To whom is "problemas de nervos" meaningful

In a recent article published in Transcultural Psychiatry, James and colleagues (2009) present research on a form of suffering or ‘‘idiom of distress’’ specific to a Portuguese immigrant community (‘‘problemas de nervos’’), with the aim of supporting more culturally sensitive health services for this community. Using a qualitative methodology, the authors identified possible symptom clusters within ‘‘problemas de nervos’’ and explored the relation between ‘‘problemas de nervos’’ and psychiatric categories in DSM-IV, based on an all-female sample of Portuguese immigrants from the Azores islands living in Boston, MA, USA, and Waterloo, ON, Canada. They used hierarchical cluster analysis to analyse responses to every symptom cause and cure of ‘‘problemas de nervos’’ mentioned by the participants. A person of Portuguese descent coded all of the responses. The authors found four clusters emerging in both settings: ‘‘mal da cabeca’’ (problems in the head), ‘‘aPicao’’ (afFiction), immigration stress and conFicts with others. We write to express our concern that this article reifies ordinary language in ways that are misleading for mental health workers and researchers. As Portuguese mental health workers dealing with the expression ‘‘nervos’’ every day, we see the expression as a broad term referring not only to psychiatric illnesses, but also a range of nonspecific symptoms. Taken by itself, nervos is ambiguous, it is the accompanying symptoms, or their absence, that identify its personal significance and its clinical importance. For example, in the authors’ analysis of ‘‘ele esta mal da cabeca’’ (problems in the head), participants reported a wide range of symptoms (from loss of control

Distress · Linguistics · Mental health · Portuguese · Psychiatry · Clinical Psychology · Computer Science · Mental Health Treatment and Access · Migration, Health and Trauma · Philosophy · Psychology · Racial and Ethnic Identity Research

• Culture and Somatization

  L J Kirmayer, Alma H Young et al.•Psychosomatic Medicine•1998

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• Problemas de Nervos

  Open Access•Jame, Susan James et al.•Transcultural Psychiatry•2009

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• From Peculiar Psychiatric Disorders through Culture-bound Syndromes to Culture-related Specific Syndromes

  Open Access•Wen-Shing Tseng•Transcultural Psychiatry•2006

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