Clinical considerations in cross-cultural diagnosis

When psychiatrists and patients come from different cultural backgrounds, special knowledge, assistance, and awareness are needed for accurate diagnosis. Understanding the sociocultural milieu in which the patient lives and functions is crucial for distinguishing psychopathology from culture-bound beliefs or behavior. Clinical observation and physical examination may be the primary diagnostic tools in the cross-cultural setting if clinical history is scanty or the mental status examination is unsatisfactory. Interviewing techniques must be designed to encourage rapport and reduce fear. The author discusses issues to be considered in choosing the language to be spoken during the interview and using a translator. He emphasizes the need for clinicians to detect and transcend their own cultural biases and those of their patients, as well as the need for professional training in making cross-cultural diagnostic assessments.