Culturally-sensitive complaints of depressions and anxieties in women.

Uriel Halbreich; Renato D Alarcon; Helena Calil; Saida Douki; Peter Gaszner; Enrique Jadresic; Miroslava Jasovic-Gasic; Nadia Kadri; Florence Kerr-Correa; Vikram Patel; +2 more... Xarifa Sarache; JK Trivedi; (2007) Culturally-sensitive complaints of depressions and anxieties in women. Journal of affective disorders, 102 (1-3). pp. 159-176. ISSN 0165-0327 DOI: 10.1016/j.jad.2006.09.033
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BACKGROUND: 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. METHODS: 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. RESULTS: 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. LIMITATIONS: 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. CONCLUSIONS: 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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