Cross-Cultural Issues

  • Ilaria TarriconeEmail author
  • Iris T. Graef-Calliess
  • Nasim Chaudhry
  • Marianne Kastrup
  • Domenico Berardi
  • Dinesh Bhugra
  • Mauro Braca
  • Ronald Burian
  • Albert Diefenbacher
  • Silvia Ferrari
  • Nusrat Husain
  • Adil Qureshi
  • Meryam Schouler-Ocak
  • Sarah Tosato
Part of the Integrating Psychiatry and Primary Care book series (IPPC)


Migrants and ethnic minorities are at higher risk to develop mental disorders compared to native population. Culture has an important impact on the symptom presentation, diagnostic process and treatment strategies in all populations. Cultural competence represents good clinical practice and can be defined as a two-way learning encounter where clinician acknowledges the patient’s culture as well as his own cultural values and prejudices. Cultural competent response to the mental health care requires knowledge, skills and attitudes. Both individual and organizational cultural competences are needed to improve the effectiveness of psychiatric treatment. In this chapter, we revised the WPA Guidance on Mental Health and Mental Health Care for Migrants and the EPA Guidance on Mental Health Care for Migrants and list a series of recommendations for policy-makers, service providers and clinicians. Cultural competent experiences in the treatment of somatization and other psychiatric disorders across several countries in Europe are also presented.


Migration Ethnic minorities Psychiatric disorders Somatization Cultural competence Cross-cultural issues Sociocultural determinants of health Interpreters Cultural mediators Cultural knowledge Cultural skills Cultural attitudes 


  1. 1.
    Fung K, Lo HT, Srivastava R, Andermann L. Organizational cultural competenceconsultation to a mental health institution. Transcult Psychiatry. 2012;49(2):165–84.CrossRefPubMedGoogle Scholar
  2. 2.
    Mahoney JS, Carlson E, Engebretson JC. A framework for cultural competence in advanced practice psychiatric and mental health education. Perspect Psychiatr Care. 2006;42(4):227–37.CrossRefPubMedGoogle Scholar
  3. 3.
    Bhugra D, Gupta S, Bhui K, Craig T, Dogra N, Ingleby JD, et al. WPA guidance on mental health and mental health care in migrants. World Psychiatry. 2011;10(1):2–10.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Bhui K, Warfa N, Edonya P, McKenzie K, Bhugra D. Cultural competence in mental health care: a review of model evaluations. BMC Health Serv Res. 2007;7:15.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Brach C, Fraser I. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Med Care Res Rev. 2000;57:181–217.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Johnsen BH, Meeùs P, Meling J, Rogde T, Eid J, Esepevik R, et al. Cultural differences in emotional intelligence among top officers on board merchant ships. Int Marit Health. 2012;63(2):90–5.PubMedGoogle Scholar
  7. 7.
    Andresen J. Cultural competence and health care: Japanese, Korean, and Indian patients in the United States. J Cult Divers. 2001;8(4):109–21.PubMedGoogle Scholar
  8. 8.
    Flores G. Culture and the patient-physician relationship: achieving cultural competency in health care. J Pediatr. 2000;136(1):14–23.CrossRefPubMedGoogle Scholar
  9. 9.
    Siegel CE, Wanderling J, Haugland G, Laska EM, Case BG. Access to and use of non-inpatient services in New York State among racial-ethnic groups. Psychiatr Serv. 2013;64(2):156–64.CrossRefPubMedGoogle Scholar
  10. 10.
    Tarricone I, Mimmi S, Paparelli A, Rossi E, Mori E, Panigada S, et al. First episode psychosis at the West Bologna Community Mental Health Centre: results of an 8-year prospective study. Psychol Med. 2012;42(11):2255–64.CrossRefPubMedGoogle Scholar
  11. 11.
    Warren BJ. How culture is assessed in the DSM-5. J Psychosoc Nurs Ment Health Serv. 2013;51(4):40–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Ferrari S, Burian R, Hahn E, Chaudhry N, Chaudhry IB, Husain N, Ta TM, Diefenbacher A, Qureshi A, Berardi D, Braca M, Tarricone I. Somatization among ethnic minorities and immigrants: why does it matter to Consultation Liaison Psychiatry? J Psychosom Res. 2015;79(1):85–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Tarricone I, Stivanello E, Poggi F, Castorini V, Marseglia MV, Fantini MP, et al. Ethnic variation in the prevalence of depression and anxiety in primary care: a systematic review and meta-analysis. Psychiatry Res. 2012;195:91–106.CrossRefPubMedGoogle Scholar
  14. 14.
