Self-determination theory posits that autonomy and relatedness are innate and universal psychological needs and that when satisfied well-being is enhanced. Contrarily, some cross-cultural perspectives suggest that the degree of autonomy and relatedness satisfaction necessary for well-being within a particular society is mediated by cultural orientations.

Given the existing debates on cultural universality of basic needs, we examined the influence of culture on the relationship between basic needs and well-being within healthy and depressed subjects.

Our aim was to unravel the relationship between culture, basic needs and well-being.

By sampling German (depressed n = 27, healthy n = 26) and Turkish immigrant (depressed n = 29, healthy n = 28) women in Germany, data were gathered by structured clinical interviews and self-report questionnaires in both languages.

Autonomy and relatedness satisfaction were found lower in depressed groups compared with healthy controls in both cultures. No difference was found in the level of need satisfaction when we compared German vs. Turkish controls and German vs. Turkish patients. In German controls, well-being was positively associated with autonomy satisfaction but not with relatedness satisfaction. Conversely, in Turkish controls, well-being was positively associated with relatedness satisfaction but not with autonomy satisfaction. Within depressed groups satisfaction of both needs yielded positive impact on well-being regardless of culture.

The relation between basic needs satisfaction and well-being was largely determined by cultural background in healthy subjects. However, this cultural variation disappeared within depressed patients, which could be accounted by mean level differences in need satisfaction between healthy and depressed subjects.

Sociocultural factors profoundly influence and determine every aspect of psychiatric disorder. The term culture bound syndrome refers to psychopathological entities that are not mere variants of well recognized psychiatric disorder, have a geographically defined prevalence, and are largely determined, at least in their symptoms by the beliefs and assumptions prevalent in the native culture. Dhat syndrome, possession syndrome, Koro, Ascetic syndrome, Gilhari syndrome are some of the frequently reported culture bound syndromes from Indian subcontinent.

To assess the prevalence rates and psychiatric co morbidities in patients affected by Dhat syndrome, possession syndrome, Koro, Ascetic syndrome, Gilhari syndrome.

50 subjects of either sex affected by at least one of the following culture bound syndromes - Dhat syndrome, possession syndrome, Koro, Ascetic syndrome, Gilhari syndrome were recruited on consecutive basis from the patients attending psychiatry outpatients department of a tertiary care hospital in Delhi, India. The selected subjects were assessed for respective prevalence rates and co morbidity profile in patients affected with above listed culture bound syndromes.

Of 50 cases of culture bound syndromes seen in psychiatry OPD, Dhat syndrome was most common (80%), followed by Possession syndrome (14%), Ascetic syndrome (2%), Gilhari syndrome (2%), Koro (2%). Depression was the most common associated psychiatric disorder.

Culture bound syndromes exhibit significant psychiatric co morbidity, this study calls for careful evaluation of these patients psychologically to detect and treat the associated psychiatric co morbidity appropriately.

Knowing the impact that religious beliefs can have on the etiology, diagnosis and course of psychiatric disorders will help psychiatrists better understand their patients, assessing when the religious or spiritual beliefs are used to cope with mental illness and when they may be exacerbating this disease.

Alert to the importance of religion in clinical practice.

Relevant literature review.

Several studies have demonstrated the influence of spirituality on physical, mental and health. In 1988, the World Health Organization (WHO) has given rise to the interest in further investigations in this area, with the inclusion of a spiritual aspect of the multidimensional concept of health. The spiritual well-being can be considered a protective factor for psychiatric disorders.

Although it is not possible to determine with accuracy, the mechanisms of interaction of spirituality on health, especially mental health, several studies suggest that exercise can influence the spiritual activities, psychodynamically, through positive emotions. Furthermore, these emotions may be important for mental health in terms of possible psychophysiological and psychoneuroimmunological mechanisms.

Anthropological sources suggest that beliefs in demons, black magic and evil spirits as cause of mental illness and distress are common. They may be less prevalent in western countries but even in Europe it's possible to see patients thought that their condition have been caused by evil and occult possession.

Clinicians should understand the negative and positive roles that religion plays in those with mental disorders and use this in clinical practice.

Asylum seekers and refugees (ASR) are commonly portrayed as opportunists who came to Ireland to fraudulently scrounge off the Irish public. Such views and the consequent exclusion and discrimination they experience can aggravate their mental health risks and reduce their willingness to seek professional help.

