[FUNCTIONAL SOMATIC SYNDROMES AMONG ETHIOPIAN IMMIGRANTS IN ISRAEL]

The psychiatric classifications of disease (DSMIV; ICD-10) relate to a family of high incidence somatoform disorders whose use isn't uniform and cannot be measured. DSM-5 presents the term "cultural conceptualization of distress", which attempts to describe the cultural construct and its influences on mental distress and symptom presentation. Somatization among immigrants poses a diagnostic, treatment and research challenge due to cultural differences such as wrong understanding of their symptoms that may lead to misdiagnosis and to prescribing wrong and possibly harmful treatment and unnecessary hospitalization. This challenge is greater when encountering Ethiopian new immigrants due to the significant doctor-patient cultural gaps on one hand, and the community's heterogeneity, on the other. The Integrative Culture Sensitive Assessment and Treatment Model helps structure the diagnostic and treatment processes appropriately.

Two culture-related functional somatic disorders are presented, alongside with their diagnosis and treatment: The "Ken-Ken" syndrome (worms in the ear) - where the patient complains worms have entered her ear and head influencing her daily functioning, and the "prolonged pregnancy" syndrome, where the menopausal woman believes she is pregnant for many years and that the fetus "has turned into bone".

This article presents the somatization mechanism via two culture-related case studies of Ethiopian new immigrants to Israel suffering from emotional distress via culturally different symptomatology. It further presents an integrated cultural oriented treatment approach as a way to reduce overuse of primary and secondary medical services.