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Symptomatology of minor psychiatric morbidity: a crosscultural comparison

Published online by Cambridge University Press:  09 July 2009

Tai Ann Cheng
Tai Ann Cheng*
Affiliation:
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan, ROC
*
1Address for correspondence: Dr Tai Ann Cheng, Department of Psychiatry, National Taiwan University Hospital No. 1, Chang-Te Street. Taipei, Taiwan, ROC.
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Synopsis

The basic symptoms of minor psychiatric morbidity (MPM) reported elsewhere were also found in a community survey in Taiwan. However, differences in the patterns of and manifestations of the symptoms were evident. Contrary to most Western surveys, the prevalence of anxiety (24·7 %) was found to be higher than that of depression (8·3 %) in Taiwan. Possible explanations based on sociocultural characteristics of the Chinese family were proposed. The notion of somatization as a predominant symptom in Chinese neurotic patients advocated by some research workers was not supported in this study. As a result of findings in community cases, it is argued that the importance of somatization has been considerably overemphasized as a factor in the illness behaviour of neurotic cases in Chinese and other cultures, and it is therefore not a culturespecific disease phenomenon. It is also suggested that certain culture-specific neurotic syndromes reported in Chinese, such as shen-ching-shuai-jo (neurasthenia) and shen-k'uei (semen loss syndrome), are clinically equivalent to MPM. Implications of the present findings on crosscultural research and management of MPM were discussed.

Type
Original Articles
Information
Psychological Medicine , Volume 19 , Issue 3 , August 1989 , pp. 697 - 708
Copyright
Copyright © Cambridge University Press 1989