    Commander MJ, Dharan SP, Odell SM, Surtees PG. Access tomental health care in an inner-city health district. II: association with demographic factors. Br J Psychiatry. 1997;170:317–20.CrossRefPubMedGoogle Scholar
  15. 15.
    Borowsky SJ, Rubenstein LV, Meredith LS, Camp P, Jackson-Triche M, Wells KB. Who is at risk of nondetection of mental health problems in primary care? J Gen Intern Med. 2000;15:381–8.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Husain N, Waheed W, Tomenson B, Creed F. The validation of personal health questionnaire amongst people of Pakistani family origin living in the United Kingdom. J Affect Disord. 2007;97:261–4.CrossRefPubMedGoogle Scholar
  17. 17.
    Gillam SJ, Jarman B, White P, Law R. Ethnic differences in consultation rates in urban general practice. BMJ. 1989;299:953–7.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Bhui K, Bhugra D, Goldberg D, Sauer J, Tylee A. Assessing the prevalence of depression in Punjabi and English primary care attenders: the role of culture, physical illness and somatic symptoms. Transcult Psychiatry. 2004;41:307–22.CrossRefPubMedGoogle Scholar
  19. 19.
    Cornwell J, Hull S. Do GPs prescribe antidepressants differently for South Asian patients? Fam Pract. 1998;15:S16–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Melfi CA, Croghan TW, Hanna MP, Robinson RL. Racial variation in antidepressant treatment in a Medicaid population. J Clin Psychiatry. 2000;61:16–21.CrossRefPubMedGoogle Scholar
  21. 21.
    Hull SA, Cornwell J, Harvey C, Eldridge S, Bare PO. Prescribing rates for psychotropic medication amongst east London general practices: low rates where Asian populations are greatest. Fam Pract. 2001;18:167–73.CrossRefPubMedGoogle Scholar
  22. 22.
    Padgett DK, Patrick C, Burns BJ, Schlesinger HJ. Ethnicity and the use of outpatient mental health services in a national insured population. Am J Public Health. 1994;84:222–6.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Zhang M, Booth BM, Smith GR. Services utilization before and after the prospective payment system by patients with somatization disorder. J Behav Health Serv Res. 1998;25:76–82.CrossRefPubMedGoogle Scholar
  24. 24.
    Schouler-Ocak M, Graef-Calliess IT, Tarricone I, Qureshi A, Kastrup MC, Bhugra D. EPA guidance on cultural competence training. Eur Psychiatry. 2015;30(3):431–40. Scholar
  25. 25.
    Betancourt JR, Green AR, Carrillo JE, et al. Cultural competence and health care disparities: key perspectives and trends. Health Aff. 2005;24:499–505.CrossRefGoogle Scholar
  26. 26.
    Mendez JL, Westerberg D. Implementation of a culturally adapted treatment to reduce barriers for Latino parents. Cultur Divers Ethnic Minor Psychol. 2012;18(4):363–72.CrossRefPubMedGoogle Scholar
  27. 27.
    Qureshi A, Collazos F, Ramos M, Casas M. Cultural competency training in psychiatry. Eur Psychiatry. 2008;23(1):49–58.CrossRefPubMedGoogle Scholar
  28. 28.
    Vega WA. Higher stakes ahead for cultural competence. Gen Hosp Psychiatry. 2005;27(6):446–50.CrossRefPubMedGoogle Scholar
  29. 29.
    Yamada AM, Brekke JS. Addressing mental health disparities through clinical competence not just cultural competence: the need for assessment of sociocultural issues in the delivery of evidence-based psychosocial rehabilitation services. Clin Psychol Rev. 2008;28(8):1386–99.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Hornberger JC, Gibson CD Jr, Wood W, Dequeldre C, Corso I, Palla B, et al. Eliminating language barriers for non-English-speaking patients. Med Care. 1996;34(8):845–56.CrossRefPubMedGoogle Scholar
  31. 31.
