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A Psychiatric Curriculum Directed to the Care of the Hispanic Patient

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Abstract

Hispanics are the second-largest ethnic minority group in the United States, numbering approximately 20.7 million. This population has distinct cultural and linguistic characteristics with which psychiatrists should be familiar, and psychiatric residents should be taught how to appropriately diagnose and treat Hispanic patients. This article describes a model curriculum for psychiatric residency training programs that addresses the sociodemographic, epidemiological, psychosocial, cultural, and behavioral characteristics of Hispanics. The authors strongly recommend that faculty who are knowledgeable and sensitive about Hispanic culture be available for the supervision and teaching of psychiatric residents during their training. Supervision should focus on key educational issues such as cultural formulation, family dynamics, and other factors of importance in clinical psychiatric practice. A bibliography of relevant works is also included.

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References

  1. U.S. Bureau of the Census: Current Population Reports, Series P-20, no. 449,1991

    Google Scholar 

  2. Ruiz P: Assessing and treating culturally diverse individuals: a Hispanic perspective. Psychiatr Q 1995; 16:329–341

    Article  Google Scholar 

  3. Ruiz P: Access to health care for uninsured Hispanics: policy recommendations. Hospital and Community Psychiatry 1993; 44:958–962

    CAS  PubMed  Google Scholar 

  4. Escobar JI: Cross cultural aspects of the somatization trait. Hospital and Community Psychiatry 1987; 38:174–179

    CAS  PubMed  Google Scholar 

  5. Karno M, Hough RL, Burnam MA, et al: Lifetime prevalence of specific psychiatric disorders among Mexican-Americans and non-Hispanic whites in Los Angeles. Arch Gen Psychiatry 1987; 44:695–701

    Article  CAS  PubMed  Google Scholar 

  6. Ruiz P: Puerto Ricans: a psychopolitical point of view. American Journal of Social Psychiatry 1984; 4:21–24

    Google Scholar 

  7. Ruiz P: Clinical care up-date: the minority patient. Commun Ment Health J 1985; 21:208–216

    Article  CAS  Google Scholar 

  8. Ruiz P: Culture and mental health: a Hispanic perspective. Journal of Contemporary Psychotherapy 1977; 9:24–27

    Article  Google Scholar 

  9. Abad V, Ramos J, Boyce E: A model for delivery of mental health services to Spanish speaking minorities. Am J Orthopsychiatry 1971; 44:584–595

    Google Scholar 

  10. Bernal y del Rio V: Peculiarities of psychoanalytic treatment in a bicultural/bilingual situation. J Am Acad Psychoanal 1982; 10:173–193

    PubMed  Google Scholar 

  11. Del Castfflo JD: The influence of language upon symptomatology in foreign born patients. Am J Psychiatry 1970; 127:242–244

    Google Scholar 

  12. Escobar J: Unfounded physical complaints: conceptual and epidemiological aspects, in Medical Psychiatry: Theory and Practice, Vol 1, edited by Garza-Trevitio ES. River Edge, NJ, World Scientific, 1989, pp. 177–202

    Google Scholar 

  13. Martinez C: Group process and the Chicano: clinical issues. Intl Group Psychother 1977; 25:225–231

    Google Scholar 

  14. Canino IA, Spurlock J: Culturally Diverse Children and Adolescents: Assessment, Diagnosis, and Treatment. New York, Guilford, 1994

    Google Scholar 

  15. Caetano R: Drinking patterns and alcohol problems in a national sample of U.S. Hispanics, in Alcohol Use Among U.S. Ethnic Minorities, research monograph no.18 (DHHS pubi no [ADMI 89–1435). Washington, DC, US Government Printing Office, 1989, pp. 147–162

    Google Scholar 

  16. Canino IA, Rubio-Stipec M, Escobar J: Functional somatic symptoms: a cross-ethnic comparison. Am J Orthopsychiatiy 1992; 62:605–617

    Article  CAS  Google Scholar 

  17. Escobar JI, Burnam MA, Karno MF, et al: Somatization in the community. Arch Gen Psychiatry 1987; 44:713–718

    Article  CAS  PubMed  Google Scholar 

  18. Fabrega H: The study of disease in relation to culture. Behav Sd 1972; 17:182–203

    Google Scholar 

  19. Garza-Trevino ES: Aspectos biopsicosociales y epistemol#243gicos en Ia investigacion del cancer. Salud Mental 1988; 4:31–42

    Google Scholar 

  20. Martinez C: Psychiatric care of Mexican Americans, in Culture, Ethnicity, and Mental Illness, edited by Gaw AC. Washington, DC, American Psychiatric Press, 1993, pp.431–466

