Differential incidence of Bipolar Disorder I associated with race or ethnicity has not been reported (DSM-IV, 1994, p. 352). Some evidence exists suggesting that clinicians may overdiagnose Schizophrenia rather than Bipolar Disorder I in some ethnic groups (DSM-IV, 1994, pp. 352-353). The DSM-IV (1994) did not provide a description of cultural variants for Bipolar II, Dysthymic, and Cyclothymic Disorders. A major characteristic of Bipolar II and Cyclothymic Disorders is the presence of hypomanic symptoms. As noted by Castillo (1997), these symptoms are culturally accepted in some cultural contexts. For example, members of the Hindu culture generally engaged in "meditative trances to achieve a permanent hypomanic state [during their religious practices]" (Castillo, 1997, p. 219). In the case of Dysthymic Disorder, being depressed most of the time over at least two years could be the result of specific cultural variables such as racial discrimination and severe poverty (Castillo, 1997; Weiss, 1995).
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