With adolescents presenting acute psychiatric disorders, and who are also isolated and foreign-born, doubts about the diagnosis are frequent, with the risk of diagnostic error – and inadequate care – as well of over-diagnosis of psychotic disorders as opposed to depression or post-traumatic syndrome. The course of the treatment of Lila, a sixteen year-old adolescent from Rwanda, illustrates the problematic of diagnostic erros or misdiagnosis which can be reduced by recourse to studies on diagnostic error and a transcultural approach to treatment.
Adolescence, 2013, T. 31, n°3, pp. 625-632.
In transcultural psychotherapy with an adolescent who is an isolated foreign minor, with medical personnel or social workers, the therapists come to know the patients psychical suffering, behaviors and demands within a setting where listening and elaboration can take place with all the complexity and multiplicity of the patient’s experience, using cultural and psychiatric materials, which helps to avoid diagnostic errors and frequent splitting between the native cultural and the host country. Faced with an external reality made up of uncertainty, precariousness and isolation, how can we take this reality into account without letting it take up too much psychotherpeutic space ? When a request for diagnostic evaluation is hanging over the treatment, what are the implications of this diagnosis for the transcultural work, particularly when the patient presents delusive elements suggestive of psychotic disorder ?
Adolescence, 2013, T. 31, n°3, pp. 541-550.