    Google Scholar 

  21. Ruiz P, Langrod J: The ancient art of folk healing: African influence in a New York City community mental health center, in Traditional Healing: New Science or New Colonialism? edited by Singer P. New York, Conch Magazine Publishers, 1977, pp. 80–95

    Google Scholar 

  22. Fabrega H, Rubel AJ, Wallace CA: Working class Mexican psychiatric outpatients. Arch Gen Psychiatry 1967; 16:704–712

    Article  PubMed  Google Scholar 

  23. Cuellar I, Roberts RE: Psychological disorders among Chicanos, in Chicano Psychology, edited by Martinez JL, Mendoza RH. New York, Academic Press, 1984, pp. 133–161

    Chapter  Google Scholar 

  24. Diaz Guerrero R: Neurosis and the Mexican family structure. Am J Psychiatry 1955; 112:411–417

    CAS  PubMed  Google Scholar 

  25. Edgerton RB, Karno M: Mexican-American bilingualism and the perception of mental illness. Arch Gen Psychiatry 1971; 24:286–290

    Article  CAS  PubMed  Google Scholar 

  26. Amaro N, Fortes A: Una sociología del exilio: situación de los grupos cubanos en los EE. UU. Aportes 1972; 23:6–24

    Google Scholar 

  27. Ruiz F: Cuban-Americans: migration, acculturation and mental health, in Theoretical and Conceptual Issues in Hispanic Mental Health, edited by Malgady R, Rodriguez O. Malabar, FL, Krieger, 1994, pp.70–89

    Google Scholar 

  28. American Medical Association: Directory of Graduate Medical Education Programs, 1992–1993. Chicago, IL, American Medical Association, 1993

    Google Scholar 

  29. Rumbaut RD, Rumbaut RG: The family in exile: Cuban expatriates in the U.S. Am J Psychiatry 1976; 133:395–399

    CAS  PubMed  Google Scholar 

  30. Markides KS, Kranse H: Intergenerational solidarity and psychological well being among older Mexican- Americans: a three-generation study. J Gerontol 1985; 40:390–392

    Article  CAS  PubMed  Google Scholar 

  31. Rogler LH, Cortes DE, Malgady RG: Acculturation and mental health status among Hispanics. Am Psychol 1991; 46:585–697

    Article  CAS  PubMed  Google Scholar 

  32. Rogler LH: Culturally sensitizing psychiatric diagnoses. J Nerv Ment Dis 1993; 181:401–408

    Article  CAS  PubMed  Google Scholar 

  33. Gaw AC (ed): Culture, Ethnicity, and Mental ifiness. Washington, DC, American Psychiatric Press, 1993

    Google Scholar 

  34. Ruiz F, Langrod J: Psychiatry and folk healing: a dichotomy. Am J Psychiatry 1983; 14:112–114

    Google Scholar 

  35. Sandoval M: Santeria: Afro-Cuban concepts of disease and its treatment in Miami. Journal of Operational Psychiatry 1977; 8:52–53

    Google Scholar 

  36. Gomez GE, Gomez EA, Ruiz P: Mental health care of Hispanic-Americans in the U.S.: a cultural and clinical perspective. World Journal of Psychosynthesis 1983; 15:19–23

    Google Scholar 

  37. Sanchez EG, Mohl PC: Psychotherapy with Mexican American patients. Am J Psychiatry 1992; 149:626–630

    CAS  PubMed  Google Scholar 

  38. Gomez EA, Ruiz F, Laval R: Psychotherapy and bilingualism: is acculturation important? Journal of Operational Psychiatry 1982; 13:13–16

    Google Scholar 

  39. Olmedo EL: Testing linguistic minorities. Am Psychol 1981; 36:1078–1085

    Article  Google Scholar 

  40. Escobar JI, Tuason BV: Antidepressant agents: a cross-cultural study. Psychopharmacol Bull 1980; 16:49–52

    CAS  PubMed  Google Scholar 

  41. Gaviria M, Gil AA, Javaid JI: Nortriptyline kinetics in Hispanic and Anglo subjects. J Clin Psychopharmacol 1986; 6:227–231

    Article  CAS  PubMed  Google Scholar 

  42. Yamamoto J, Keh-Ming L: Psychopharmacology, ethnicity, and culture, in Review of Psychiatry, vol 14, edited by Oldham JM, Riba MB. Washington, DC, American Psychiatric Press, 1995, pp 529–541