    Samu KS, Suaalii-Sauni T. Exploring the ‘cultural’ in cultural competencies in Pacific mental health. Pac Health Dialog. 2009;15(1):120–30.PubMedGoogle Scholar
  32. 32.
    Schouler-Ocak M, Reiske S-L, Rapp M, Heinz A. Cultural Factors in the diagnosis and treatment of traumatised migrant patients from Turkey. Transcult Psychiatry. 2008;45(4):652–70.CrossRefPubMedGoogle Scholar
  33. 33.
    Vardar A, Kluge U, Penka S. How to express mental health problems—Turkish immigrants in Berlin compared to native Germans in Berlin and Turks in Istanbul. Eur Psychiatry. 2012;27(2):S50–6.CrossRefPubMedGoogle Scholar
  34. 34.
    Williams MT, Domanico J, Marques L, Leblanc NJ, Turkheimer E. Barriers to treatment among African Americans with obsessive-compulsive disorder. J Anxiety Disord. 2012;26(4):555–63.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Bhugra D, Gupta S, Schouler-Ocak M, Graeff-Calliess I, Deakin NA, Qureshi A, et al. EPA guidance mental health care of migrants. Eur Psychiatry. 2014;29(2):107–15.CrossRefPubMedGoogle Scholar
  36. 36.
    Bhui K, Abdi A, Abdi M, Pereira S, Dualeh M, Robertson D, et al. Traumatic events, migration characteristics and psychiatric symptoms among Somali refugees-preliminary communication. Soc Psychiatry Psychiatr Epidemiol. 2003;38(1):35–43.CrossRefPubMedGoogle Scholar
  37. 37.
    Lederbogen F, et al. City living and urban upbringing affect neural social stress processing in humans. Nature. 2011;474:498–501.CrossRefPubMedGoogle Scholar
  38. 38.
    Kim SP. Culture and child and adolescent psychiatry. In: Tseng WS, Streltzer J, editors. Cultural competence in clinical psychiatry. Arlington: American Psychiatric Publishing, Inc.; 2004.Google Scholar
  39. 39.
    Tseng WS, Streltzer J. Cultural competence in health care. A guide for professionals. New York: Springer Science + Business Media, LLC; 2008.CrossRefGoogle Scholar
  40. 40.
    Kirmayer LJ. Rethinking cultural competence. Transcult Psychiatry. 2012;49(2):149–64.CrossRefPubMedGoogle Scholar
  41. 41.
    Kleinman A, Benson P. Anthropology in the clinic: the problem of cultural competency and how to fix it. PLoS Med. 2006;3(10):e294.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Neelam K, Duddu V, Chaudhry IB, Antonysamy AS, Husain N. A survey of British senior psychiatry trainees’ ethnocultural personal values. Acad Psychiatry. 2009;33(5):423–6.CrossRefPubMedGoogle Scholar
  43. 43.
    Shaw SJ, Armin J. The ethical self-fashioning of physicians and health care systems in culturally appropriate health care. Cult Med Psychiatry. 2011;35(2):236–61.CrossRefPubMedGoogle Scholar
  44. 44.
    Brannigan MC. Connecting the dots in cultural competency: institutional strategies and conceptual caveats. Camb Q Health Ethics. 2008;17(2):173–84.CrossRefGoogle Scholar
  45. 45.
    Gregory H Jr, Van Orden O, Jordan L, Portnoy GA, Welsh E, Betkowski J, et al. New directions in capacity building: incorporating cultural competence into the interactive systems framework. Am J Community Psychol. 2012;50(3–4):321–33.CrossRefPubMedGoogle Scholar
  46. 46.
    Penka S, Kluge U, Vardar A, Borde T, Ingleby D. The concept of “intercultural opening”: the development of an assessment tool for the appraisal of its current implementation in the mental health care system. Eur Psychiatry. 2012;27(2):S63–9.CrossRefPubMedGoogle Scholar
  47. 47.
    Cross T, Bazon B, Isaacs M. Towards a culturally competent system of care, volume I. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assitance Center; 1989.Google Scholar
  48. 48.
    Kastrup M. Staff competence in dealing with traditional approaches. Eur Psychiatry. 2008;23(1):59–68.CrossRefPubMedGoogle Scholar
  49. 49.
