Culturally-sensitive complaints of depressions and anxieties in women
ABSTRACT Current classifications of Mental Disorders are centered on Westernized concepts and constructs. "Cross-cultural sensitivity" emphasizes culturally-appropriate translations of symptoms and questions, assuming that concepts and constructs are applicable.
Groups and individual psychiatrists from various cultures from Asia, Latin America, North Africa and Eastern Europe prepared descriptions of main symptoms and complaints of treatment-seeking women in their cultures, which are interpreted by clinicians as a manifestation of a clinically-relevant dysphoric disorder. They also transliterated the expressions of DSM IV criteria of main dysphoric disorders in their cultures.
In many non-western cultures the symptoms and constructs that are interpreted and treated as dysphoric disorders are mostly somatic and are different from the Western-centered DSM or ICD systems. In many cases the DSM and ICD criteria of depression and anxieties are not even acknowledged by patients.
The descriptive approach reported here is a preliminary step which involved local but Westernized clinicians-investigators following a biomedical thinking. It should be followed by a more systematic-comprehensive surveys in each culture.
Westernized concepts and constructs of mental order and disorders are not necessarily universally applicable. Culturally-sensitive phenomena, treatments and treatment responses may be diversified. Attempts at their cross-cultural harmonization should take into consideration complex interactional multi-dimensional processes.
- SourceAvailable from: Saija Kuittinen
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- "Therefore, in these societies, indirect expressions of distress through bodily sensations and other somatic symptoms can be appropriate means of communicating psychological problems (e.g., Kleinman & Kleinman, 1985). Accordingly, somatic symptoms of depression have been frequently reported in some Asian (Ryder et al., 2008), African (Binitie, 1981), Latin American, and Indian populations (Halbreich et al., 2007). Although studies on depression among Somalis are lacking, there is some evidence that Somali refugees commonly express psychological distress through somatic complaints (Bhui et al., 2003; Silveira & Ebrahim, 1995). "
ABSTRACT: In this study, we analyzed the manifestation of somatic-affective and cognitive depressive symptoms among older Somali refugees and native Finns. Second, we explored how depressive symptoms, alexithymia, and somatization are associated in the two groups. Finally, we analyzed how two psychosocial factors, sense of coherence (SOC) and social support, are connected to depressive symptoms among Somalis and Finns. The participants were examined with the Beck Depression Inventory (BDI) for depressive symptoms, the Symptom Checklist-90-Revised (SCL-90-R) for somatization, Toronto Alexithymia Scale (TAS-20) for alexithymia, and the Sense of Coherence (SOC-13) concept for SOC. Social support was indicated by help received from social networks and marital status. Results showed that Somalis manifested more somatic-affective symptoms of depression than Finns, whereas Finns manifested more cognitive symptoms than Somalis. The association between depressive symptoms and alexithymia was stronger in the Finnish group, whereas the association between depressive symptoms and somatization was stronger in the Somali group. The association between alexithymia and somatization did not differ between the groups. A weak SOC explained depressive symptoms among Somalis and Finns, but poor social support did not explain depression in either group. The results are discussed in relation to Somali and Finnish cultures, mental health beliefs, and immigrant populations.Journal of Cross-Cultural Psychology 08/2014; 45(9). DOI:10.1177/0022022114543519 · 1.42 Impact Factor
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- "dos somáticos (Marsella, 1985). Halbreich et al. (2007) citam que, em culturas não ocidentais, os sintomas que são tratados como distúrbios disfóricos são, sobretudo, somáticos, diferentemente do sistema ocidental centrado nos manuais diagnósticos. Em muitos casos, os critérios destes manuais não são sequer reconhecidos pelos pacientes. Pereira et al. (2007), estudando mulheres de Goa, na Índia, diagnosticadas como deprimidas, identificaram que elas expressam seus problemas de saúde mental especialmente através de uma série de queixas somáticas; localizam a sua angústia na vida através das desvantagens sociais que experimentam em seu dia a dia, e só procuram ajuda médica para queixas somáti"
ABSTRACT: O objetivo deste estudo de caráter etnográfico foi analisar o significado da busca de tratamento por mulheres com transtorno depressivo atendidas em um Núcleo de Atenção Psicossocial do município de Santos, São Paulo, Brasil. Foram identificados, neste contexto: o tratamento da depressão no serviço (do encaminhamento ao atendimento), as noções de doença elaboradas pelas mulheres e o consumo de medicamentos. Ficaram evidentes: a banalização da depressão, a importância do psiquiatra e do uso de antidepressivos e ansiolíticos no tratamento. Os padrões encontrados de consumo dos medicamentos pelas mulheres sugerem a ocorrência de uma "toxicomania medicamentosa". O uso de medicamentos, além da ação farmacológica, possui uma ação simbólica, no sentido de conforto e cuidado. O trabalho aponta para a necessidade de se articularem o significado das experiências das mulheres e as abordagens terapêuticas da depressão na construção das políticas públicas de saúde mental.Interface - Comunicação Saúde Educação 12/2012; 16(43):885-899. DOI:10.1590/S1414-32832012000400003
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- "The World Health Report 2001). Cultural influences on the presentation of depression can be significant and the clinician should be aware of differences in the expression of psychological distress in patients from other countries or cultures (Halbreich et al. 2007). "
ABSTRACT: Type 2 diabetes (T2DM) doubles the odds of comorbid depression. Depression is a strong predictor of developing T2DM. The aim of the study was to compare depressed patients with T2DM to non-depressed ones with respect to demographic, psycho-social, clinical, anthropometric and metabolic characteristics; to examine the relationship between glycemic control and depression severity in depressed patients; to estimate the risk factors of depression. A group of depressed diabetic patients comprising those with a Major depressive episode, first or repeated (ICD-10; 1992) and endocrinologist-diagnosed T2DM, duration ≥5 years on oral, insulin therapy or both (N=46) and non-depressed ones (N=44) (90 in total) of both genders (<65 years) were included in this cross-sectional study. Laboratory and non-laboratory measures were performed.. The patient Health Questionnaire (PHQ-9) and a structured interview (MINI) were used to establish diagnosis, while the Beck Depression Inventory (BDI; cut off ≥16) was used to assess the severity ofdepression. Scaling of Life Events (SLE) for self-assessment of life events and Problem in Areas in Diabetes (PAID) for self-assessment of diabetes distress were also performed. Statistically significant higher rates of psychiatric heredity, neuropathy, higher level of diabetes related distress and a greater number of life events in depressed patients compared to non-depressed ones were found. There was a statistically significant positive correlation between BDI somatic subscore and the HbA1c level (r=0.343; p=0.020). The level of diabetes related distress (OR=1.084; p=0.000), total number of life events (OR=4.528; p=0.001) and neuropathy (OR=8.699; p=0.039) were statistically significant predictors of depression using logistic regression. The results obtained showed that depression in diabetic patients was predicted by both psychological (diabetes related distress, life events) and disease-specific variables (neuropathy). The severity of self-reported somatic depressive symptoms significantly correlated with the HbA1c level in depressed diabetic patients.Psychiatria Danubina 03/2011; 23(1):34-44. · 0.65 Impact Factor