    Google Scholar 

  43. Ruiz P: Cultural barriers to effective medical care among Hispanic-American patients. Annu Rev Med 1985; 36:63–71

    Article  CAS  PubMed  Google Scholar 

  44. Ruiz F, Ruiz PP: Treatment compliance among Hispanics. Journal of Operational Psychiatry 1983; 14:112–114

    Google Scholar 

  45. Foulks EF, Bland IJ, Shervington D: Psychotherapy across cultures, in Review of Psychiatry, vol 14, edited by in Oldham JM, Riba MB. Washington, DC, American Psychiatric Press, 1995, pp. 511–528

    Google Scholar 

  46. Griffith EEH, Ruiz P: Cultural factors in the training of psychiatric residents in a Hispanic urban community. Transcultural Psychiatric Research Review 1976; 133:179–184

    Google Scholar 

  47. Ruiz P, Langrod J: Substance abuse among Hispanic Americans: current issues and future perspectives, in Substance Abuse: A Comprehensive Textbook, 2nd edition, edited by Lowinson JH, Ruiz F, Millman RB. Baltimore, MD, Williams & Wilkins, 1992, pp. 868–874

    Google Scholar 

  48. Comas-Diaz L, Griffith EEH (eds): Clinical Guidelines in Cross-Cultural Mental Health. New York, Wiley, 1988

    Google Scholar 

  49. Vargas LA, Koss-Chioino JD (eds): Working With Culture: Psychotherapeutic Interventions With Ethnic Minority Children and Adolescents. San Francisco, CA, Jossey-Bass, 1992

    Google Scholar 

  50. Favazza AR, Leon R, Ruiz F: Cultural Factors in Diagnosis and Treatment (monograph). New York, Medical Information Systems, Inc., Psychiatric Update, 1983, pp. 1–10

    Google Scholar 

  51. Gomez R, Ruiz P, Rumbaut RD: Hispanic patients: a linguo-cultural minority. Hispanic Journal of Behavioral Sciences 1985; 7:177–186

    Article  Google Scholar 

  52. Marcos LR, Alpert, M, Urcuyo L, et al: The effects of interview language on the evaluation of psychopathology in Spanish-American schizophrenic patients. Am J Psychiatry 1973; 130:549–553

    CAS  PubMed  Google Scholar 

  53. Marcos LR, Urcuyo L, Kesselman M, et al: The language barrier in evaluating Spanish-American patients. Arch Gen Psychiatry 1973; 29:655–659

    Article  CAS  PubMed  Google Scholar 

  54. Marcos LR: Effects of interpreters on the evaluation of psychopathology in non-English-speaking patients. Am J Psychiatry 1979; 136:171–174

    CAS  PubMed  Google Scholar 

  55. Marcos LR, Alpert M: Strategies and risks in psychotherapy with bilingual patients: the phenomenon of language independence. Am J Psychiatry 1976; 133:1275–1278

    CAS  PubMed  Google Scholar 

  56. Laval RA, Gomez EA, Ruiz F: A language minority: Hispanic Americans and mental health care. American Journal of Social Psychiatry 1983; 3:42–49

    Google Scholar 

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Author information

Authors and Affiliations

  1. San Antonio Mood Disorders Clinic, San Antonio, TX, USA

    Enrique S. Garza-Treviño M.D. (private practice)

  2. Department of Psychiatry and Behavioral Sciences, University of Texas/Houston Health Science Center, Houston, TX, USA

    Pedro Ruiz M.D. (professor and vice chair) &  Karen Venegas-Samuels M.D.

Authors
  1. Enrique S. Garza-Treviño M.D.
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  2. Pedro Ruiz M.D.
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  3. Karen Venegas-Samuels M.D.
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Additional information

Editor’s Note: This article is one of six residency training curricula written for psychiatric educators by members of the American Psychiatric Association’s (APA) minority and underrepresented component committees. Commissioned by the APA Assembly and reviewed by the APA’s Council of National Affairs and Board of Trustees, these curricula are intended to represent collectively a state-of-the-art description of psychiatric training regarding the needs of individuals from minority and traditionally underrepresented populations within the United States. They may be seen as a companion work to the growing interaction of psychiatry, culture, and ethnicity. This article is the fourth in the series. Samuel J. Keith, M.D., Editor

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Garza-Treviño, E.S., Ruiz, P. & Venegas-Samuels, K. A Psychiatric Curriculum Directed to the Care of the Hispanic Patient. Acad Psychiatry 21, 1–10 (1997). https://doi.org/10.1007/BF03341892

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