    Hoke MM, Robbins LK. Continuing the cultural competency journey through exploration of knowledge, attitudes, and skills with advanced practice psychiatric nursing students: an exemplar. Nurs Clin North Am. 2011;46(2):201–5.CrossRefPubMedGoogle Scholar
  50. 50.
    Tervalon M, Murray-García J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved. 1998;9(2):117–25.CrossRefPubMedGoogle Scholar
  51. 51.
    Dastjerdi M. The case of Iranian immigrants in the greater Toronto area: a qualitative study. Int J Equity Health. 2012;11:9.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Harris TL, McQuery J, Raab B, Elmore S. Multicultural psychiatric education: using the DSM-IV-TR Outline for Cultural Formulation to improve resident cultural competence. Acad Psychiatry. 2008;32(4):306–12.CrossRefPubMedGoogle Scholar
  53. 53.
    Rechel B, Mladovsky P, Ingleby D, Mackenbach JP, McKee M. Migration and health in an increasingly diverse Europe. Lancet. 2013;381(9873):1235–45.CrossRefPubMedGoogle Scholar
  54. 54.
    Kirmayer LJ. Cultural competence and evidence-based practice in mental health: epistemic communities and the politics of pluralism. Soc Sci Med. 2012;75:249–56.CrossRefPubMedGoogle Scholar
  55. 55.
    Kirmayer LJ, Fung K, Rousseau C, Lo HT, Menzies P, Guzder J, et al. Guidelines for training in cultural psychiatry—position paper. Can J Psychiatr. 2012;57(3):1–17.CrossRefGoogle Scholar
  56. 56.
    Cattacin S, Chimienti M et al. Difference sensitivity in the field of migration and health. National policies compared. Geneva: Working Paper No. 1 of the Department of sociology of the University of Geneva; 2007.Google Scholar
  57. 57.
    Chiarenza A. Developments in the concept of cultural competence. In: Ingleby D, Chiarenza A, Devillé W, Kotsioni I, editors. Inequalities in health care for migrants and ethnic minorities. Antwerp: Garant; 2012. p. 66–81.Google Scholar
  58. 58.
    Morawska A, Fletcher R, Pope S, Heathwood E, Anderson E, McAuliffe C. Evaluation of mental health first aid training in a diverse community setting. Int J Ment Health Nurs. 2013;22(1):85–92.CrossRefPubMedGoogle Scholar
  59. 59.
    Sue S, Zane N. The role of culture and cultural techniques in psychotherapy. A critique and reformulation. Am Psychol. 1987;42(1):37–45.CrossRefPubMedGoogle Scholar
  60. 60.
    Schouler-Ocak M, Bretz HJ, Penka S, Koch E, Hartkamp N, Siefen RG, et al. Patients of immigrant origin in inpatient psychiatric facilities. Eur Psychiatry. 2008;23(Suppl 1):S21–7.CrossRefGoogle Scholar
  61. 61.
    Rucci P, Piazza A, Perrone E, Tarricone I, Maisto R, Donegani I, et al. Disparities in mental health care provision to immigrants with severe mental illness in Italy. Epidemiol Psychiatr Sci. 2014;30:1–11.Google Scholar
  62. 62.
    Griner D, Smith TB. Culturally adapted mental health intervention: a meta-analytic review. Psychotherapy (Chic). 2006;43(4):531–48.CrossRefGoogle Scholar
  63. 63.
    Kleinman A. Major conceptual and research issues for cultural (anthropological) psychiatry. Cult Med Psychiatry. 1980;4(1):3–23.CrossRefPubMedGoogle Scholar
  64. 64.
    Bauer AM, Alegría M. Impact of patient language proficiency and interpreter service use on the quality of psychiatric care: a systematic review. Psychiatr Serv. 2010;61(8):765–73.CrossRefPubMedPubMedCentralGoogle Scholar
  65. 65.
    Devillé W, Greacen T, Bogic M, Dauvrin M, Dias S, Gaddini A, Koitzsch Jensen N, Karamanidou C, Kluge U, Mertaniemi R, Puigpinos I, Riera R, Sárváry A, Soares JJF, Stankunas M, Strassmayr C, Welbel M, Priebe S. Health care for immigrants in Europe: is there still consensus among country experts about principles of good practice? A Delphi study. BMC Public Health. 2011;11:699.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Westermeyer J. Working with an interpreter in psychiatric assessment and treatment. J Nerv Ment Dis. 1990;178(12):745–9.CrossRefPubMedGoogle Scholar
  67. 67.
