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Comorbidity: Meaning and uses in cross-cultural clinical research

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Abstract

American Indians and Alaska Natives were the subject of a workshop sponsored by the National Institute of Mental Health and the Indian Health Service. Comorbidity of anxiety, depression, and substance abuse is highly prevalent in these two populations, and this was the focus of the meeting. This paper introduces the topic of psychiatric comorbidity, and considers the topics of culture, psychiatric diagnosis, and assessment. Future research directions and a brief summary of the papers presented at the workshop, which are included in this issue, are provided.

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References

  • American Psychiatric Association 1980 Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition. Washington, D.C.: American Psychiatric Press.

    Google Scholar 

  • American Psychiatric Association 1987 Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition Revised. Washington, D.C.: American Psychiatric Press.

    Google Scholar 

  • Bell, C. C., B. Shakoor, B. Thompson, D. Dew, E. Hughley, R. Mays, and K. Shorter-Gooden 1984 Prevalence of Isolated Sleep Paralysis in Black subjects. Journal of the National Medical Association 76: 501–508.

    Google Scholar 

  • Bell, C.C., D.D. Dixie-Bell, and B. Thompson 1986 Further Studies on the Prevalence of Isolated Sleep Paralysis in Black subjects. Journal of the National Medical Association 75: 649–659.

    Google Scholar 

  • Berkson, J. 1946 Limitations of the Application of Fourfold Table Analysis to Hospital Data. Biometric Bulletin 2: 47–53.

    Google Scholar 

  • Berry, J. and V. Kim 1988 Acculturation and Mental Health. In Health and Cross-cultural Psychology P. Dasen, J. Berry, and N. Sartorius (eds.), pp. 207–238. Newbury Park, CA: Sage.

    Google Scholar 

  • Boyd, J.H., J.D. Burke, E. Gruenberg, C.E. Holzer, III, D.S. Rae, L.K. George, M. Karno, R. Stoltzman, L. McEvoy, and G. Nestadt 1984 Exclusion Criteria of DSM-III. Archives of General Psychiatry 41: 983–989.

    Google Scholar 

  • Dinges, N.G., and Duong-Tran, Q. 1991 Suicide ideation and suicide attempt among American Indian and Alaska Native Boarding School Adolescents. In W. Sack, C. Duclof, and S. Manson (eds.), American Indian and Alaska Native Adolescent Suicide Research, Monograph Series of the National Center for American Indian and Alaska Native Mental Health Research, Volume 4.

  • Dinges, N.G., Joos, S.K., and Duong-Tran, Q. 1987 Development and validation of a mental health screening measure for American Indian adolescents. Final report to the Mental Health Branch, Portland Area Office, U.S. Indian Health Service.

  • Dinges, N.G., and Joos, S.K. 1988 Stress, coping, and health: Models of interaction for Indian and native populations. American Indian and Alaska Native Mental Health Research 1: 8–55.

    Google Scholar 

  • Endicott, J. and R.L. Spitzer 1978 A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry 35: 837–844.

    Google Scholar 

  • Everett, H.C. 1963 Sleep Paralysis in Medical Students. Journal of Nervous and Mental Diseases 136:283–287.

    Google Scholar 

  • Fabrega, H. 1982 Culture and Psychiatric illness: Biomedical and Ethnomedical Aspects. In A. Marsella, and G. White (eds.), pp. 39–68. Cultural Conceptions of Mental Health and Therapy. Dordrecht, Holland: D. Reidel Publishing Co.

    Google Scholar 

  • Fabrega, H. 1987 Psychiatric Diagnosis: A Cultural Perspective. The Journal of Nervous and Mental Disease 175 (7): 383–394.

    Google Scholar 

  • Fabrega, H., Jr. 1990 A Plea for a Broader Ethnomedicine. Culture, Medicine and Psychiatry 14: 129–132.

    Google Scholar 

  • Feinstein, A.R. 1970 The pre-therapeutic classification of co-morbidity in chronic disease. Journal of Chronic Diseases 23: 455–468.

    Google Scholar 

  • Good, B.J. and M.-J.D. Good 1986 The Cultural Context of Diagnosis and Therapy: A View from Medical Anthropology. Mental Health Research & Practice in Minority Communities: Development of Culturally Sensitive Training Programs. In M.R. Miranda and H.H.L. Kitano (eds.), pp. 1–27. U.S. Department of Health and Human Services Publication No. (ADM) 86–1466. Washington, D.C.: U.S. Government Printing Office.

    Google Scholar 

  • Good, B.J. and A.M. Kleinman 1985 Culture and Anxiety: Cross-Cultural Evidence for the Patterning of Anxiety Disorders. In Anxiety and the Anxiety Disorders A.H. Tuma and J.D. Maser (eds.), pp. 297–323. Hillsdale, N.J.: Lawrence Erlbaum Associates.

    Google Scholar 

  • Goode, G.B. 1962 Sleep paralysis. Archives of Neurology 6: 228–234.

    Google Scholar 

  • Jenkins, J., Kleinman, A. and Good, B. 1990 Cross-cultural studies of depression. In J. Becker and A. Kleinman (eds.) Advances in Mood Disorder pp. 67–99. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.

