ABSTRACT
Mental health clinicians frequently encounter cases with unusual clinical pictures that are diff erent from textbook or standard classifi cation categories and are puzzling to the clinicians in making their assessments. For instance, when an Asian patient complained of an “empty heart,” the doctor needed to clarify whether the patient was suff ering from the medical problem of a weak heart, with other cardiac-related somatic symptoms such as palpitations or shortness of breath, or from a low spirit, with feelings of emptiness and depression. ·
In a hospital setting, a Latino man shouted very loudly while dramatically and emotionally striking his own body with his fi sts when he learned of his spouse’s death. The doctor was uncertain whether this was a usual acute grief reaction for a man of Latin background, or if the behavior was an excessively emotional and dramatic hysterical reaction that required psychiatric attention.
