Cultural Diversity and the DSM-III-R: Can a Barking Man be Diagnosed?

The case of the Barking Man JJP 9(1):82-88, 1991) raises once again the question whether some mental disorders are Culture Bound Syndromes or are merely cultural manifestations of basic mental disorders which plague humankind wherever they live. Bernstein and Gaw (1) have recently made a compelling argument for the former position using the example of Koro. Koro affects a variety of ethnic groups throughout Southeast Asia and is characterized by an acute, morbid panic accompanied by the idea that the penis is retracting and will disappear, at which time, the patient fears, he will die. The disorder is widespread, affecting many people, and has been prevalent in the region for generations

GAP-REACH

Growing awareness of health and health care disparities highlights the importance of including information about race, ethnicity, and culture (REC) in health research. Reporting of REC factors in research publications, however, is notoriously imprecise and unsystematic. This article describes the development of a checklist to assess the comprehensiveness and the applicability of REC factor reporting in psychiatric research publications. The 16-item GAP-REACH checklist was developed through a rigorous process of expert consensus, empirical content analysis in a sample of publications (N = 1205), and interrater reliability (IRR) assessment (N = 30). The items assess each section in the conventional structure of a health research article. Data from the assessment may be considered on an item-by-item basis or as a total score ranging from 0% to 100%. The final checklist has excellent IRR (κ = 0.91). The GAP-REACH may be used by multiple research stakeholders to assess the scope of REC reporting in a research article