Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH.
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati Medical Center, Cincinnati, OH.
J Acad Consult Liaison Psychiatry. 2022 Nov-Dec;63(6):628-634. doi: 10.1016/j.jaclp.2022.03.001. Epub 2022 Mar 23.
We describe the case of a 33-year-old pre-eclamptic Bhutanese woman who presented with postpartum hallucinations. We discuss our concern for postpartum psychosis versus a culturally appropriate phenomenon, with her diagnostic picture complicated by the use of interpreters and the intersection of culture and medicine. Top experts in the consultation-liaison (CL) field provide guidance for this clinical scenario based on their experience and a review of the available literature. This case highlights both the impact of language barriers and the challenges of interpreting psychiatric symptoms within a cultural context. Key teaching points include differential diagnoses for postpartum hallucinations, the importance of interpreting patient presentations within their unique cultural contexts and identities, and the impact of language interpretation on patient care. Specifically, we offer guidance on differentiating postpartum psychosis from a culturally appropriate phenomenon.
我们描述了一位 33 岁的产前子痫的不丹籍妇女，她出现了产后幻觉。我们讨论了我们对产后精神病与文化上适当现象的关注，她的诊断情况因口译员的使用以及文化和医学的交叉而变得复杂。咨询联络（CL）领域的顶尖专家根据他们的经验和对现有文献的回顾，为这一临床情况提供了指导。这个案例既突出了语言障碍的影响，也突出了在文化背景下解释精神症状的挑战。关键的教学要点包括产后幻觉的鉴别诊断、在独特的文化背景和身份下解释患者表现的重要性，以及语言解释对患者护理的影响。具体来说，我们提供了从文化上适当的现象中区分产后精神病的指导。
