On the basis of their clinical psychiatric experience with South-East Asian refugees, particularly Khmers living in camps on the Khmer-Thai border, the authors suggest three lines of thought: 1) The process of acculturation is discussed with emphasis on the Red Khmers' attempt to disorganize the Cambodian society and destroy personal identity and to the irruption of Western identification models which may cause refugees to turn away from traditional values. 2) Relationships of some symptoms, especially psychotic manifestations, with the collective traumatic experience, are discussed. The authors suggest a concept of cultural imprinting and point out the prevalence of delusional forms of melancholia where the symptoms seem to be modeled on the collective trauma of the Pol-Pot years. 3) The specific effects of the presence of an interpreter are discussed: the interpreter lessens the distress experienced by the patient during encounters with the physician and represents a transitional space which is an anlage of a culture shared by the patient and by the therapist.

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Short Survey delusion refugee psychotrauma melancholia society Thailand human ego identity