Click here to download

Toward a transcultural clinical practice in public mental health services: Humanitarian conflict and forced mass migrations
Journal Title: RIVISTA SPERIMENTALE DI FRENIATRIA 
Author/s: Sergio Zorzetto, Azzurra Tavano, Giuseppe David Inglese, Giuseppe Cardamone, Salvatore Inglese 
Year:  2017 Issue: Language: Italian 
Pages:  28 Pg. 23-50 FullText PDF:  775 KB
DOI:  10.3280/RSF2017-003003
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 


Since the end of the past decade, particularly during the North African humanitarian Emergency, international mass migrations entered the new legal framework of international human rights protection. This novel approach not only modified the conceptual interpretation of migration, but also the management of migration, producing major repercussions - some of which are still underway - on public mental health care. Asylum seekers and refugees pose nowadays unprecedented organizational and clinical issues to the public health system. Researchers and clinicians are currently observing the development of a "psychopathology of forced migration". This phenomenon is generated by a cumulative trauma exposure starting from the pre-migration phase (disintegration and breakdown of social links in the country of origin), then amplified during the migratory phase (life-threatening situations) and becoming chronic during the post-migratory phase (forced settlement in an imposed environment). These traumas do not only affect single individuals, but also whole groups, i.e. significant parts of migrant populations. This perspective of trans-cultural research, applied to the different phases of migration, is in line with the long-established trend of studies on the "psychopathology of migration". Public mental health services should take into account the complexity of this phenomenon and build stronger links with the reception facilities for asylum seekers and refugees, in order to reduce the psychopathological consequences of migration.
Keywords: Ethnopsychiatry, psychopathology, migration, asylum seekers, refugees, borders.

  1. Di Donato R. I greci, l’irrazionale e noi. Introduzione alla nuova edizione. In: Dodds E.R. I Greci e l’Irrazionale. Milano: La Nuova Italia; 2000. p. V-XXIV.
  2. Dodds E.R. I Greci e l’Irrazionale. Milano: La Nuova Italia; 2000.
  3. Höfer J. Dissertatio medica de nostalgia, oder Heimweh. Basileae: Universitätsbibliothek Basel; 1688 Shelf Mark: Diss 45:2
  4. Foville A. Les aliénés voyageurs ou migrateurs. Etude clinique sur certains cas de lypémanie. Annales Médico-Psychologiques 1875; 2: 5-45.
  5. Inglese S. Dalla psicopatologia delle migrazioni all’etnopsichiatria. I fogli di Oriss 2000; 13/14: 141-158 (riedito in: Inglese S, Cardamone G, ed. Déjà vu. Tracce di etnopsichiatria critica. Paderno Dugnano (MI): Edizioni Colibrì; 2010. p. 61-75).
  6. Inglese S. L’inquieta alleanza tra psicopatologia e antropologia. Ricordi e riflessioni da un’esperienza sul campo. I fogli di ORISS 1993; 1: 34-62.
  7. Frigessi Castelnuovo D, Risso M. A mezza parete. Emigrazione, nostalgia, malattia mentale. Torino: Einaudi; 1982.
  8. Häfner H. Obituary in honour of Professor Dr. Ørnulv Ødegard. Social Psychiatry 1987; 22, 3: 177-178., 10.1007/BF00583853DOI: 10.1007/BF00583853
  9. Fearon P, Morgan C. Environmental factors in schizophrenia: the role of migrant studies. Schizophrenia Bulletin 2006; 32, 3: 405-408.
  10. Harrison G, Owens D, Holton A, Neilson D, Boot D. A prospective study of severe mental disorder. Afro-Caribbean patients Psychol. Med. 1988; 18: 643-657., 10.1017/S0033291700008321DOI: 10.1017/S0033291700008321
  11. Kirkbride JB, Fearon P, Morgan C, Dazzan P, Morgan K, Tarrant J et al. Heterogeneity in incidence rates of schizophrenia and other psychotic syndrome. Arc. Gen. Psychiatry 2006; 63: 250-258
  12. Cantor-Graae E, Pedersen CB. Full spectrum of psychiatric disorders related to foreign migration. Jama Psychiatry 2013; 70: 427-435.
  13. De Almeida Z. Introduction à la psychopathologie de la transplantation. L’Information psychiatrique 1972; 2: 167-173.