    Google Scholar 

  • Jenkins, J., A. Kleinman, and B. Good 1991 Cross-cultural Studies of Depression. In J. Becker and A. Kleinman (eds.), Psychosocial Aspects of Depression, pp. 67–99. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.

    Google Scholar 

  • Keane, T.M. and Wolfe, J. 1990 Comorbidity in post-traumatic stress disorder: An analysis of community and clinical studies. Journal of Applied Social Psychology 20 (21 pt. 1): 1776–1788.

    Google Scholar 

  • Kirmayer, L. 1991 The Place of Culture in Psychiatric Nosology: Taijin Kyofusho and DSM-III-R. The Journal of Nervous and Mental Disease 179 (1), 19–28.

    Google Scholar 

  • Levy, J., S. Kunitz and E. Henderson 1987 Hopi Deviance in Historical and Epidemiological Perspective. In Themes in ethnology and culture: Essays in honor of David F. Aberle. J. Jorgensen and L. Donald (eds.), Berkeley: Folklore Institute.

    Google Scholar 

  • Lock, M. 1987 DSM-III as a Culture-bound Construct: Commentary on Culture-bound Syndromes and International Disease Classification. Culture Medicine and Psychiatry, 11: 35–42.

    Google Scholar 

  • Lutz, K. 1985 Depression and translation of emotional worlds. In: Culture and depression: Studies in the anthropology and cross-cultural psychiatry of affect and disorder. A. Kleinman and B. Good, (eds.), 63–100 Berkeley, CA: U. of California Press.

    Google Scholar 

  • Manson, S.M., Shore, J.H. and Bloom, J.D. 1985 Depressive experiences in Indian communities: A challenge for psychiatric diagnosis and theory. In A. Kleinman and B. Good (eds.), Culture and depression: studies in the anthropology and cross-cultural psychiatry of affect and disorder. Berkeley, CA: University of California Press.

    Google Scholar 

  • Maser, J.D. and C.R. Cloninger 1990 Comorbidity of Mood and Anxiety Disorders. Washington, D.C.: American Psychiatric Press.

    Google Scholar 

  • Maser, J.D., C. Kaelber and R.E. Weise 1991 International Use and Attitudes toward DSM-III and DSM-III-R: Growing Consensus in Psychiatric Classification. Journal of Abnormal Psychology 100 (3): 271–279.

    Google Scholar 

  • Monroe, S.M. 1990 Psychosocial Factors in Anxiety and Depression. In Comorbidity of Mood and Anxiety Disorders, J.D. Maser and C.R. Cloninger (eds.), pp. 463–497. Washington, D.C.: American Psychiatric Press.

    Google Scholar 

  • Neal, A.M. and S.M. Turner 1991 Anxiety Disorders Research With African Americans: Current Status. Psychological Bulletin 109 (3): 400–410.

    Google Scholar 

  • Ness, R.C. 1978 The Old Hag Phenomenon as Sleep Paralysis: a Biocultural Interpretation. Culture, Medicine and Psychiatry 2: 15–39.

    Google Scholar 

  • O'Nell, T.D. 1989 Psychiatric Investigations among American Indians and Alaska Natives: A Critical Review. Culture, Medicine and Psychiatry 13: 51–87.

    Google Scholar 

  • Radloff, L.S. 1977 The CES-D scale: a self-report depressive scale for research in the general population. Journal of Applied Psychological Measurement 1: 385–401.

    Google Scholar 

  • Regier, D.A., M. Farmer, D. Rae, B.Z. Locke, S. Keith, L. Judd, and F. Goodwin 1990 Comorbidity of Mental Disorders with Alcohol and Other Drug Abuse: Results from the Epidemiological Catchment Area (ECA) Study. Journal of the American Medical Association 264 (19): 2511–2518.

    Google Scholar 

  • Robins, L.N., J.E. Helzer, J. Croughan, and K.S. Ratcliff 1981 National Institute of Mental Health Diagnostic Interview Schedule. Archives of General Psychiatry 38: 381–389.

    Google Scholar 

  • Sturt, E. 1981 Hierarchical Patterns in the Distribution of Psychiatric Symptom. Psychiatric Medicine 11: 783–794.

    Google Scholar 

  • Tyrer, P., J. Alexander, M. Remington, and P. Riley 1987 Relationship between Neurotic Symptoms and Neurotic Diagnosis: A Longitudinal Study. Journal of Affective Disorders 13: 13–21.

    Google Scholar 

  • Vitaliano, P., P. Katon, J. Russo, R. Maiuro, K. Anderson and M. Jones 1987 Coping as an Index of Illness Behavior in Panic Disorder. The Journal of Nervous and Mental Disease 179 (2): 78–84.

    Google Scholar 

  • Watson, D. and L.A. Clark 1984 Negative Affectivity: The Disposition to Experience Aversive Emotional States. Psychological Bulletin 96: 465–490.

    Google Scholar 

  • World Health Organization 1977 International Classification of Diseases, Injuries, and Causes of Death (9th edition). Geneva: World Health Organization.

    Google Scholar 

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Maser, J.D., Dinges, N. Comorbidity: Meaning and uses in cross-cultural clinical research. Cult Med Psych 16, 409–425 (1992). https://doi.org/10.1007/BF00053585

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