Orthostatic panic attacks among Vietnamese refugees.
Viewed historically and cross-culturally, orthostatic-induced dizziness, i.e., dizziness caused by standing up from a sitting or a lying position, forms a key aspect of many syndromes: irritable heart (American Civil War), effort syndrome (World War I and World War II), chronic fatigue syndrome (contemporary USA), Gulf War syndrome (contemporary USA), and orthostatic dysregulation (contemporary Japan). Among Vietnamese refugees attending a psychiatric clinic, this study documents a high rate of orthostatic panic (OP), as well as certain processes seemingly generating these panic attacks, viz., flashbacks and culturally specific catastrophic cognitions. Case examples are used to demonstrate OP's phenomenology and relevance to clinical care. To illustrate the mechanisms producing OP, we adduce the multiplex model of panic generation. Culturally appropriate care of Vietnamese refugees should include assessment and treatment of OP.
Hinton
Devon E
DE
Harvard Medical School, Massachusetts General Hospital, Department of Psychiatry, Boston 02114, USA. devon_hinton@hms.harvard.edu
Hinton
Ladson
L
Tran
Minh
M
Nguyen
Men
M
Nguyen
Lim
L
Hsia
Curtis
C
Pollack
Mark H
MH
D000328:Adult; D001714:Bipolar Disorder / Q000208:ethnology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000208:ethnology* / Q000523:psychology*; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D016584:Panic Disorder / Q000208:ethnology* / Q000209:etiology*; D012036:Refugees / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000208:ethnology / Q000628:therapy; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D019966:Substance-Related Disorders / Q000208:ethnology / Q000628:therapy; D014481:United States / Q000453:epidemiology; D014744:Vietnam / Q000208:ethnology