    Tribe R. Bridging the gap or damming the flow? Some observations on using interpreters/bicultural workers when working with refugee clients, many of whom have been tortured. Br J Med Psychol. 1999;72(Pt4):567–76.CrossRefPubMedGoogle Scholar
  68. 68.
    Sandhu S, Bjerre NV, Dauvrin M, Dias S, Gaddini A, Greacen T, Ioannidis E, Kluge U, Jensen NK, Lamkaddem M, Puigpinós I, Riera R, Kósa Z, Wihlman U, Stankunas M, Straßmayr C, Wahlbeck K, Welbel M, Priebe S. Experiences with treating immigrants: a qualitative study in mental health services across 16 European countries. Soc Psychiatry Psychiatr Epidemiol. 2013;48(1):105–16.CrossRefPubMedGoogle Scholar
  69. 69.
    Pace P. The right to health of migrants in Europe. In: Rechel B, Mladovsky P, Devillé W, Rijks B, Petrova-Benedict R, McKee M, editors. Migration andhealth in the European Union. Maidenhead: Open University Press; 2011. p. 55–66.Google Scholar
  70. 70.
    Heinz A, Kluge U. Mental health in different groups of migrants and ethnic minority within Europe and beyond: regional and cross-national challenges and approaches in research, practice and training. Eur Psychiatry. 2012;27(2):S1–3.CrossRefPubMedGoogle Scholar
  71. 71.
    Butow PN, Aldridge L, Bell ML, Sze M, Eisenbruch M, Jefford M, et al. Inferior health-related quality of life and psychological well-being in immigrant cancer survivors: a population-based study. Eur J Cancer. 2013;49(8):1948–56.CrossRefPubMedGoogle Scholar
  72. 72.
    Chiarenza A, Robinson J, Spilker R, HPH TF MFCCH Task Force on Migrant Friendly, Culturally Competent Health Care. Developing standards for assessing equity of access, quality of health care for migrants, other vulnerable groups. Workshop of the Task Force MFCCH. Turku: International HPH Conference; 2011 June 1–3.Google Scholar
  73. 73.
    Kleinman A. Epilogue. Mental health in different groups of migrants and ethnic minority in Europe and beyond. Eur Psychiatry. 2012;27(2):S81–2.CrossRefPubMedGoogle Scholar
  74. 74.
    Laban CJ, Komproe IH, Gernaat HB, JT DJ. The impact of a long asylum procedure on quality of life, disability and physical health in Iraqi asylum seekers in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2008;43:507–15.CrossRefPubMedGoogle Scholar
  75. 75.
    Wilson M, MacCarthy B. GP consultation as a factor in the low rate of mental health service use by Asians. Psychol Med. 1994;24:113–9.CrossRefPubMedGoogle Scholar
  76. 76.
    Tarricone I, Atti AR, Salvatori F, Braca M, Ferrari S, Malmusi D, Berardi D. Psychotic symptoms and general health in a socially disadvantaged migrant community in Bologna. Int J Soc Psychiatry. 2009;55(3):203–13.CrossRefPubMedGoogle Scholar
  77. 77.
    Tarricone I, Stivanello E, Ferrari S, Colombini N, Bolla E, Braca M, et al. Migrant pathways to community mental health centres in Italy. Int J Soc Psychiatry. 2012;58:505–11.CrossRefPubMedGoogle Scholar
  78. 78.
    Tarricone I, Atti AR, Braca M, Pompei G, Morri M, Poggi F, et al. Migrants referring to the Bologna Transcultural Psychiatric Team: reasons for drop-out. Int J Soc Psychiatry. 2011;57:627–30.CrossRefPubMedGoogle Scholar
  79. 79.
    Tarricone I, Braca M, Allegri F, Barrasso G, Bellomo A, Berlincioni V, Carpiniello B, Ceregato A, Conforti Donati M, Defilippi S, Del Vecchio V, De Rosa C, Ferrannini L, Ferrari S, Furio MA, Gramaglia C, La Cascia C, Luciano M, Mulè A, Nardini M, Podavini F, Primavera D, Reggianini C, Rigatelli M, Todarello O, Turella E, Ventriglio A, Zeppegno P, Fiorillo A, Berardi D. First-episode psychosis and migration in Italy (PEP-Ita migration): a study in the Italian mental health services. BMC Psychiatry. 2014;14(1):186.CrossRefPubMedPubMedCentralGoogle Scholar
  80. 80.
