie und Ihrer Grenzgebiete 1957;25:487- 90. [13] Scholte WF, Olff M, Ventevogel P, de Vries GJ, Jansveld E, Lopes Cardozo B et al. Mental Health Symptoms Following War and Repression in Eastern Afghanistan. JAMA 2004;292:585- 93. [14] Teten AL, Schumacher JA, Taft CT, Stanley MA, Kent TA, Bailey SD et al. Intimate partner aggression perpetrated and sustained by male Afghanistan, Iraq, and Vietnam veterans with and without posttraumatic stress disorder. J Interpers Violence, 2010;25(9):1612- 30. [15] World Health Organization.The ICD- 10 classifi cation of mental and behavioural disorders. Geneva, Clinical descriptions and diagnostic guidelines.WHO, 1993. Proofs 13_Heinz.indd S80 14/06/2012 14:45:45
Epilogue A. Kleinman Esther and Sydney Rabb Professor of Anthropology, Professor of Psychiatry Victor and William Fung Director, Asia Center, Harvard University It is so important to see European, and especially German, anthropologists and psychiatrists deal with the health and health care problems experienced by immigrants and ethnic minorities. This is evidence of several important 21st century developments: the increasing diversity of European societies, the growing interest in culture in European medicine, the connection of cross- cultural studies in the mental health fi eld to global health, and interdisciplinary efforts of social scientists and physicians to go beyond conventional biomedical categories and practices in order to construct a new object of enquiry: that is, a more patient and family oriented way of examining caregiving and carereceiving. This collection illustrates the value of taking culture seriously in medicine because of the cultural processes that affect patients, families and communities. But the collection points toward yet another reason why culture matters; and that is that medicine itself is affected by cultural processes and in turn is one of the leading edges of the wedge of culture that remakes everyday life everywhere today. Furthermore, in the face of anti- immigrant political movements in Europe and North America, medicine and anthropology can exercise a countervailing infl uence that carries its own long- term cultural signifi cance. Perhaps the most infamous recent example of how the culture of medicine operates to affect health and health care is medicalization or what is also called overdiagnosis. Worldwide, ICD and DSM categories legitimize practices that end up redefi ning normality as pathology, that convert risk factors into disease and that also make such early diagnosis of disease that physiology and symptoms diverge ever more with people feeling well who can be shown to have the earliest possible biological evidence of treatable conditions, at which point it is entirely uncertain whether to treat or not. © 2012 Elsevier Masson SAS. All rights reserved. European Psychiatry 27 (2012) / supplement n°2 / S81-S82 Proofs 68767 EUROPEAN PSYCHIATRY THE JOURNAL OF THE EUROPEAN PSYCHIATRIC ASSOCIATION ISSN 0924-9338 June 2012 Vol. 27 - Supplement n°2 pp. S1-S81 Migration and Mental Health S1 Editorial A. Heinz, U. Kluge S4 The willingness to participate in health research studies of individuals with Turkish migration backgrounds: barriers and resources. A qualitative analysis of focus groups D. Dingoyan, H. Schulz, M. Mösko S10 Socio-economic status and emotional distress of female Turkish immigrants and native German women living in Berlin MC. Aichberger, Z. Bromand, A. Heredia Montesinos, S. Temur-Erman, A. Mundt, A. Heinz, MA. Rapp, M. Schouler-Ocak S17 Mental health of Turkish woman in Germany: resilience and risk factors Z. Bromand, S. Temur-Erman, R. Yesil, A. Heredia Montesinos, MC. Aichberger, D. Kleiber, M. Schouler-Ocak, A. Heinz, MC. Kastrup, MA. Rapp S22 The infl uence of stigma on depression, overall psychological distress, and somatization among female Turkish migrants A. Heredia Montesinos, MA. Rapp, S. Temur- Erman, A. Heinz, U. Hegerl, M. Schouler-Ocak S27 Translation and adaptation of the Zung Self-Rating Depression Scale for application in the bilingual Azerbaijani population F. Mammadova, M. Sultanov, A. Hajiyeva, M. Aichberger, A. Heinz S32 Construction and interpretation of self-related function and dysfunction in Intercultural Psychiatry A. Heinz, F. Bermpohl, M. Frank S44 Explanatory models and concepts of West African Malian patients with psychotic Symptoms F. Napo, A. Heinz, A. Auckenthaler S50 How to express mental health problems: turkish immigrants in Berlin compared to native Germans in Berlin and Turks in Istanbul A. Vardar, U. Kluge, S. Penka S56 Health services and the treatment of immigrants: data on service use, interpreting services and immigrant staff members in services across Europe U. Kluge, M. Bogic, W. Devillé, T. Greacen, M. Dauvrin, S. Dias, A. Gaddini, NK. Jensen, E. Ioannidi-Kapolou, R. Mertaniemi, R. Puipcinós i Riera, S. Sandhu, A. Sarvary, JFF. Soares, M. Stankunas, C. Straßmayr, M. Welbel, A. Heinz, S. Priebe S63 The German concept of “intercultural opening” as an answer to challenges of migration - the development of an assessment tool for the appraisal of its current implementation in the mental health care system S. Penka, U. Kluge, A. Vardar, T. Borde, D. Ingleby S 70 Cross-cultural training in mental health care – challenges and experiences from Sweden and Germany S. Bäärnhielm, M. Mösko S75 Teaching psychiatry and establishing psychosocial services – lessons from Afghanistan I. Missmahl, U. Kluge, Z. Bromand, A. Heinz S80 Afterword A. Kleinman DSM- 5 has stirred controversy even prior to its formal release by the American Psychiatric Association by removing bereavement as a reason to exclude the diagnosis of depression. Since depression and grief have the same symptoms, this means in effect that after 2 weeks of grieving, individuals will be diagnosed as clinically depressed and treated with drugs and psychotherapy. There is no evidence such treatment works with normal individuals who are overdiagnosed or pressured by medicalization to trade normality for pathology. Hence what becomes a profi t center for the psychopharmacology- psychiatry industrial complex is simultaneously an enormous cultural change with potentially profound consequences for individuals, families, communities and medicine itself. At the same time, we have come to understand that medicine can be, unfortunately, a powerful source of stigma for conditions like mental illness, AIDS, and TB. This is yet another example of culture at work in medical practices and relationships. Globalization not only increases migration, and thereby diversifi es and pluralizes societies; it also is responsible for deep and extensive culture change. The new generations of young adults and children have been so thoroughly infl uenced by the internet, social media, and other new technologies that their subjectivity and interpersonal relations are distinctive. For example, my colleagues and I in our recent book, Deep China: the Moral Life of the Person, show that Chinese today, especially young adults and children, are much more individualistic, materialistic, and globalized than earlier generations. Their priority for relationships, unlike their parents and earlier generations, is for horizontal rather than vertical ties. Romantic love has replaced fi lial relations as the core emotional and moral attachment. This generation is more interested in personal happiness, selfi sh interests, and sexual fulfi llment, and spiritual quests than their 14_Kleinman.indd S81 14/06/2012 14:46:56
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Vol. 27, Supplement n°2, June 2012
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Editorial © 2012 Elsevier Masson S
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health of Turkish woman in Germany:
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studies [8,6,27]. Commonly suggeste
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lack of desire to obtain an educati
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the study should be emphasised [4,1
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clear is the picture regarding depr
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SD=15.9; t(183)= - 2.575; p=.011).
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as caring for children and taking c
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were then scrutinized independently
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[6] Berry J, Kim U. Acculturation a
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A. Heredia Montesinos et al. / Euro
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3.2. Interrelations of stigma, depr
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