Brown-Séquard syndrome: a rare manifestation of decompression sickness.

Neurological decompression sickness (DCS) is a rare condition that commonly leads to spinal cord injury. We report the case of a 30-year-old man who developed left-sided weakness and numbness after diving to a maximum depth of 15 m with a total dive time of 205min (10 repetitive dives). To the best of our knowledge, only six cases diagnosed as Brown-Séquard syndrome caused by DCS have been reported in the literature. Divers should be aware of the risk factors of DCS before diving and clinicians should make the diagnosis of spinal cord DCS based primarily on clinical symptoms, not on magnetic resonance imaging findings.

Psychotherapy: historical roots, universal elements, and cultural variations.

The authors review various forms of traditional psychotherapeutic interventions to trace the historical development of psychotherapy, which demonstrates a shift in focus from the supernatural world, to the natural world, to the physical person, then to the psychological person. The basic processes of identifying problems, providing explanations, and prescribing for change are observed among various kinds of treatment systems. Universal elements fundamental to successful treatment can be identified in each of these processes, and each is strongly modified by cultural factors. The authors conclude that the special cultural dimension of psychotherapy consists of defining cultural norms, reinforcing culturally sanctioned coping mechanisms, and providing "time out" from usual cultural expectations.

Diagnostic pattern for neuroses in China, Japan, and the United States.

To investigate the diagnostic patterns for neuroses in China, Japan, and the United States, the authors showed videotapes and brief written case histories of six Chinese patients to psychiatrists and psychiatrists-in-training in Beijing, Tokyo, and Honolulu. In cases with a well-distinguished clinical picture the diagnoses were congruent in the three countries. Diagnostic disagreement occurred in cases with symptoms of decline in mental function, which were overwhelmingly diagnosed as neurasthenia by the Chinese clinicians, and cases with situational stress, which were diagnosed as adjustment reaction by the Americans. This illustrates that different professional concepts and classification systems are used in different countries.

Family planning and child mental health in China: the Nanjing Survey.

The authors studied the impact of China's one-child-per-couple family planning policy on child development in 697 preschool children in the city of Nanjing and in two rural areas surrounding Nanjing. A home-visit questionnaire survey including a Chinese version of Achenbach's Child Behavior Checklist was used. The behavior problem profiles of children who were their parents' only children and those who had siblings were compared, revealing a significant difference between girls who were only children and those who had siblings. Girls who were only children tended to have slightly higher scores on the factors of depression, moody, and temper.

PIP: The 1 child per family policy was begun in China in 1980 in order to keep the population down to 1.15 billion by year 2000. By 1985, 80-90% of urban families and 50-60% of rural families had only 1 child. This study of 697 children aged 3-6 in urban, suburban-rural, and remote rural areas in and around Nanjing was designed to determine whether only children developed significantly more behavior problems than did children with siblings. The survey used the Child and Family Questionnaire and a Chinese version of the Achenbach Child Behavior Checklist. The age of the parents ranged from 25-40 years, and 99% of the marriages were not arranged. 60% of the families were nuclear, and 40% were stem, i.e., the married couple lived with either the husband's or the wife's parents. Only 1/4 of the families had wanted children for traditional reasons, such as to continue a clan, to provide labor, or to provide old-age security. 29% had wanted only 1 child, 63% preferred 2, and 3% preferred 3 children. The remote rural families wanted the most children. 54% of families indicated no preference for a boy or a girl, and 51.59% of the children were boys, and 48.5% were girls. 71% of the children attended public day care institutions and were thus exposed to socialization even if they were only children. 89% of the children slept in the same bed as their parents, the usual custom in China. Behavior problems included in the questionnaire were immaturity, regression, schizoid behavior, depression, moodiness, neuroses, and aggression. Single factor and multifactor analyses of variance were used to determine the effects of demographic variables and presence or absence of siblings on behavior problems. Boys who were only children and who were cared for by grandparents had more anxious aggression than only children cared for by parents. But boys who had siblings and were cared for by grandparents scored lower for anxious aggression. All boys who were cared for by grandparents had more anxious aggression than boys cared for by parents. Girls who were only children of parents who preferred 2 children scored high for moodiness, but girls who had siblings and whose parents preferred 1 child had highest scores for obsessive-neurotic behavior and aggression. Girls who were only children and lived in rural areas had higher temper scores than did only children girls in the country. But for girls with siblings temper scores were higher in the city. Girls who were only children and lived in nuclear families had higher temper scores than those who lived in stem families, but girls who had siblings and lived in nuclear families had lower temper scores than those who lived in stem families. In general, the behavior patterns of only children were significantly different only for boys. The results of this study indicate that the 1 child per family policy will not result in problem behavior among children.

Family interaction patterns among Japanese-American and Caucasian families in Hawaii.

The authors compared the family interaction patterns of Japanese-American and Caucasian families in Hawaii by rating videotapes of structured family interactions. There were significant differences between the two groups in many aspects of family interaction, such as power, coalition, closeness, negotiation, clarity of self-disclosure, responsibility, invasiveness, affect, and empathy. The differences in family interaction could be explained by the cultural differences between the two groups and indicate that profiles of healthy families differ between distinct cultures, and there is a need to establish a culturally relevant family interaction profile; otherwise normal interactions in families outside the mainstream could be misinterpreted as pathological.

Transethnic adoption and personality traits: a lesson from Japanese orphans returned from China to Japan.

