The University of the West Indies, Mona, Kingston, Jamaica.
Transcult Psychiatry. 2012 Apr;49(2):223-44. doi: 10.1177/1363461512441596.
The level of out-migration from the Caribbean is very high, with migration of tertiary-level educated populations from Caribbean countries being the highest in the world. Many clinicians in receiving countries have had limited diagnostic and therapeutic experience with Caribbean migrants, resulting in diagnostic and therapeutic controversies. There is an urgent need for better understanding of these cultural differences. The paper explores issues of clinical and cultural competence relevant to assessing, diagnosing, and treating Caribbean migrants with a focus on three areas: cultural influences on illness phenomenology; the role of language differences in clinical misunderstandings; and the complexities of culture and migration. Clinical issues are illustrated with case studies culled from four decades of clinical experience of the first author, an African Jamaican psychiatrist who has worked in the Caribbean, North America, Europe, and New Zealand.
加勒比地区的移民外流水平非常高，其中受过高等教育的人口外流率居世界之首。许多接收国的临床医生对加勒比移民的诊断和治疗经验有限，导致诊断和治疗方面存在争议。因此，迫切需要更好地了解这些文化差异。本文探讨了与评估、诊断和治疗加勒比移民相关的临床和文化能力问题，重点关注三个方面：疾病表现学中的文化影响；语言差异在临床误解中的作用；以及文化和移民的复杂性。临床问题通过从第一作者四十年来的临床经验中提取的案例研究来说明，第一作者是一位非洲裔牙买加精神病学家，曾在加勒比地区、北美、欧洲和新西兰工作。
