Reported immigration and medical coercion among immigrants referred to a cultural consultation service.

Members of visible minorities are commonly targets of social coercion related to immigration and medical measures. Social coercion is associated with poor mental health outcomes and mistrust of medical services. This study will determine if Afro-Canadian immigrants referred to a Cultural Consultation Service (CCS) in Montreal report more or less medical and immigration coercion compared with other ethnic minorities. We reviewed the charts of 729 referrals to the CCS and gathered data on the 401 patients included in the study. Chi-square statistics examined the relation between minority group and self-reported coercion. Binary logistic regression models controlled for standard sociodemographic variables in addition to ethnicity, language barrier, length of stay in Canada since immigration, refugee claimant status, referral source, presence of psychosis in the main diagnosis, and presence of legal history. Patients were diverse and included 105 Afro-Canadians, 40 Latin Americans, 73 Arab and West Asians, 149 South Asians, and 34 East and Southeast Asians. Being Afro-Canadian was significantly and positively associated with medical coercion (p = .02, 95% CI = 1.15-4.57), while being South Asian was negatively and significantly associated with immigration coercion (p = .03, 95% CI = .29-.93). Members of visible minority communities are not equal in their reported experience of social coercion after arriving to Canada. Future research clarifying pathways to mental health care for immigrants and the experience of new Canadians in immigration and health care settings would give needed context to the findings of this study.

First Manic Episode in an 11 Year-old Girl.

OBJECTIVE: We present the case of an 11 year-old girl admitted to the Centre hospitalier universitaire de Sherbrooke for a first manic episode. METHOD: Differential diagnoses of adjustment disorder, attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder were considered but eliminated. RESULTS: No organic etiology was detected. Her condition rapidly remitted with aripiprazole 3mg. After her discharge, she suffered a relapse due to instability of her living conditions and was rehospitalized. CONCLUSION: Mania is a difficult diagnosis in youths due to its nonspecific symptoms, rare prepubertal occurrence, and diagnostic complexity. Despite ongoing research, there is little conclusive information on the impact of psychosocial stressors on the evolution of early-onset bipolar disorder.

OBJECTIF: Nous présentons le cas d'une fillette de 11 ans hospitalisée au Centre hospitalier universitaire de Sherbrooke pour un premier épisode de manie. MÉTHODE: Les diagnostics différentiels du trouble d'adaptation, du trouble de déficit de l'attention avec hyperactivité, du trouble oppositionnel avec provocation et du trouble des conduites ont été envisagés mais rejetés. RÉSULTATS: Aucune étiologie organique n'a été détectée. La rémission de son affection a été rapide avec 3 mg d'aripiprazole. Après son congé, elle a souffert d'une rechute attribuable à l'instabilité de ses conditions de vie et a été réhospitalisée. CONCLUSION: La manie est un diagnostic difficile chez les adolescents en raison de ses symptômes non spécifiques, d'une rare occurrence pré-pubère, et de la complexité diagnostique. Malgré la recherche en cours, il y a peu d'information concluante sur l'effet des stresseurs psychologiques sur l'évolution du trouble bipolaire d'apparition précoce.