  14. De Almeida Z. Les perturbation mentales chez le migrants. L’Information psychiatrique 1975; 51: 249-281.
  15. Mejri O, Hagi A. La rivolta dei dittatoriati. Messina: Mesogea; 2013.
  16. Bracci F, ed. Emergenza Nord Africa: i percorsi di accoglienza diffusa. Analisi e monitoraggio del sistema. Pisa: Pisa University Press; 2012.
  17. Lasalvia A, Bonatto C, Tosato S, Zanatta G, Cristofalo D, Salazzari D. et al. First-contact incidence of psychosis in north-eastern Italy: influence of age, gender, immigration and socioeconomic deprivation. British Journal of Psychiatry 2014; 205: 127-134.
  18. Zorzetto S. Funzione biopolitica delle frontiere nell’accoglienza a richiedenti asilo e rifugiati. Cambio. Rivista sulle trasformazioni sociali 2016; VI, 12: 215-229.
  19. Hyndman H, Giles W. Waiting for what? The feminization of asylum in protracted situations. Gender, Place & Culture: A Journal of Feminist Geography 2011; 18, 3: 361-379., 10.1080/0966369X.2011.56634DOI: 10.1080/0966369X.2011.56634
  20. Zandi T, Havenaar JM, Limburg-Okken AG, van Es H, Sidali S, Kadri N. et al. The need for culture sensitive diagnostic procedures: a study among psychotic patients in Morocco. Soc. Psychiatry Psychiatr. Epidemiology 2008; 42: 244-250.
  21. Turner S. Suspended spaces. Contesting sovereignties in a refugee camp. In: Blom Hansen T, Stepputat F, ed. Sovereign bodies citizens, migrants, and states in the postcolonial world. Princeton: Princeton University Press; 2005. p. 312-332.
  22. Zandi T, Havenaar JM, Smith M, Limburg-Okken AG, van Es H, Cahn W. et al. First contact incidence of psychotic disorders among native Dutch and Moroccan immigrants in Netherlands: influence of diagnostic bias. Schizophrenia Research, 2010, 119, 27-33.
  23. Holzer E. What happens to law in a refugee camp? Law & Society Review 2013; 47, 4: 837-872.
  24. Zandi T, Havenaar JM, Laan W, Kahn RS, van den Brink W. Predictive validity of a culturally informed diagnosis of schizophrenia: a 30 month follow-up study with first episode psychosis. Schizophrenia Research 2011; 133, 1-3: 29-35.
  25. Zorzetto S. Dalla continuità disciplinare alle discontinuità etnologiche. La comparazione fra culture in un’ottica etnopsichiatrica. Archivio di Etnografia n.s. 2010; V.1-2: 35-56., 10.1400/189339DOI: 10.1400/189339
  26. Littlewood R. La migration des syndromes liés à la culture. Psychopathologie Africaine 1984-1985; 20, 1: 5-16.
  27. Malkki LH. Refugees and exile: from “refugee studies” to the national order of things. Annual Review of Anthropology 1995; 24: 496-523.
  28. Devereux G. ed. Saggi di etnopsichiatria generale (Nuova edizione italiana a cura di S. Inglese) Roma: Armando; 2007.
  29. Murphy HBM. The resettlement of Jewish refugees in Israel, with special reference to those known as displaced persons. Population Studies 1951; 5, 2: 153-174.
  30. Nathan T. L’influence qui guérit. Paris: Odile Jacob; 1994.
  31. Murphy HBM. The assimilation of refugee immigrants in Australia. Population Studies 1952; 5, 3: 179-206.
  32. Bracci F, Valzania A, ed. Zone d’ombra. Migranti irregolari, operatori e servizi socio sanitari. Un’indagine a Prato. Acireale - Roma: Bonanno Editore; 2012.
  33. Inglese S. Radici strappate e malattie migranti. Intorno al costrutto nosologico di Culture-Bound Syndrome. In: Inglese S, Cardamone G, ed. Déjà vu. Tracce di etnopsichiatria critica. Paderno Dugnano (MI): Edizioni Colibrì; 2010. p. 153-176.
  34. Hyndman H, Mountz A. Another brick in the wall? Neo-refoulement and the externalization of asylum by Australia and Europe. Government and Opposition 2008; 43, 2: 249-269.
  35. Casas-Cortes M, Cobarrubias S, Pickles J. Riding routes and itinerant borders. Autonomy of migration and border externalization. Antipode 2015; 47, 4: 894-914.
  36. Peters K, Richards P. Jeunes combattants parlant de la guerre et de la paix en Sierra Leone. Cahiers d’études africaines 1998; 38, 150-152: 581-617.
