© 2008 Elsevier Masson SAS. Tous droits réservés. http://france.elsevier.com/direct/EURPSY/ EUROPEAN PSYCHIATRY European Psychiatry 23 (2008) S1–S3 Editorial Migration and transcultural psychiatry in Europe M. Schouler-Ocak 1 , C. Haasen 2 , A. Heinz 1,* 1 Department of Psychiatry and Psychotherapy, Charité - University Medical Center, CCM Berlin, Germany 2 Department of Psychiatry and Psychotherapy, UKE Hamburg, Germany European societies are characterised by an increasing number of migrants, and in several countries about one third of all adolescents now have a migratory background [15]. However, migration is nothing new in the history of Europe. From the migration of Indo-European speaking groups to the spread of Celtic tribes as far as Turkey, famously depicted in the Pergamon temple now exhibited in Berlin, from the Roman Empire, which sent its soldiers from dif- ferent parts of the Mediterranean all over the European continent, to the migration of Anglo-Saxons, Franks and Gothic tribes, and from the spread of Jewish, Protestant and Catholic refugees throughout the 16 th , 17 th and 18 th century to enforced displacement and genocide in the 20 th century: Europeans have been much closer connected than it has often been reflected in nationalist ideologies. This contact – as much as it has been associated with individual suffering – has stimulated the exchange of ideas and techniques and cre- ated a vibrant network of cultures. Dealing with psychosocial problems within these settings therefore is nothing new. Psychiatrists who travelled the world have for more than 100 years pointed to cultural differences in the manifestation of certain psychiatric disor- ders. One example are Kraepelin’s travels to Java, from which he returned with vivid descriptions of differences in specific hallucinations and delusions [9]. However, trans- cultural psychiatry has also been influenced by predominant Eurocentric ideas, which prevailed in the first half of the 20 th century. Inspired by an evolutionary understanding of not only human biological history, but also the phylogenetic development of the brain and individual ontogenesis, many psychiatrists assumed that psychiatric disorders can be con- ceptionalised as an evolutionary dissolution or regression to a more primitive level [4]. Of course, theories about phylo- genetically “primitive” mental states remained speculative and authors often instead referred to contemporary colonial- ised populations, thus denying an adequate appreciation of the cultural development of these people. Modern transcul- tural psychiatry has to avoid these biases and needs to pro- mote an understanding about basic mental functions and disease categories, while paying specific attention to culturally influenced constellations of stress factors, psycho- social variables that influence treatment outcome and the individual understanding and interpretation of disease symptoms. It was the psychiatrist and anthropologist Arthur Kleinman who coined the term “explanatory models” to emphasize that every patient perceives and explains his or her illness within the network of a culturally influenced model of health and diseases [8]. Differences in explanatory models between patients and professionals, particularly from separate social or cultural backgrounds, can lead to misunderstanding. For example in Jamaica, diabetes, trans- lated as “too much sugar in the blood” and requiring a “diet”, does not motivate a traditionally minded patient to reduce the intake of carbohydrates but instead to consume bitter teas, because bitter teas in the traditional explanatory model of disorders are assumed to balance too much sweet- ness in the blood [5]. Transcultural psychiatry thus requires careful and constant communication and a reflection of the cultural and social background of the individual patient. Transcultural psychiatry also has to reflect differences in sensitivity for certain side-effects of pharmaceutical drugs in different populations. However, it does not seem to be helpful to understand such population differences within the traditional concept of “race”. The race term has been coined on the idea that in different parts of the world, pre-human primates developed into different human “races” [2]. Cur- rent research instead indicates that the human race origi- nated in Africa and that the currently existing populations developed by migration from this original population. As a consequence, there is no categorical genetic difference * Corresponding author. E-mail: andreas.heinz@charite.de (A. Heinz). 01_Edito.fm Page 1 Jeudi, 10. janvier 2008 3:22 15