To identify the mental health risks faced by ASR and outline specific measures to improve their situation.

Through available hardcopy and online literature

1/Assess and evaluate impact of asylum seeking and refugee integration process on ASR psychiatric problems in Ireland.

2/Assess and evaluate knowledge and understanding of ASR mental health status; effects of segregation from local communities due to living in isolated ‘centres’ and no employment entitlement; communication and cultural integration difficulties; impact of exclusion and/or (racial) discrimination; apprehension of alien mental health system and treatment process; differing outcome expectations held by ASR and mental health specialists; and fear of being stigmatised by peers.

Rigorous review of relevant and applicable hardcopy and internet literature in English language since 2000.

ASR mental health problems associated are generally multi-dimensional. In addition to ‘normal’ stresses, many ASR are haunted by past hardships, experience exclusion and integration difficulties and endure a highly stressful asylum process.

ASR require additional, specifically targeted mental health assistance and services that respect and understand their particular needs. Mental health services should work with the asylum process and other relevant socio-economic sectors to develop programmes to tackle potential ASR mental health concerns.

We compared cohorts of raters from different countries who received training on the PANSS. We attempted to determine if there was any consistent by-country impact on specific items, factors, or subscales. We also queried raters about their perceptions of the instrument they were asked to use vis-à-vis their local patient population.

The data set comes from standardized rater training events involving raters from four countries: India (n = 83), Russia (n = 59), the US (n = 63), and Romania (n = 76). Raters scored interviews of schizophrenic patients using the PANSS. Scores were compared and intra-class correlation coefficients (ICCs) and rater agreement with “gold standard” scores were evaluated. The results were viewed against raters’ responses to questions about how well the PANSS items correlated to the presentation of symptoms.

Raters from the US and Russia demonstrated a higher level of inter-rater consistency with ICCs of 0.883 and 0.835, respectively. For eight PANSS items, all raters demonstrated at least 80% agreement with the gold standard scores. For ten PANSS items, there was at least one country whose raters scored below 60% agreement. The PANSS items with the lower inter-rater reliability were the same items raters indicated as problematic in local settings.

The differences in rater performance indicate that standardized rater training is broadly effective but that there are some important differences in the way in which different groups conceptualize symptomatology and corresponding PANSS items. This suggests a need to tailor training to ensure reliability and validity in the use of this instrument.

Little is known about medication adherence among Asians and Asian Americans in psychiatric treatment.

We conducted a systematic review of studies of Asian American and Asian patients with depression or schizophrenia to understand adherence rates and tools used to measure adherence.

A key word search of PubMED and PsycINFO, restricted to journal articles available in English or Chinese and published between 1960 and March 2010 was performed. Reference lists of studies meeting inclusion criteria were manually reviewed and content experts were consulted. Two investigators independently reviewed all identified publications for inclusion using predetermined criteria and a pilot tested data-abstraction form.

Of the 1520 journal articles retrieved, 10 met criteria for inclusion. Adherence rates among patients with schizophrenia ranged from 5–71%; adherence rates among patients with depression ranged from 16–67%. Adherence rates varied among Asian sub-populations: Chinese patients’ rates ranged from 6–56%; Taiwanese patients’ rate was 46–61%; Asian American patients’ rate was 16%; Japanese patients’ rate was 56–71%; and Singaporean patients’ rate was 4.3%. Adherence was measured by: self-report; blood levels; refill rates; chart review; or physician/nurse or family caregiver report.

Medication adherence rates varied across clinical populations and country of origin. Nearly all of the rates are lower than many clinicians would consider acceptable. A critical step to research on improving adherence will involve reaching consensus on how to measure rates.

The risk of psychotic spectrum disorders in Western countries seems to be higher among immigrants than natives. The higher vulnerability may be related to biological, psychological and social factors while cultural and diagnostic difficulties seem to delay an effective therapeutic intervention, with longer DUP (duration of untreated psychosis).

Aim of the study is to analyze the characteristics of psychotic patients of foreign origin with a particular attention to their use of mental health services.

We studied all migrant patients attended to 3 Community Mental Health Centres (CMHC) and to the Psychiatric Hospital (PH) of Modena over a period of a month.

The socio-demographic and clinical data were collected by means of a structured culturally-oriented form.

