TABLE II (continued)
All subtypes All subtypes All subtypes All subtypes disorders Sexual dysfunctions
Sleep disorders related to another mental
All subtypes All subtypes disorder Somatoform disorders Tic disorders
All subtypes Tourette's disorder provided specific information regarding cultural variations. It should be noted that in the DSM-IV (1994) cultural variants were not described across all subtypes of disorders within a set of disorders (Lewis-Fernandez & Kleinman, 1995; Smart & Smart, 1997; Paniagua, 1998, pp. 126-143). For example, in the DSM-IV these variants were described in the case of Major Depressive Disorder and Bipolar I Disorder; however, these variants were not described in the case of other subtypes of Mood Disorders (e.g., Dysthymic Disorder). Another example is Attention Deficit and Disruptive Disorders, in which these variations were described in the case of only two subtypes (Conduct Disorder and ADHD); these variations were not mentioned in the case of Oppositional Defiant Disorder. Therefore, in Table II the particular disorder is listed (left-side of table) with a reference to whether these variations are described for only specific subtypes or across all subtypes in the disorder under consideration. Examples of cultural variations across disorders listed in Table II were provided above; a brief summary of these variants across similar disorders can be found in Paniagua (1998, pp. 128-139) and Paniagua et al. (1996).
In the case of culturally sensitive codes in the DSM-IV, clinicians are encouraged to use four V-Codes when assessing and treating multicultural groups in mental health services: Partner Relational Problem (V61.1, p. 681), Religious or Spiritual Problem (V62.89, p. 685), Acculturation Problem (V62.4, p. 685), and Parent-Child Relational Problem (V61.20, p. 681).
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