There is currently not yet full support for PTSD-SP as a nosological entity. However, the delineation of PTSD-SP from other psychiatric syndromes is notable and biological studies seem to support the validity as a separate diagnostic entity.

The Self Reporting Questionnaire (SRQ), a psychiatric-case-finding instrument designed by the WHO for developing countries, was tested in Ethiopia. It was submitted to 40 patients attending a psychiatric clinic, 30 at a somatic clinic, and 40 subjects not attending a clinic. Forty per cent of the yes-answers were rated as invalid. The concept-invalidity contributed mainly to the rather poor criterion-validity of the SRQ. In addition, clinic patients seemed to heighten the number of yes-answers to express their need for help. The SRQ measured not only psychiatric complaints but also illness behaviour, even without the presence of any illness. This is a substantial disadvantage if the SRQ is applied to detect the psychiatric cases in the primary-care facilities.

Attenders of health care facilities usually present somatic complaints. It is important to identify the psychiatric patients among them, especially the neurotic complainers. They are at risk for being exposed to expensive somatic investigations and being prescribed useless and sometimes harmful drug treatment. The World Health Organization designed the Self Reporting Questionnaire (SRQ), to be a universally applicable psychiatric case finding instrument, for use in medical clinics. A feasibility study with this instrument was carried out with 110 respondents in Ethiopia. A moderate criterion validity was found, limitations being partly due to the sensitivity of the SRQ to help-seeking behavior, even in the absence of any mental illness. This study also revealed problems in transcultural communication because many of the diagnostic concepts used in this instrument were too western to be transposed unchanged to the Ethiopian culture. Items need fairly extensive modification to be applicable there.

To improve mental health care in Nepal, a National Mental Health Policy, Strategy and Plan of Action was approved by the Government in 1997. Nepal has high vulnerability to natural disasters compounded by a prolonged violent civil conflict affecting almost all districts of the country. Floods, landslides and earthquakes are the most regularly occurring disasters in Nepal. There is a Health Sector Emergency and Disaster Response Plan of the Ministry of Health, but mental health and psychosocial relief is not adequately addressed in this plan. In 2003 guidelines on best public health practices in emergencies for district health workers was developed in which the minimum standard and indicators include aspects of mental and social aspects of health. The experience of the complex emergency in April 2005 showed that in general the emergency preparedness plan has not been prepared well enough, but on the other hand the health system was able to cope quite well because of past training. Further strengthening of the mental health and psychosocial aspects of disaster preparedness is strongly recommended.

It is often difficult for people from different cultural backgrounds to understand one another. On the other hand, this article provides some information about the problems Ethiopians have in understanding the concepts of Western psychiatry. In this study, the Western concepts are contained specifically in the items of the Self-Reporting Questionnaire, a psychiatric case-finding instrument designed by the World Health Organization. On the other hand, this article illustrates how Western-trained health workers often experience grave difficulties in understanding the - in their eyes, often bizarre - complaints of Ethopians seeking help. Western psychiatric jargon is culture-bound, and needs adaptation before being exported to other cultures.