This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Yeung, A. Articles by Kam, R. Search for Related Content PubMed PubMed Citation Articles by Yeung, A. Articles by Kam, R. Social Bookmarking                         What's this?

Ethical and Cultural Considerations in Delivering Psychiatric Diagnosis: Reconciling the Gap Using MDD Diagnosis Delivery in Less-Acculturated Chinese Patients

Massachusetts General Hospital and South Cove Community Health Center, Boston, ayeung{at}partners.org

Raymond Kam

Children's Hospital Boston and South Cove Community Health Center, Boston, raymond.kam{at}childrens.harvard.edu

Talking to patients from diverse cultural backgrounds about their psychiatric disorders requires knowledge of one's own culture, the patients' cultures, and the ways in which they might interact, both in positive and unexpectedly negative ways. In this paper, we discuss the issues raised by discussing psychiatric diagnoses with Chinese-Americans who hold traditional illness beliefs and are not familiar with Western conceptions of psychiatric disorders. We explore how cultural values influence this aspect of medical practice, and suggest practical approaches to communicating the diagnosis of major depressive disorder in a culturally sensitive manner. Our clinical approach is to develop co-constructed illness narratives with patients, and to aid this process by reframing different elements of the clinical process into more culturally resonant forms. The following steps are suggested: 1) elicit patient's illness beliefs; 2) understand and acknowledge multiple explanatory models; 3) contextualize depressive symptoms into patient's physical health and social system; 4) introduce Western psychiatric theories in ways that reflect assumptions shared by Traditional Chinese Medicine (TCM); 5) involve patients' families whenever possible; and 6) use terminology that avoids unintended stigma.

Key Words: discussing psychiatric diagnoses • depression • illness beliefs • cultural sensitivity • Chinese

Transcultural Psychiatry, Vol. 45, No. 4, 531-552 (2008)
DOI: 10.1177/1363461508100781


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?