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References

Barsky, A. J. & Klerman, G. L. (1983). Overview: hypochondriasis, bodily complaint, and somatic styles. American Journal of Psychiatry 125, 681–684.Google Scholar
Ben-Tovim, D. I. (1987). Headaches and heartaches (2). In Development Psychiatry Mental Health and Primary Health Care in Botswana, pp. 155–184. Tavistock: London.Google Scholar
Binitie, A. (1975). A factor-analytic study of depression across cultures (African and European). British Journal of Psychiatry 127, 559–563.CrossRefGoogle Scholar
Brown, G. W. & Harris, T. (1978). The Social Origins of Depression. Tavistock: London.Google ScholarPubMed
Cheng, T. A. (1985). A pilot study of mental disorders in Taiwan. Psychological Medicine 15, 195–203.CrossRefGoogle ScholarPubMed
Cheng, T. A. (1986). The view from abroad - Taiwan. In Mental Illness in Primary Care Settings (ed. Shepherd, M.Wilkinson, G. and Williams, P.), pp. 224–225. Tavistock: London.Google Scholar
Cheng, T. A. (1987). A community study of minor mental disorders in Taiwan. Unpublished PhD thesis: University of London.Google Scholar
Cheng, T. A. (1988). A community study of minor psychiatric morbidity in Taiwan. Psychological Medicine 18, 953–968.CrossRefGoogle ScholarPubMed
Cheng, T. A. (1989). Psychosocial stress and minor psychiatric morbidity: a community study in Taiwan. Journal of Affective Disorders (in the press).CrossRefGoogle Scholar
Cheng, T. A. & Williams, P. (1986). The design and development of a screening questionnaire (CHQ) for use in community studies of mental disorders in Taiwan. Psychological Medicine 16, 415–422.CrossRefGoogle ScholarPubMed
Cheng, T. A., Williams, P. & Clare, A. W. (1983). Reliability study of the Clinical Interview Schedule (CIS) between the British and Chinese psychiatrists. Bulletin of the Chinese Society of Neurology and Psychiatry 9, 54–55.Google Scholar
Cheung, F., Lau, B. & Waldmann, E. (1981). Somatization among Chinese depressives in general practice. International Journal of Psychiatry in Medicine 10, 361–362.CrossRefGoogle Scholar
Cheung, F., Lee, S. Y. & Chan, Y Y. (1983). Variations in problem conceptualization and intended solutions among Hong Kong students. Culture, Medicine, and Psychiatry 7, 263–278.CrossRefGoogle ScholarPubMed
Chong, M. Y. & Cheng, T. A. (1985). Reliability study of the Clinical Interview Schedule (CIS): The use of community sample. Bulletin of the Chinese Society of Neurology and Psychiatry 11, 27–34.Google Scholar
Clyne, M. B. (1964). Indian patients. Practitioner 193, 195–199.Google ScholarPubMed
Collomb, H. (1967). Methodological problems in cross-cultural research. International Journal of Psychiatry 3, 17–19.Google Scholar
Cox, J. L. (1977). Aspects of transcultural psychiatry. British Journal of Psychiatry 130, 211–221.CrossRefGoogle ScholarPubMed
Dohrenwend, B. P. & Dohrenwend, B. S. (1976). Sex differences and psychiatric disorders. American Journal of Sociology 81, 1447–1454.CrossRefGoogle ScholarPubMed
Dohrenwend, B. P., Chin-Shong, E. T., Egri, G., Mendelson, F. S. & Stokes, J. (1970). Measures of psychiatric disorder in contrasting class and ethnic groups: a preliminary report of on-going research. In Psychiatric Epidemiology: An International Symposium (ed. Hare, E. H. and Wing, J. K.), pp. 159–202. Oxford University Press: London.Google Scholar
German, G. A. (1972). Aspects of clinical psychiatry in Sub-Saharan Africa. British Journal of Psychiatry 121, 461–479.CrossRefGoogle ScholarPubMed
Gillis, L. & Egert, S. (1973). The Psychiatric Out-patient: Clinical and Organisational Aspects. Faber & Faber: London.Google Scholar
Goldberg, D P. & Blackwell, B. (1970). Psychiatric illness in general practice: a detailed study using a new method of case-identification.: British Medical Journal 2, 439–443.CrossRefGoogle Scholar
Goldberg, D. P., Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970). A standardized psychiatric interview for use in community surveys. British Journal of Preventive & Social Medicine 24, 18–23.Google ScholarPubMed
Hoch, E. (1961). Contents of depressive ideas in Indian patients. Indian Journal of Psychiatry 3, 28–36; 120–129.Google Scholar
Hsu, F. L. K. (1971). Psychosocial homeostasis and Jen: concepts for advancing psychological anthropology. American Anthropologist 73, 23–44.CrossRefGoogle Scholar
Hsu, F. L. K. (1973). Kinship is the key. The Center Magazine 11-December, 4–14.Google Scholar
Jenkins, R. (1985). Sex Difference in Minor Psychiatric Morbidity. Psychological Medicine Monograph Supplement 7. Cambridge University Press: Cambridge.CrossRefGoogle ScholarPubMed
Kalton, W., Ries, R. & Kleinman, A. (1984). The prevalence of somatization in primary care. Comprehensive Psychiatry 25, 208–215.CrossRefGoogle Scholar
King, L. M. (1978). Social and cultural influences on psychopathology. Annual Review of Psychology 29, 405–433.CrossRefGoogle ScholarPubMed
Kirmayer, L. J. (1984). Culture, affect, and somatization. Transcultural Psychiatry Research Review 21, 237–261.CrossRefGoogle Scholar
Kleinman, A. (1977). Depression, somatization and the ‘new crosscultural psychiatry’. Social Science & Medicine 11, 3–10.CrossRefGoogle ScholarPubMed
Kleinman, A. (1980). Patients and Healers in the Context of Culture. University of California Press: Berkeley.CrossRefGoogle Scholar
Kleinman, A. (1982). Neurasthenia and depression: a study of somatization and culture in China. Culture, Medicine and Psychiatry 6, 117–190.CrossRefGoogle ScholarPubMed
Kleinman, A. (1987). Anthropology and psychiatry: the role of culture in crosscultural research on illness. British Journal of Psychiatry 151, 447–454.CrossRefGoogle ScholarPubMed
Kleinman, A. & Kleinman, J. (1985). Somatization: the interconnections in Chinese society among culture, depressive experiences, and the meanings of pain. In Culture and Depression (ed. Kleinman, A. and Good, B.), pp. 429–490. University of California Press: Berkeley.CrossRefGoogle Scholar
