“MEDITERRANEAN GUTS ACHE”

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Abstract
The syndrome colloquially called “Mediterranean guts ache“—that is, non‐organic symptoms and attention‐seeking behaviour in Italian patients—is seen frequently in the casualty and outpatient departments of certain hospitals. It is argued in this paper that the syndrome is the consequence of cultural differences between Italian and native Australian ways of life. Particular emphasis has been placed on the difference in the patient's attitude to the doctor; he expects attention and may be critical of the doctor's opinion. His traditional views of disease usually have a totally different basis from the physician's, and hence the two may be unable, without conceptual adjustment by one or the other, to understand each other, even when language problems are overcome. The Italian patient expects to be given dramatic treatment and is liable to judge its efficacy by factors which the sophisticated doctor would consider peripheral, such as the mode of administration of a drug. The immigrant is more liable to be in situations which are stressful for him; he is likely to have problems of integration, to feel the lack of a supporting group, and to find that his employability is restricted. Women are particularly liable to present with neurotic symptoms, because they are restricted by language difficulties and family commitments from making contact with others, and after the family grows up, they may find themselves without support. Within the family, substantial cultural differences in child rearing may lead to neurotic symptoms in the adolescent children of Immigrants. Treatment is briefly discussed.

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