title: A Vietnamese man with selective mutism: the relevance of multiple interacting 'cultures' in clinical psychiatry.
abstract: Multiple cultural variables have effects on the psychobiology and behavioral manifestations of illness, as do patient and physician perceptions of illness. The interaction among these variables is at the heart of clinical psychiatry. This case of a Vietnamese man with selective mutism underscores the relevance of the 'cultures' of medicine, psychiatry, and war and trauma on the manifestations of illness and illness perceptions by patient and physician. The discussion focuses on how these cultures interact and play a crucial role in formulating diagnosis and treatment planning. Suggestions are given for shifts in medical education that will encourage relevant cultural paradigms to make their way into educational and clinical systems, which in turn should improve cultural competence in clinical psychiatry.
authors.affiliation: Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque 87131, USA. mhollifield@salud.unm.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Hollifield
authors.forename: Cynthia
authors.initials: C
authors.lastname: Geppert
authors.forename: Yuam
authors.initials: Y
authors.lastname: Johnson
authors.forename: Carol
authors.initials: C
authors.lastname: Fryer
mesh_terms: D000328:Adult; D003142:Communication; D018864:Cultural Diversity; D006801:Humans; D008016:Life Change Events; D008297:Male; D009155:Mutism / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D014744:Vietnam