Suchergebnisse

Potential patients who do not show up for their first appointments at a mental health clinic represent a puzzling and important phenomenon. When the setting, as in this study, is a multi-ethnic community, the psychosocial determinants for such behaviour are complex indeed. The author presents preliminary data relating clinic no-show rate to the variables of age, sex, presenting problem, and referral source. From the patterns which emerge from the data, certain possible explanations and tentative hypotheses are discussed in relation to previous reports in the literature. Some prac tical, clinical implications of these findings are considered. The results of this pilot project indicate some directions for future investigation in this area.

The authors report on 37 referrals seen for psychiatric consultation during visits to various islands in Micronesia. A large number demonstrated either organic mental disorders or con tributory medical illnesses. Observed differences between males and females are examined. In such cross-cultural settings, the authors emphasize the need for psychiatric expertise respon sive not only to the dimension of culture in evaluation and treatment, but also to the impor tance of vigilance for organic processes that may require special attention.

Patients evaluated by the authors as consulting clinical psychiatrists in a cross- cultural setting, Micronesia, form the basis for an examination of regional variations in demographic characteristics, diagnoses, and referral patterns. Different rates of occurrence of disorders, selective referral practices, and diversity in manifestation of symptomatology are all considered. The authors offer suggestions regarding social and cultural factors which may account for the observed differences.

The authors would like to express their gratitude to the patients and staff of the Guam Community Mental Health Center, in particular to Dr. E, Paramaguru (Medical Director), Gregory Marone (Psychologist), Mama Cing (Administrator), and Josephine Mesa (Secretary), for the many ideas and insights which made possible this manuscript.