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Haroz EE, Ritchey M, Bass JK, Kohrt BA, Augustinavicius J, Michalopoulos L, Burkey MD, Bolton P. How is depression experienced around the world? A systematic review of qualitative literature. Soc Sci Med 2017; 183:151-162. [PMID: 28069271 PMCID: PMC5488686 DOI: 10.1016/j.socscimed.2016.12.030] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 12/16/2016] [Accepted: 12/20/2016] [Indexed: 11/18/2022]
Abstract
To date global research on depression has used assessment tools based on research and clinical experience drawn from Western populations (i.e., in North American, European and Australian). There may be features of depression in non-Western populations which are not captured in current diagnostic criteria or measurement tools, as well as criteria for depression that are not relevant in other regions. We investigated this possibility through a systematic review of qualitative studies of depression worldwide. Nine online databases were searched for records that used qualitative methods to study depression. Initial searches were conducted between August 2012 and December 2012; an updated search was repeated in June of 2015 to include relevant literature published between December 30, 2012 and May 30, 2015. No date limits were set for inclusion of articles. A total of 16,130 records were identified and 138 met full inclusion criteria. Included studies were published between 1976 and 2015. These 138 studies represented data on 170 different study populations (some reported on multiple samples) and 77 different nationalities/ethnicities. Variation in results by geographical region, gender, and study context were examined to determine the consistency of descriptions across populations. Fisher's exact tests were used to compare frequencies of features across region, gender and context. Seven of the 15 features with the highest relative frequency form part of the DSM-5 diagnosis of Major Depressive Disorder (MDD). However, many of the other features with relatively high frequencies across the studies are associated features in the DSM, but are not prioritized as diagnostic criteria and therefore not included in standard instruments. The DSM-5 diagnostic criteria of problems with concentration and psychomotor agitation or slowing were infrequently mentioned. This research suggests that the DSM model and standard instruments currently based on the DSM may not adequately reflect the experience of depression at the worldwide or regional levels.
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Affiliation(s)
- E E Haroz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States.
| | - M Ritchey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205, United States
| | - J K Bass
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - B A Kohrt
- Duke University, Duke Global Health Institute & Department of Psychiatry and Behavioral Sciences, Durham, NC 27710, United States
| | - J Augustinavicius
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - L Michalopoulos
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, United States
| | - M D Burkey
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States
| | - P Bolton
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, United States
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Yeung EYW, Partridge M, Irvine F. Satisfaction with social care: the experiences of people from Chinese backgrounds with physical disabilities. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:e144-e154. [PMID: 26094871 DOI: 10.1111/hsc.12264] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/07/2015] [Indexed: 06/04/2023]
Abstract
The satisfaction of social care among service users provides an important indication of how services are performing. Although there is evidence to suggest that people from black and minority ethnic communities experience less satisfaction with social care than majority groups, there is little literature which focuses specifically on people from Chinese backgrounds in England. This article provides an opportunity to hear the voices of people from Chinese backgrounds and their experiences of social care for a physical disability. Individual semi-structured interviews and focus groups were conducted in 2012 and 2013 respectively with people from Chinese backgrounds who lived in England, were aged between 18 and 70, and received social care for a physical disability. Interview and focus group transcripts were analysed using a thematic approach. The findings show that language difference created a structural barrier for most participants to negotiating access to and navigating through social care. Language difference and the cultural expectation that families should look after their own were main factors that explained their late utilisation of social care. Because of limited social support, many families struggled to meet the long-term care needs of their relative with a physical disability and hence initially welcome the input of social care. However, many found that social care could not adequately meet their needs but did not feel that they had the right to voice their dissatisfaction. They would either stop using social care services or become more reliant on their family for support. Chinese welfare organisations play a crucial role to meet the cultural and linguistic needs of people from Chinese backgrounds. Closer collaboration between local authorities and Chinese welfare organisations is needed to enable an effective use of social care and community resources to meet the needs of people from Chinese backgrounds with physical disabilities.