Lee, M. B. & Rin, H. (1986). Crosscultural Comparisons of the Nature and Formation of Psychosomatic Symptoms - Taipei and Rochester. Paper presented at the World Psychiatric Association, Regional Symposium, Copenhagen.Google Scholar
Leff, J. P. (1981). Psychiatry Around the Globe: A Transcultural View. Marcel Dekker: New York.Google Scholar
Lin, K. M. (1981). Traditional Chinese medical beliefs and their relevance for mental illness and psychiatry. In Normal and Abnormal Behaviour in Chinese Culture (ed. Kleinman, A. and Lin, T. Y.), pp. 95–111. D. Reidel: Dordrecht.CrossRefGoogle Scholar
Lin, T. Y. (1982). Culture and psychiatry: a Chinese perspective. Australian and New Zealand Journal of Psychiatry 16, 313–336.CrossRefGoogle ScholarPubMed
Maguigad, L. C. (1964). Psychiatry in the Philippines. American Journal of Psychiatry 121, 21–25.CrossRefGoogle ScholarPubMed
Mari, J. J., Sen, B. & Cheng, T. A. (1989). Case definition and case identification in cross-cultural perspective. In The Scope of Epidemiological Psychiatry (ed. Williams, P.Wilkinson, G. and Rawnsley, K.), pp. 489–506. Routledge: London.Google Scholar
Marsella, A. J., Kinzie, D. & Gorson, P. (1973). Ethnic variation in the expression of depression. Journal of Cross-Cultural Psychology 4, 435–458.CrossRefGoogle Scholar
Marsella, A. J., Sartorius, N., Jablensky, A. & Fenton, F. R. (1985). Cross-cultural studies of depressive disorders: an overview. In Culture and Depression (ed. Kleinman, A. and Good, B.), pp. 299–324. University of California Press: BerkeleyCrossRefGoogle Scholar
Mathew, R. J., Weinman, M. L. & Mirabi, M. (1981). Physical symptoms of depression. British Journal of Psychiatry 139, 293–296.CrossRefGoogle ScholarPubMed
Mechanic, D. (1978 a). Medical Sociology (2nd edn). Free Press: New York.Google Scholar
Mechanic, D. (1978 b). Sex, illness, illness behaviour and the use of health services. Social Science and Medicine 12B, 207–214.Google Scholar
Mezzich, J. E. & Raab, E. S. (1980). Depressive symptomatology across the Americas. Archives of General Psychiatry 37, 818–823.CrossRefGoogle ScholarPubMed
Murphy, H. B. M. (1982). Comparative Psychiatry: The International and Intercultural Distribution of Mental Illness. Springer-Verlag: Berlin.CrossRefGoogle ScholarPubMed
Murray, R. & Reveley, A. (1981). The genetic contribution to the neuroses. British Journal of Hospital Medicine 02, 185–190.Google Scholar
Neki, J. S. (1973). Psychiatry in South-East Asia. British Journal of Psychiatry 149, 7–16.Google Scholar
Obeyesekere, G. (1976). The impact of Ayurvedic ideas on the culture and the individual in Sri Lanka. In Asian Medical Systems A Comparative Study (ed. Leslie, C.), pp. 201–226. University of California Press: Berkeley.CrossRefGoogle Scholar
Orley, J. & Wing, J. K. (1979). Psychiatric disorder in two African villages. Archives of General Psychiatry 36, 513–520.CrossRefGoogle ScholarPubMed
Rin, H. (1982). Linchuang Jingshen Yixue (Clinical Psychiatry). Maochang: Taipei. (In Chinese.)Google Scholar
Shepherd, M. (1977). Beyond the layman's madness: the extent of psychiatric disease. In Development of Psychiatric Research (ed. Tanner, J.), pp. 178–198, London: Hodder & Stoughton.Google Scholar
Shepherd, M. (1987). Mental illness and primary care (editorial). American Journal of Public Health 77, 12–13.CrossRefGoogle Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. W. (1966). Psychiatric Illness in General Practice. Oxford University Press: Oxford.Google Scholar
Singer, K. (1972). Drinking patterns and alcoholism in the Chinese. British Journal of Addiction 67, 3–14.Google ScholarPubMed
Singer, K. (1975). Depressive disorders from a transcultural perspective. Social Science and Medicine 9, 289–301CrossRefGoogle ScholarPubMed
Singh, G. (1985). Dhat syndrome revisited. Indian Journal of Psychiatry 27, 119–122.Google ScholarPubMed
Tan, E. S. (1969). The symptomatology of anxiety in West Malaysia. Australian & New Zealand Journal of Psychiatry 3, 271–276.Google Scholar
Torgersen, S. (1983). Genetics of neuroses: the effects of sampling variation upon the twin concordance ratio. British Journal of Psychiatry 142, 126–132.CrossRefGoogle ScholarPubMed
Torgersen, S. (1985). Hereditary differentiation of anxiety and affective neuroses. British Journal of Psychiatry 146, 530–534.CrossRefGoogle ScholarPubMed
Tseng, W. S. (1975). The nature of somatic complaints among psychiatric patients: the Chinese case. Comprehensive Psychiatry 16, 237–245.CrossRefGoogle Scholar
Tuckett, D. (1976). Introduction. In An Introduction to Medical Sociology (ed. Tuckett, D.), pp. 32–33. Tavistock. London.Google Scholar
Wen, J. K. & Wang, C. L. (1981). Shen-K'uei Syndrome: a culturespecific sexual neurosis in Taiwan. In Normal and Abnormal Behaviour m Chinese Culture (ed. Kleinman, A. and Lin, T. Y.), pp. 357–369. D. Reidel: Dordrecht.CrossRefGoogle Scholar
Wig, N. N. (1960). Problems of mental health in India. Journal of Clinical Society Medical College, Lucknow, 17, 48–56.Google Scholar
Williams, P., Tarnopolsky, A. & Hand, D. J. (1980). Case-definition and case-identification in psychiatric epidemiology: review and reassessment. Psychological Medicine 10, 101–114.CrossRefGoogle Scholar
Wittkower, E. C. & Termansen, P. E. (1969). Cultural psychiatric research in Asia. In Mental Health Research in Asia and the Pacific (ed. Caudill, W. and Lin, T.), pp. 433–447. East-West Center Press: Honolulu.CrossRefGoogle Scholar
Woodruff, R. A., Murphy, G. E. & Herjanic, M. (1967). The natural history of affective disorders. 1. Symptoms of 72 patients at the time of index hospital admission. Journal of Psychiatric Research 5, 255–263.CrossRefGoogle Scholar
World Health Organization (1983). Depressive Disorders in Different Cultures WHO Geneva.Google Scholar
Yap, P. (1965). Phenomenology of affective disorder in Chinese and other cultures. In Transcultural Psychiatry (ed. De Reuck, A. V. S. and Porter, R.), pp. 84–105. Ciba Foundation: London.Google Scholar