  37. Inglese S. A sud della mente. Etnopsichiatria e psicopatologia delle migrazioni in sei movimenti. In: Attenasio L, Casadei F, Inglese S, Ugolini O, ed. La cura degli altri. Seminari di etnopsichiatria. Roma: Armando editore; 2005. p. 61-163.
  38. Inglese S. La psicopatologia dell’emigrazione: un’esperienza di cambiamento catastrofico individuale e collettivo. In: Mellina S, ed. Medici e sciamani. Fratelli separati. Roma: Lombardo Editore; 1997. p. 85-93.
  39. Foucault M. Il faut défendre la société. Paris: Seuil-Gallimard; 1997.
  40. Zorzetto S, Inglese S, Cardamone G. Accoglienza dei popoli in fuga e salute mentale. Proposte per l’Italia. Psichiatria e Psicoterapia Culturale 2014; II, 1: 52-72.
  41. Dalakoglou D. Europe’s last frontier: the spatialities of the refugee crisis. City 2016; 20, 2: 180-185., 10.1080/13604813.2016.117046DOI: 10.1080/13604813.2016.117046
  42. Foucault M. Del governo dei viventi. Corso al Collège de France (1979-1980). Milano: Feltrinelli; 2014.
  43. Foucault M. Tecnologie del sé. Torino: Bollati Boringhieri; 1992.
  44. Inglese S, Cardamone G, Inglese GD, Zorzetto S. Scenari di salute mentale: migrazioni internazionali e generazioni discendenti. Psichiatria e Psicoterapia Culturale 2016; IV, 1: 91-111.
  45. Seddio K. Trauma, psychopathology, and the refugee crisis: a call to action. AJPH 2017; 107, 7: 1044-1045., 10.2105/AJPH.2017.303857DOI: 10.2105/AJPH.2017.303857
  46. Jakobsen M, Meyer De Mott MA, Wentzel-Larsen T, Heir T. The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway. BMJ Open 2017; 7: e015157.
  47. Stotz SJ, Elbert T, Müller V, Schauer M. The relationship between trauma, shame, and guilt: findings from a community-based study of refugee minors in Germany. European Journal of Psychotraumatology 2015; 6: 25863.
  48. Oppedal B, Idsoe T. The role of social support in the acculturation and mental health of unaccompanied minor asylum seekers. Scandinavian Journal of Psychology 2015; 56, 2: 203-11.
  49. Jensen TK, Bjørgo Skårdalsmo EM, Fjermestad KW. Development of mental health problems: a follow-up study of unaccompanied refugee minors. Child and Adolescent Psychiatry and Mental Health 2014; 8: 29., 10.1186/1753-2000-8-29DOI: 10.1186/1753-2000-8-29
  50. Völkl-Kernstock S, Karnik N, Mitterer-Asadi M, Granditsch E, Steiner H, Friedrich MH. Responses to conflict, family loss and flight: posttraumatic stress disorder among unaccompanied refugee minors from Africa. Neuropsychiatrie 2014; 28:6-11.
  51. Huemer J, Völkl-Kernstock S, Karnik N, Denny KG, Granditsch E, Mitterer M. Personality and psychopathology in african unaccompanied refugee minors: repression, resilience and vulnerability. Child Psychiatry Hum Dev 2013; 44: 39-50.
  52. Smid GE, Lensvelt-Mulders GJLM, Knipscheer JW, Gersons BPR, Kleber RJ. Late-onset PTSD in unaccompanied refugee minors: exploring the predictive utility of depression and anxiety symptoms. Journal of Clinical Child & Adolescent Psychology 2011; 40, 5: 742-755., 10.1080/15374416.2011.597083DOI: 10.1080/15374416.2011.597083
  53. Derluyn I, Broekaert E. Unaccompanied refugee children and adolescents: the glaring contrast between a legal and a psychological perspective. International Journal of Law and Psychiatry 2008; 31: 319-330.
  54. Goodman JH. Coping with trauma and hardship among unaccompanied refugee youths from Sudan. Qual Health Res 2004; 14, 9: 1177-1196., 10.1177/1049732304265923DOI: 10.1177/1049732304265923
  55. Lussier M. Terra d’asilo, terra di lutto. Il lavoro psichico dell’esilio. Roma: Borla; 2012.
  56. Desjarlais R, Kleinman A. Violence and demoralization in the New World Disorder. Anthropology Today 1994; 10, 5: 9-12., 10.2307/2783077DOI: 10.2307/2783077
  57. Nathan T, Zajde N. Psychothérapie démocratique. Paris: Odile Jacob; 2012.
  58. Bradley L, Tawfiq N. The physical and psychological effects of torture in Kurds seeking asylum in the United Kingdom. Torture 2006; 16, 1: 41-47. PMID: 17460346.