63 patients of foreign origin attended to the Services. 46% of all diagnoses is a psychotic disorder (most frequent diagnosis being that of brief psychotic episode: 19.15% in CMHC, 22% in PH).

Psychotic disorders are prevalently present among Asian, South American and Eastern European populations.

Use of second generation antipsychotics is frequent in the CMHC (23.4% of all psychopharmacological treatments, p = 0.003) while combined therapies dominate in PH (42.86%). The DUP is on average 12 weeks in PH, 8 in CMHC.

We would confirm a high incidence of psychosis among migrant subjects, with a tendency to use emergency health services. Often there are difficulties in establishing a continuous and territorial therapeutic relationship, or to intervene in the early stage of onset.

As Aldoux Huxley said in his essay Music at Night (1931) ”After silence, that which comes nearest to expressing the inexpressible is music.”

Music has always played an important role in knowledge and communication among different cultures and it plays a very important role in young people culture, transmitting their worries and interests. The music world, especially rock, jazz and blues, has been related to drugs and alcohol. Themes related to drug and alcohol abuse and other mental disorders are frequent in the contents of songs, titles and even in the names of bands.

The authors aim to show the relation between music and mental disorders.

The authors made a brief review of lyrics, song titles and names of popular bands of different music styles and times.

In many song lyrics and titles it is frequent to appear promotion of drugs and alcohol abuse as well as reference to psychiatric clinical terms as suicide, hallucination and depression.

Cultural formulation (CF) of the DSM-IV is the cultural assessment tool promoted by the APA, not fully developed, that has limitations in clinical practice. An abridged cultural development, integrated into the overall clinical development of the case, might be more operational.

Develop an abridged CF of a clinical case, focusing only on relevant cultural elements for the proper understanding of the case diagnosis and therapeutic approach.

A 43 year old woman from Hispanic Caribbean was admitted to a psychiatric unit, diagnosed with cycloid psychosis. She had been hospitalized twice before, with diagnosis of acute polymorphic psychotic episode. The three episodes seemed reactive to stress - loneliness, isolation, lack of protection - all on an abnormal development of personality with a clear overdevelopment of professional self versus other aspects of the self. The knowledge of sociopolitical conditions of her country, provided by a key informant, was necessary to deepen the narrative sense that the patient gave her disease.

The diagnostic formulation including an abridged CF, made by introducing cultural elements, lead to a better understanding of the underlying psychopathology and sense of anomalous behaviour, develop an explanation of the disease acceptable to the patient and improve the therapeutic alliance, ensuring adherence to treatment and satisfaction with it.

Cognitive neuroscience and anthropological theories have to mix their methods to offer a more valid and reliable instrument than currently available. Future instruments must be compatible with work of a clinical psychiatrist and demonstrate cost-effectiveness of their use.

To review the current status, directions and distortions in the field of culture and mental health, and their interface with politics.

Arising from the ruins of Adam Smith's shattered capitalist dream, shattered by the Great Depression, Keynesenian economics underpinned post-neoliberal thought and shaped politics, culture and science in ways few could have imagined.

Biomedical science did not remain immune, and mental health provided a soft target to political activists and reformers. Research evidence relating to ethnic variations in the prevalence, pathways to care and outcomes in schizophrenia, generated from epidemiological studies on migrant populations and a series of WHO-sponsored cross-cultural studies, has become enmeshed in the dialectic around alleged institutional racism in psychiatry, with deeply entrenched and highly adversarial posturing on both sides.

Examine research evidence linking schizophrenia and culture, and how the politics of post-neoliberalism impacts scientific inquiry, with illustrations from different countries, and attempt to identify islands of credible research and outline possible future directions.

Fragmented and often contradictory evidence in this area does not lend itself to coherent inferences, with the problem being compounded by allegations of institutional racism.

There are many unanswered questions:

• • Does cultural research improve clinical practice?

• • Or does it merely distract attention from core/ important secular issues?

• • Does it tend to demonise mainstream services and alienate ethnic minority patients?

• • Does what some term cultural gimmickry serve a hidden political agenda?

• • Has cultural research evidence lead to meaningful macro or micro-level interventions?

Social Anxiety Disorder has been repeatedly shown to be very prevalent in the Western society with prevalence rates of 10% or above. However, very few studies have been performed in the Middle East and in Arab countries.