The authors interviewed 25 Japanese who had been left as orphans in China at the end of World War II and who had recently returned to Japan with their Chinese spouses after almost four decades. It was found that even though they had been raised as Chinese culturally for almost their entire lives, most of these subjects had retained certain Japanese personality traits and social behavior from early childhood, and these characteristics distinguished them from their Chinese counterparts.

Psychiatric complications of family reunion after four decades of separation.

OBJECTIVE: After four decades of separation due to civil war, many people who had migrated to Taiwan from mainland China had the unexpected opportunity to briefly visit their families in mainland China. A study was conducted to examine psychiatric complications associated with these family reunions following long involuntary separation. METHOD: Eighty subjects who made the journey were given semistructured interviews investigating their psychological experiences relating to the family reunion. The variables investigated were sociodemographic characteristics, the subject's previsit emotional condition, factors related to the family reunion experience, and stress encountered during the visit. RESULTS: The survey indicated that more than one-fifth of the subjects (22.5%) developed psychiatric complications, mainly depression, immediately after the visit. Determinants found to contribute significantly to the occurrence of emotional disorders were previous ways of expressing homesickness, family members seen during the reunion, family misfortunes that the subjects discovered, family conflict encountered at the reunion, and tactics for coping with such stressors. CONCLUSIONS: The study results suggest that family reunions after long-term separation can be trauma-repairing experiences for some but for others can lead to trauma reexperiencing and psychiatric complications requiring mental health intervention.

A sociocultural study of koro epidemics in Guangdong, China.

Koro, a culture-related psychiatric disorder characterized by panic due to fear of genital retraction, occurred as the rare phenomenon of koro epidemics in a remote region of Guangdong, China, in 1984-1985 and 1987. The sociocultural and historical backgrounds of the area are described. The life pattern and attitudes toward supernatural beings and the commonly shared folk belief of evil-induced genital retraction were considered grounds for the panic, while the community's anxious reaction and hysterical atmosphere facilitated the intensification and recurrence of the episodes. Geographic seclusion associated with localism in folk beliefs and practices may have kept the epidemics confined to the region.

Reexamining the concept of adolescence: differences between adolescent boys and girls in the context of their families.

As part of a larger study on family functioning, the authors administered a questionnaire on individual attitudes toward family values to 158 Japanese-American and Caucasian families. Differences between the generations on questions of authority and responsibility were predictable; few differences were found between ethnic groups. However, differences were striking between adolescent boys and girls, regardless of ethnicity: Girls valued family affiliation, closeness, and emotional expression significantly more highly than did boys. The authors emphasize the need for families to value girls' needs for closeness and emotional expression as highly as boys' needs for independence and self-differentiation. They suggest that the concept of separation-individuation as the major goal of adolescence be reexamined.

Cultural aspects of psychiatric clinic utilization a cross-cultural study in Hawaii.

Data was obtained by ethnic status from 411 outpatients at a psychiatric clinic in Honolulu, Hawaii, and were then analyzed according to demographic variables, welfare status, source of referral, primary compliants or symptoms, diagnosis, and duration of treatment received. Clinic utilization was highly related to ethnicity, with Caucasians highly over-represented in proportion to the population, and other groups, especially Japanese, being greatly under-represented. The Caucasians were more likely to be self-referred, to have subjective symptoms of anxiety and depression, and to receive a neurotic diagnosis. The Japanese, and to some extent all other groups, were more often referred after a crisis or severe mental illness, displayed more socially disruptive symptoms, and had a higher percentage of schizophrenic diagnoses. Ethnicity was thus highly related to utilization of mental health services; however, once entry into the system was made, review of therapist case loads and analysis of duration of treatment revealed no ethnic difference in the clinic's response to patients.

Multi-cultural study of minor psychiatric disorders in Asia: symptom manifestations.

Patients with minor psychiatric disorders, including neuroses, situational adjustment reaction or acute emotional reaction, were investigated using symptom questionnaires at five research sites in Asia including: Chiang-Mai, Thailand; Bali, Indonesia; Kao-Hsiung, Taiwan, China; Shanghai, China; and Tokyo, Japan. The results revealed that the symptom profiles differ significantly among groups of different settings indicating that sociocultural background does contribute to the manifestation of neurotic symptomatology. It was also found that numerous and various subtypes of somatic scales were identified through factor analysis of symptoms for these Asian populations. It demonstrates that the spectrum of neurotic symptoms has a different focus for subjects in different sociocultural settings.

Mental health in Asia: social improvements and challenges.

Remarkable improvements in economic conditions and a considerable upgrade in the quality of life have been observed in many parts of Asia during the past several decades. At the same time, many mental health challenges face the people of Asia. Various social mental health indexes are reviewed here, with available data from China, Japan, Korea, Singapore, Malaysia, and other Asian societies. The data are compared with data from the United States, Australia in the Pacific Rim, and some other Western countries to examine patterns of similarity or difference between East and West in the process of modernization. Common trends in mental health issues associated with rapid sociocultural change observed in different Asian societies are discussed, as well as the relative shortage of mental health personnel available in many Asian societies. It is emphasized that, in addition to expanding psychiatric services, there is an even more urgent need to promote mental health knowledge and concern through education in the general population. Mental health needs to be cultivated and maintained by social forces and cultural strengths. It is stressed that there is a challenge for Asian people to advance mental health beyond economic development in the 21st century.