    Husain N, Creed F, Tomenson B. Adverse social circumstances and depression in people of Pakistani origin in the UK. Br J Psychiatry. 1997;171:434–8.CrossRefPubMedGoogle Scholar
  81. 81.
    Creed F, Winterbottom M, Tomenson B, Britt R, Anand IS, Wander GS, et al. Preliminary study of non-psychotic disorders in people fromthe Indian subcontinent living in the UK and India. Acta Psychiatr Scand. 1999;99:257–60.CrossRefPubMedGoogle Scholar
  82. 82.
    Duddu V, Husain N, Dickens C. Medically unexplained presentations and quality of life: a study of a predominantly South Asian primary care population in England. J Psychosom Res. 2008;65:311–7.CrossRefPubMedGoogle Scholar
  83. 83.
    Gater R, Tomenson B, Percival C, Chaudhry N, Waheed W, Dunn G, et al. Persistent depressive disorders and social stress in people of Pakistani origin and white Europeans in UK. Soc Psychiatry Psychiatr Epidemiol. 2009;44:198–207.CrossRefPubMedGoogle Scholar
  84. 84.
    Ta TM, Neuhaus AH, Burian R, Schomerus G, von Poser A, Diefenbacher A, et al. Mental health care utilization of first generation Vietnamese migrants in Germany. Psychiatr Prax. 2015;42(5):267–73.PubMedGoogle Scholar
  85. 85.
    Griffiths G, Tarricone I, Berardi D, Donegani I, Fioritti A, Maisto R, Braca M, Menchetti M, Tonti L, Nolet M, Piazza A, Spigonardo V. The provision of mental health services to immigrants and refugees in Italy: the barriers and facilitating factors experienced by mental health workers. J Psychopathol. 2017;23(2):79–86.Google Scholar
  86. 86.
    Tarricone I, Mencacci E, Braca M, Salvatori F, Di Marco S, Nolet M, Storbini V, Berardi D. Work of the Bologna Transcultural Psychiatric Team (BoTPT) with refugees and asylum seekers: when remembering helps. J Psychopathol. 2013;19(3):234–41.Google Scholar
  87. 87.
    Conti, L., Dell’Osso, L. & Cassano, G.B. (1990) Il sistema AMDP. Manuale per la valutazione e la documentazione della psicopatologia. Milano: Edizioni Grafiche Mazzucchelli.Google Scholar
  88. 88.
    Arbeitsgemeinschaft fur Methodik und Dokumentation in der Psychiatrie. Das MDP-System (3 Auflage). Manual zur Dokumentation psychiatrischer Befunde. Berlin: Springer;1979.Google Scholar
  89. 89.
    Schedule for clinical assessment of neuropsychiatry, version 2.1. Geneva: World Health Organization, Division of Mental Health; 1998.Google Scholar
  90. 90.
    Pietzcker A, Gebhardt R. Depressive syndromes and scales in the AMDP-system. Acta Psychiatr Scand. 1983;310:65–84.CrossRefGoogle Scholar
  91. 91.
    Pietzcker A, Gebhardt R, Strauss A, Stockel M, Langer C, Freudenthal K. The syndrome scales in the AMDP-system. Mod Probl Pharmacopsychiatry. 1983;20:88–99.CrossRefPubMedGoogle Scholar
  92. 92.
    Diefenbacher A, Heim G. Somatic symptoms in Turkish and German depressed patients. Psychosom Med. 1994;56:551–6.CrossRefPubMedGoogle Scholar
  93. 93.
    Mumford DB, Bavington JT, Bhatnagar KS, Hussain Y, Mirza S, Naraghi MM. The Bradford Somatic Inventory. A multi-ethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent. Br J Psychiatry. 1991;158:379–86.CrossRefPubMedGoogle Scholar
  94. 94.
    Mumford DB, Tareen IA, Bhatti MR, Bajwa MA, Ayub M, Pervaiz T. An investigation of ‘functional’ somatic symptoms among patients attending hospital medical clinics in Pakistan—II. Using somatic symptoms to identify patients with psychiatric disorders. J Psychosom Res. 1991;35(2–3):257–64.CrossRefPubMedGoogle Scholar
  95. 95.
