Culturally-sensitive complaints of depressions and anxieties in women

University of Santiago, Chile, CiudadSantiago, Santiago Metropolitan, Chile
Journal of Affective Disorders (Impact Factor: 3.38). 10/2007; 102(1-3):159-76. DOI: 10.1016/j.jad.2006.09.033
Source: PubMed


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.

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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). "
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    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.
    Full-text · Article · Aug 2014 · Journal of Cross-Cultural Psychology
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    • "Even despite this issue the recent literature on rs-fMRI in MDD displays a noticeable tendency toward particular Asian as well as North American or European populations. As prevalence and clinical symptomatology differ significantly between cultural contexts (Kirmayer, 2001; Halbreich et al., 2007; Juhasz et al., 2012; Yeung and Chang, 2014) results reported in this meta-analysis may not necessarily be applicable to other populations. "
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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"
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    Full-text · Article · Dec 2012 · Interface - Comunicação Saúde Educação
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