  59. Hanscom KL. Treating survivors of war trauma and torture. American Psychologist 2001; 56, 11: 1032-1039., 10.1037//0003-066X.56.11.103DOI: 10.1037//0003-066X.56.11.103
  60. Sironi F. Bourreaux et victimes. Psychologie de la torture. Paris: Odile Jacob; 1999.
  61. Rieder H, Elbert T. Rwanda – lasting imprints of a genocide: trauma, mental health and psychosocial conditions in survivors, former prisoners and their children. Conflict and Health 2013; 7:6., 10.1186/1752-1505-7-6DOI: 10.1186/1752-1505-7-6
  62. Sherrell K, Hyndman J, Preniqi F. Sharing the wealth, spreading the “burden”? The settlement of Kosovar refugees in smaller British Columbia cities. Canadian Ethnic Studies 2005; 37, 3: 76-96.
  63. Bagilishya D. Mourning and recovery from trauma: in Rwanda, tears flow within. Transcultural Psychiatry 2000; 37, 3: 337-353., 10.1177/136346150003700304DOI: 10.1177/136346150003700304
  64. Bracewell W. Rape in Kosovo: masculinity and serbian nationalism. Nations and Nationalism 2000; 6, 4: 563-590.
  65. Besteman C. Violent politics and the politics of violence: the dissolution of the Somali Nation-State. American Ethnologist 1996; 23, 3: 579-596.
  66. Inglese S. Anche Hitler accarezzava i bambini: lineamenti paranoicali del terrorismo totalitario (2008). In: Inglese S, Cardamone G. ed. Déjà vu 2. Laboratori di etnopsichiatria critica. Paderno Dugnano (MI): Edizioni Colibrì 2017. p. 171-208.
  67. Elden S. The geopolitics of Boko Haram and Nigeria’s “war on terror”. The Geographical Journal 2014; 180, 4: 414-425.
  68. Tosini D. Al-Qaeda’s strategic gamble: the sociology of suicide bombings in Iraq. Canadian Journal of Sociology 2010; 35, 2: 271-308. http://www.jstor.org/stable/canajsocicahican.35.2.271.
  69. Crepet A, Rita F, Reid A, Van den Boogaard W, Deiana P, Quaranta G, et al. Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds. Conflict and Health 2017; 11:1.
  70. Sironi F. Psychopathologie des violences collectives. Essai de psychologie géopolitique clinique. Paris: Odile Jacob; 2007.
  71. Bronstein I, Montgomery P, Dobrowolski S. PTSD in asylum-seeking male adolescents from Afghanistan. Journal of Traumatic Stress 2012; 25: 551-557.
  72. Vinson GA, Chang Z. PTSD symptom structure among west African war trauma survivors living in african refugee camps: a factor-analytic investigation. Journal of Traumatic Stress 2012; 25: 226-231.
  73. Bentley JA, Thoburn JW, Stewart DG, Boynton LD. The indirect effect of somatic complaints on report of posttraumatic psychological symptomatology among Somali refugees. Journal of Traumatic Stress 2011; 24, 4: 479-482.
  74. Loutan L, Bollini P, Pampallona S, Bierens De Haan D, Gariazzo F. Impact of trauma and torture on asylum-seekers. European Journal of Public Health 1999; 9.2: 93-96.
  75. Hollander AC, Dal H, Lewis G, Magnusson C, Kirkbride JB, Dalman C. Refugee migration and risk of schizophrenia and other non-affective psychoses: cohort study of 1.3 million people in Sweden. BMJ 2016; 352.
  76. Kroll J, Yusuf AI, Fujiwara K. Psychoses, PTSD, and depression in Somali refugees in Minnesota. Soc Psychiatry Psychiatr Epidemiol 2011; 46: 481-493. doi 10.1007/s00127-010-0216-0.
  77. Panter-Brick C, Eggerman M. Understanding culture, resilience, and mental health: the production of hope. In: Ungar M, ed. The Social Ecology of Resilience. New York: Springer; 2012. p. 369-386.