    Nicholls TL, Ronald R, Olley MC, Ogloff JRP, Hemphill F. Jail Screening Assessment Tool (JSAT), manuale e libretto intervista. Firenze: Giunti Editore; 2011.Google Scholar
  96. 96.
    Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. 1995;51(6):768–74.CrossRefPubMedGoogle Scholar
  97. 97.
    Aragona M, Pucci D, Roma P, Aprigliano A, Camilo da Silva E, Urbinati S, Zakeri S, Frabotta P, Pisani R. Il LiMEs (List of Migration Experiences): Costruzione e validazione di uno strumento per valutare le esperienze traumatiche e le difficoltà di vita in contesti migratori. In: Aragona M, Geraci S, Mazzetti M, editors. Quando le ferite sono invisibili. Vittime di tortura e di violenza: strategie di cura. Bologna: Pendragon; 2014. p. 106–18.Google Scholar
  98. 98.
    Beusenberg M, Orley JH, World Health Organization, Division of Mental Health. A User’s guide to the self reporting questionnaire (SRQ/compiled by M. Beusenberg and J. Orley). Geneva: World Health Organization; 1994.Google Scholar
  99. 99.
    Chaudhry N, Husain N, Tomenson B, Creed F. A prospective study of social difficulties, acculturation and persistent depression in Pakistani women living in the UK. Psychol Med. 2012;42(6):1217–26.CrossRefPubMedGoogle Scholar
  100. 100.
    Wolf S, Hahn E, Dettling M, Nguyen MH, Wingenfeld K, Stingl M, Hanewald B, Ta TMT. Migration-related stressors and their effect on the severity level and symptom pattern of depression among vietnamese in Germany. Depress Res Treat. 2017;2017:8930432. Epub 2017 Aug 22.PubMedPubMedCentralGoogle Scholar
  101. 101.
    Dreher A, Hahn E, Diefenbacher A, Burian H, Dettling M, Burian R, Ta TM. Cultural differences in symptom representation for depression and somatization measured by the PHQ between Vietnamese and German psychiatric outpatients. J Psychsom Res. 2017;(102):71–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Ilaria Tarricone
    • 1
    Email author
  • Iris T. Graef-Calliess
    • 2
  • Nasim Chaudhry
    • 3
  • Marianne Kastrup
    • 4
  • Domenico Berardi
    • 5
  • Dinesh Bhugra
    • 6
  • Mauro Braca
    • 7
  • Ronald Burian
    • 8
  • Albert Diefenbacher
    • 8
  • Silvia Ferrari
    • 9
  • Nusrat Husain
    • 10
  • Adil Qureshi
    • 11
  • Meryam Schouler-Ocak
    • 12
  • Sarah Tosato
    • 13
  1. 1.Bologna Transcultural Psychosomatic Team (BoTPT), Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum Bologna UniversityBolognaItaly
  2. 2.Department of PsychiatryHannover Medical School, Social Psychiatry and PsychotherapyHannoverGermany
  3. 3.Dow University of Health Sciences, Pakistan Institute of Living and LearningKarachiPakistan
  4. 4.CopenhagenDenmark
  5. 5.Dipartimento di Scienze Biomediche e Neuromotorie (DIBINEM)Alma Mater Studiourum Bologna UniversityBolognaItaly
  6. 6.Emeritus Professor of Mental Health and Cultural Diversity at the Institute of Psychiatry, Psychology and Neuroscience at King’s College LondonLondonUK
  7. 7.Department of Mental HealthAUSL BolognaBolognaItaly
  8. 8.Department of Psychiatry, Psychotherapy and PsychosomaticsEvangelisches Krankenhaus Königin Elisabeth HerzbergeBerlinGermany
  9. 9.Department of Diagnostics, Clinical and Public Health MedicineUniversity of Modena and Reggio EmiliaModenaItaly
  10. 10.University of Manchester, Lancashire Care Early Intervention ServiceManchesterUK
  11. 11.Hospital Universitari Vall d’Hebron, Servei de PsiquiatriaBarcelonaSpain
  12. 12.Psychiatric University Clinic of Charité at St. Hedwig’s HospitalBerlinGermany
  13. 13.Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly

Personalised recommendations