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Affiliation(s)
- Echo Yuet Wah Yeung
- Faculty of Education, Community and Health, Liverpool John Moores University, Liverpool, UK.
| | - Martin Partridge
- Faculty of Health Sciences, Staffordshire University, Staffordshire, UK
| | - Fiona Irvine
- School of Health and Population Science, The University of Birmingham, Birmingham, UK
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Li S, Hatzidimitriadou E, Psoinos M. "Tangled wires in the head": older migrant Chinese's perception of mental illness in Britain. J Aging Stud 2014; 30:73-86. [PMID: 24984910 DOI: 10.1016/j.jaging.2014.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 11/19/2022]
Abstract
In this article, the authors explored Cantonese-speaking older Chinese migrants knowledge, attitudes and expectations regarding mental illness. They obtained verbatim data from semi-structured interviews with eight participants recruited from London-based Chinese and church communities in Britain. They analyzed the data using the principles of Grounded Theory and in-depth content analysis. They examined cultural idioms in participants' accounts. Findings suggested that Western diagnostic categories of mental illness were alien to participants. They had a culturally constructed way of defining and characterizing mental illness. Participants used idioms of 'nerve', 'mood', 'behavior', 'personality', 'normal life', 'compassion' and the idiom of 'others' to construct an alternative world for stigma management. They erected an invisible but permeable barrier to limit access to their normal world. The role of traditional Chinese culture of Confucianism was significant in shaping perceptions and conceptions of mental illness. This article offered another perspective on the alternative world of Chinese migrants' cultural understandings of mental illness, an area with limited understanding at present. The authors discussed important implications for future research and social policy.
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Affiliation(s)
- Sarah Li
- Kingston University and St. George's, University of London, Faculty of Health, Social Care and Education, Grosvenor Wing, 2nd Floor, Cranmer Terrace, Tooting, London, SW17 ORE, United Kingdom.
| | - Eleni Hatzidimitriadou
- Kingston University and St George's, University of London, School of Social Work, Faculty of Health, Social Care and Education, Sir Frank Lampl's Building, Kingston Hill Campus, Kingston Hill, Surrey KT2 7LB, United Kingdom.
| | - Maria Psoinos
- Kingston University and St. George's, University of London, Faculty of Health, Social Care and Education, Grosvenor Wing, 2nd Floor, Cranmer Terrace, Tooting, London, SW17 ORE, United Kingdom.
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Yang LH, Thornicroft G, Alvarado R, Vega E, Link BG. Recent advances in cross-cultural measurement in psychiatric epidemiology: utilizing 'what matters most' to identify culture-specific aspects of stigma. Int J Epidemiol 2014; 43:494-510. [PMID: 24639447 DOI: 10.1093/ije/dyu039] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND While stigma measurement across cultures has assumed growing importance in psychiatric epidemiology, it is unknown to what extent concepts arising from culture have been incorporated. We utilize a formulation of culture-as the everyday interactions that 'matter most' to individuals within a cultural group-to identify culturally-specific stigma dynamics relevant to measurement. METHODS A systematic literature review from January 1990 to September 2012 was conducted using PsycINFO, Medline and Google Scholar to identify articles studying: (i) mental health stigma-related concepts; (ii) ≥ 1 non-Western European cultural group. From 5292 abstracts, 196 empirical articles were located. RESULTS The vast majority of studies (77%) utilized adaptations of existing Western-developed stigma measures to new cultural groups. Extremely few studies (2.0%) featured quantitative stigma measures derived within a non-Western European cultural group. A sizeable amount (16.8%) of studies employed qualitative methods to identify culture-specific stigma processes. The 'what matters most' perspective identified cultural ideals of the everyday activities that comprise 'personhood' of 'preserving lineage' among specific Asian groups, 'fighting hard to overcome problems and taking advantage of immigration opportunities' among specific Latino-American groups, and 'establishing trust among religious institutions due to institutional discrimination' among African-American groups. These essential cultural interactions shaped culture-specific stigma manifestations. Mixed method studies (3.6%) corroborated these qualitative results. CONCLUSION Quantitatively-derived, culturally-specific stigma measures were lacking. Further, the vast majority of qualitative studies on stigma were conducted without using stigma-specific frameworks. We propose the 'what matters most' approach to address this key issue in future research.
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Affiliation(s)
- Lawrence Hsin Yang
- Department of Epidemiology, Columbia University, New York, NY, USA, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK, Academic Division in Promotion of Health, School of Public Health, University of Chile Santiago, Chile and Mental Health Association of San Francisco, San Francisco, CA, USA
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