Three hundred Israeli students participated in our study and were administered the Liebowitz Social Anxiety Scale (LSAS), the Cheek Buss Shyness questionnaire (CBSQ) and a socio-demographic questionnaire.

153 Jewish and 147 Arab students participated in the survey. SAD was found in 12.33% of the sample, according to the LSAS cutoff score of ≥60. The two subsamples had similar LSAS and CBSQ scores and similar positive SAD-positive rates (LSAS≥60). Females had higher scores on the LSAS, as were those without a spouse and those that had been in psychological treatment. Based on a regression analysis, the significant predictors of the LSAS score were the CBSQ score and female gender. A very high correlation was found between the LSAS score and the CBSQ score.

SAD and shyness are similarly prevalent in Jewish and Arab students in Israel. SAD scores were higher among females, those without a spouse and those that received psychological treatment. Further studies on the clinical and cultural characteristics of SAD in Israeli sub-cultures would add to the growing body of knowledge on SAD in various cultures.

Dhat syndrome is a commonly recognized clinical entity in Indian culture. It consists of vague somatic symptoms (fatigue, weakness, anxiety, loss of appetite, guilt, etc.) and at times sexual dysfunction (impotence or premature ejaculation), which the patient attributes to the passing of semen (Dhat) in urine as a direct consequence of his excessive indulgence in masturbation or sexual intercourse.

To assess medical and psychiatric co-morbidities and prevalent knowledge and attitudes among patients of Dhat syndrome.

A cross-sectional study of 50 consecutive male patients with Dhat syndrome attending psychosexual clinic of a tertiary care hospital in Delhi was performed to ascertain co-morbid psychiatric and medical disorders and the prevalent knowledge and attitudes of subjects towards Dhat syndrome and its management.

The commonest associated psychiatric illness was neurotic depression followed by anxiety neurosis. The commonest associated medical illness was urinary tract infections (UTI) followed by sexually transmitted diseases (STDs). Majority of subjects believed Dhat to be semen; that Dhat syndrome causes both physical and mental weakness and; that health tonics are required for successful management of Dhat syndrome. More than half of the subjects believed that masturbation causes Dhat syndrome. The study reveals a change in knowledge and attitudes of patients affected with Dhat syndrome in the last decade.

Dhat syndrome exhibits significant medical and psychiatric co-morbidity. The findings of this study need to be further evaluated in the immigrant population.

Internalized stigmatization means a internalized reaction in the person with mentally illness as a answer against the people reject and discrimination.

The peoples with mentally illness believe that most people reject and devalue people with mental illnesses, they may suffer a number of negative outcomes, such as demoralization, lowered self-esteem.

The aim of our study was to identify the relationship between the factors effecting the internalized stigmatization and self-esteem among patients with mentally illness.

In this study, we measured the prevalence of internalized stigma among 115 outpatients referring to the Psychiatry Service of Antalya Education and Research Hospital between 2009–2010 using Rosenberg Self-Esteem(SE) Scale, the Internalized Stigma of Mental Illness(ISMI) Scale, and Personel Datasheet.

Of the patients, 53.9% had middle level of SE and the 22.00–70.00 ranging of ISMI, 30.4% of the patients were found to be 21–30 years-old. We found the increase of ISMI when SE was decreased in both of gender(p = 0.01, r = -0.67) and it was also found to be decreased of ISMI when the education level was increased in the patients(p = 0.004,r = -0.27). Recurrent hospitalization of the patients increased their ISMI points(p = 0.014, r = 0.23). There was no statistical relation between the living place of the patients and their ISMI points(p = 0.523).

Our results suggest that some factors effected internalized stigma and showed the relationship between the internalized stigmatization and self-esteem among patients with mentally illness. To decrease and prevent internalized stigmatization, a specific education should be provided to patients, families and society by health professionals.

Roma think highly of the family. Its function is influenced by Roma's distinguished cultural system and their system of values.

The objective of the present study was to investigate the relationship between family relationships, personal growth, family system maintenance and sociodemographic factors in Roma.

145 individuals (105 male and 89 female), residents of the general area of Greece, participated in the present study. The measures used were: a) The Family Environment Scale (Form R-FES) and b) A questionnaire concerning socio-demographic information.

