Delusional ideas (e.g., witchcraft) and auditory hallucinations (e.g., seeing the Virgin Mary or hearing God's voice) may be abnormal in one culture and normal in other cultures (Castillo, 1997). For example, in the Nigerian culture, paranoid fears of evil attacks by spirits are part of the local beliefs involving fears of malevolent attacks by evil spirits (Kirmayer et al., 1995). These fears are examples of the culture-bound syndrome named "Ode-ori" in Table I. As noted by Kirmayer et al. (1995), these paranoid fears "might be misdiagnosed as symptoms of psychosis by the uninformed clinician" (p. 509). Variability in language, style of emotional expressions, body language, and eye contact across cultures should be considered when assessing symptoms of Schizophrenia. In the case of Brief Psychotic Disorder, it should be distinguished from culturally sanctioned response patterns. For example, in certain religious ceremonies a person may report hearing voices, which are not considered as abnormal by members of that religion and generally do not persist beyond the termination of such ceremonies (DSM-IV, 1994, p. 303). Temporal visual and auditory hallucinations reported by a client in therapy may also result from the recent death of a loved one. As noted earlier, Brief Psychotic Disorder episodes may resemble the culture-bound syndrome "boufée délirante" (DSM-IV, 1994, p. 845; see Table I).
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