  78. Hooberman J, Rosenfeld B, Rasmussen A, Keller A. Resilience in trauma exposed refugees: the moderating effect of coping style on resilience variables. American Journal of Orthopsychiatry 2010; 80, 4: 557-563.
  79. Charney DS. Psychobiological mechanisms of resilience and vulnerability: implications for successful adaptation to extreme stress. Am J Psychiatry 2004; 161: 195-216.
  80. Igreja V. The effects of traumatic experiences on the infant-mother relationship in the former war zones of central Mozambique: the case of madzawde in Gorongosa. Infant Mental Health Journal 2003; 24, 5: 469-494.
  81. Stammel N, Heeke C, Bockers E, Chhim S, Taing S, Wagner B, et al. Prolonged grief disorder three decades post loss in survivors of the Khmer Rouge regime in Cambodia. Journal of Affective Disorders 2013; 144, 1-2: 87-93.
  82. Dalgaard NT, Hviid P. Exploring the transgenerational transmission of trauma in a cultural life course perspective. In: Sato T, Mori N, Valsiner J, ed. Making of the Future: Trajectory Equifinality Approach in Cultural Psychology. Charlotte NC: Information Age Publishing; 2016. p. 67-86.
  83. Dalgaard NT, Montgomer E. Disclosure and silencing: a systematic review of the literature on patterns of trauma communication in refugee families. Transcultural Psychiatry 2015; 52, 579-563., 10.1177/1363461514568442DOI: 10.1177/1363461514568442
  84. Feldman M, Dozio E, El Husseini M, Drain E, Radjack R, Moro MR. Des “résidus radioactifs” au coeur d’une dyade mère-bébé ou la transmission du trauma d’une mère à son bébé. L’Autre 2015; 16, 2: 140-149 DOI 10.3917/lautr.047.0140.
  85. Igreja V. Why are there so many drums playing until dawn? Exploring the role of Gamba spirits and healers in the post-war recovery period in Gorongosa, Central Mozambique. Transcultural Psychiatry 2003; 40, 4: 459-487, 10.1177/1363461503404001DOI: 10.1177/1363461503404001
  86. Schwartz S, Dohrenwend BP, Levav I. Nongenetic familial transmission of psychiatric disorders? Evidence from children of holocaust survivors. Journal of Health and Social Behavior 1994; 35, 4: 385-402., 10.2307/2137216DOI: 10.2307/2137216
  87. Zorzetto S. Analisi etnopsichiatrica dei conflitti identitari nel regime di frontiera dell’accoglienza ai richiedenti asilo e rifugiati. Nuova Rassegna di Studi Psichiatrici. Rivista online di psichiatria 2017; 14 (www.nuovarassegnastudipsichiatrici.it).
  88. Hinton De von E, Kredlow MA, Bui E, Pollack MH, Hofmann SG. Treatment change of somatic symptoms and cultural syndromes among Cambodian refugees with PTSD. Depression and Anxiety 2012; 29: 147-154.
  89. Nathan T, Grandsard C. Disturbi da stress post traumatico e disturbi da spavento: ripensare il trauma da una prospettiva etnopsichiatrica. Il vaso di Pandora - Dialoghi in psichiatria e scienze umane 2011; XIX, 3: 31-55.
  90. Miller KE, Omidian P, Kulkarni M, Yaqubi A, Daudzai H, Rasmussen A. The validity and clinical utility of posttraumatic stress disorder in Afghanistan. Transcultrual Psychiatry 2009; 46, 2: 220-238., 10.1177/1363461509105813DOI: 10.1177/1363461509105813
  91. Boehnlein JH. Cultural interpretation of physiological processes in posttraumatic stress disorder and panic disorder. Transcultural Psychiatry 2001; 38, 4: 461-467, 10.1177/136346150103800403DOI: 10.1177/136346150103800403
  92. Nathan T. Les maladies de la terreur. Psychothérapie des traumatismes politiques dans des pays instables: exemples guinéens. In: Nathan T, Zajde N. ed. Psychothérapie démocratique. Paris: Odile Jacob; 2012. p. 213-239.

Sergio Zorzetto, Azzurra Tavano, Giuseppe David Inglese, Giuseppe Cardamone, Salvatore Inglese, Toward a transcultural clinical practice in public mental health services: Humanitarian conflict and forced mass migrations in "RIVISTA SPERIMENTALE DI FRENIATRIA" 3/2017, pp. 23-50, DOI:10.3280/RSF2017-003003

   

FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content