Psychiatric diagnoses, East and West.

Psychiatric diagnoses, East and West

A good deal of similarity exists between the ways Chinese and Western physicians define mental disorders, according to a report in the July AMERICAN JOURNAL OF PSYCHIATRY. In the first study of nonhospitalized Chinese mental patients using the diagnostic guidelines of the American Psychiatric Association, Lori L. altshuler of the national Institute of Metal Health and her colleagues also find some marked cultural differences in the diagnosis of depression.

Altshuler's diagnoses of 116 patients seen at the Shanghai Mental Health Center matched those of Chinese psychiatrists at the facility in three-quarters of the cases. Severe depression and manic depression accounted for one out of four of Altshuler's diagnoses; the rest encompassed a range of psychiatric problems, including schizophrenia, dementia, anixiety disorders and paranoid disorders.

But almost that the patients diagnosed as severely depressed by Western standards received a different diagnosis by Chinese psychiatrists. If depressed patients have any delusions or hallucinations, they are diagnosed as schizophrenic by the Chinese, says Altshuler; those who also complain of physical symptoms are often given a diagnosis of anxiety disorder. These diagnostic differences may account for much higher reported rates of depression in the United States that in China, suggests Altshuler.

Whereas women are more commonly diagnosed as depressed in the United States, she adds, there was an equal proportion of depressed men and women among the Chinese outpatients.