The marital status correlated with the Cohesion in Roma family (r. = .225, P = .002), Expressiveness (r. = .188, P = .009), Conflict (r. = -.178, P = .013), Achievement Orientation, Intellectual - Cultural Orientation (r. = .184, P = .010), Family Organization (r. = .267, P = .000), Family Control (r. = -.178, P = .013), and Family Incongruence (r. = .200, P = .005). The sex correlated with the Achievement Orientation (r. = -.253, P = .000), Moral-Religious Emphasis (r. = -.275, P = .000), Family Organization (r. = -.172, P = .016), Family Control (r. = -.280, P = .000), and Family Incongruence (r. = -.182, P = .011). The work situation correlated with the Cohesion (r. = -.207, P = .004), Achievement Orientation (r. = -.173, P = .016), Intellectual - Cultural Orientation (r. = -.177, P = .014), Family Organization (r. = -.220, P = .002), Family Control (r. = -.180, P = .012), and Family Incongruence (r. = -.205, P = .004).. The state of residence correlated with Conflict (r. = -.213, P = .003), Independence (r. = .213, P = .003), Achievement Orientation (r. = .202, P = .005), and Moral-Religious Emphasis (r. = .191, P = .008).

In Greek Roma the different Relationship Dimensions and the Personal Growth Dimensions are influenced by certain demographic factors like the marital status, the work situation, the state of their residence (existence of bathroom, electricity) and also the possession of legal documents (ID).

The purpose of this study was to verify the Jungian concept of synchronicity and to utilize lucid dreaming techniques for the selected dreamers to experience synchronistic dreams more frequently.

1248 dreams were collected from 416 Korean college students, Yongin, South Korea: 198 males (M age = 20.46 years, SD = 1.32) and 218 females (M age = 20.17, SD = 1.26). The collected dreams were coded by the Sang Bok Lee Neurosynchronistic Dream Scales. 36 dreams (2.88%) were evaluated as synchronistic and 10 dreamers were selected randomly and voluntarily: six females (M age = 20.19, SD = 1.24) and 4 males (M age = 20.47, SD = 1.35). Total twelve sessions for lucid dreaming technique training (one-hour session, twice per week, and six-week duration) were conducted and the trained dreamers reported their dreams during and after the twelve sessions.

50 dreams that were collected during and after the lucid dreaming sessions were coded and found as significantly increased in terms of synchronistic dream frequency mode (9 dreams, 18%, when compared with the untrained dreamers: p < 0.0001). The results were empirically supported by “Lee Acculturation Dream Scale” (Lee, Sang Bok, 2005: Psychological Reports, 96, 454–456), “The Sang Bok Lee Neurocognitive Dream Orientations Scales” (2010, European Psychiatry), and by “Dreaming Brain and Acculturative Mind” (Lee, Sang Bok, 2010, European Psychiatry).

Lucid dreaming constitutes a future-oriented intentionality, adaptive function of brain/mind, neural plasticity, and a certain realization of the Jungian concept of synchronicity with measurable differences from untrained dreamers.

There is a significant disagreement in the literature concerning the validity of psychiatric instruments in different cultures.

The objective of the study was to develop a culturally sensitive psychiatric screening instrument valid for Greeks in Greece and all over the world.

Forward and back translation was used for the greek version of the instrument. The sample was divided into three groups:

i) general population(69,4%);

ii) people in non-psychiatric treatment(12,9%);

iii) people in psychiatric treatment (11,7%).

They were interviewed with the Self-Reporting Questionnaire (SRQ), modified to include SRQ-F culturally specific items and physicians also completed an encounter form about the presence of mental health symptoms in participants.

The study sample was composed of 631 Greek speaking adults, 502 females and 129 males, aged 18—67 (M = 30, SD = 11,5). Internal consistency for the overall score was very high (α = ,930). Item total correlations were between, 443 and, 692. Factor analysis revealed four factors accounting for the 54,22 of the total score variance. The factors were anxiety symptoms, depressed mood, somatic symptoms and psychotic symptoms. Content, construct, and criterion validity of each question led to 25 items. Independent t test revealed significant differences between psychiatric patients and control group in the total score (t = -17,795 p = ,0001), psychosis subscale (t = -12,622 p = ,0001) and somatic distress subscale (t = -17,712 p = ,0001).

The Greek SRQ was found to be a valid instrument which can be used in primary care to help general practitioners in the early recognition of mental illness.