Depression among Asian Americans: Review and Recommendations

Zornitsa Kalibatseva, Frederick T L Leong, Zornitsa Kalibatseva, Frederick T L Leong

Abstract

This article presents a review of the prevalence and manifestation of depression among Asian Americans and discusses some of the existing issues in the assessment and diagnosis of depression among Asian Americans. The authors point out the diversity and increasing numbers of Asian Americans and the need to provide better mental health services for this population. While the prevalence of depression among Asian Americans is lower than that among other ethnic/racial groups, Asian Americans receive treatment for depression less often and its quality is less adequate. In addition, the previous belief that Asians somatize depression may become obsolete as more evidence appears to support that Westerners may "psychologize" depression. The cultural validity of the current DSM-IV conceptualization of depression is questioned. In the course of the review, the theme of complexity emerges: the heterogeneity of ethnic Asian American groups, the multidimensionality of depression, and the intersectionality of multiple factors among depressed Asian Americans.

References

    1. Iwamasa GY, Hilliard KM. Depression and anxiety among Asian American elders: a review of the literature. Clinical Psychology Review. 1999;19(3):343–357.
    1. Yang LH, WonPat-Borja AJ. Psychopathology among Asian Americans. In: Leong FTL, Ebreo A, Kinoshita L, Inman AG, Yang LH, editors. Handbook of Asian American Psychology. 2nd edition. Thousand Oaks, Calif, USA: Sage; 2007. pp. 379–405.
    1. U.S. Census Bureau. Census 2010. Washington, DC, USA, 2010.
    1. Li G, Wang L. Model Minority Myth Revisited: An Interdisciplinary Approach to Demystifying Asian American Educational Experiences. Charlotte, NC, USA: Information Age; 2008.
    1. World Health Organization. Depression. 2005.
    1. Murray CJL, Lopez AD, editors. The Global Burden of Disease. A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Cambridge, Mass, USA: Harvard School of Public Health; 1996.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington, DC, USA: American Psychiatric Association; 1994.
    1. Kessler RC, Berglund P, Demler O, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R) Journal of the American Medical Association. 2003;289(23):3095–3105.
    1. Miranda J, Lawson W, Escobar J, et al. Ethnic minorities. Mental Health Services Research. 2002;4(4):231–237.
    1. Weissman MM, Bland RC, Canino GJ, et al. Cross-national epidemiology of major depression and bipolar disorder. Journal of the American Medical Association. 1996;276(4):293–299.
    1. Takeuchi DT, Chung RCY, Lin KM, et al. Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. American Journal of Psychiatry. 1998;155(10):1407–1414.
    1. Takeuchi DT, Hong S, Gile K, Alegría M. Developmental contexts and mental disorders among Asian Americans. Research in Human Development. 2007;4:49–69.
    1. Breslau J, Aguilar-Gaxiola S, Kendler KS, Su M, Williams D, Kessler RC. Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychological Medicine. 2006;36(1):57–68.
    1. Kuo WH. Prevalence of depression among Asian-Americans. Journal of Nervous and Mental Disease. 1984;172(8):449–457.
    1. Chang DF. Understanding the rates and distribution of mental disorders. In: Kurasaki KS, Okazaki S, Sue S, editors. Asian American Mental Health: Assessment Theories and Methods. New York, NY, USA: Kluwer Academic/Plenum; 2002. pp. 9–27.
    1. Jackson JS, Abelson JM, Berglund PA, Mezuk B, Torres M, Zhang R. Ethnicity, immigration, and cultural influences on the nature and distribution of mental disorders: an examination of major depression. In: Regier D, Narrow W, Kuhl E, Kupfer D, editors. Conceptual Evolution of DSM-5. Arlington, Va, USA: American Psychiatric Publishing; 2011. pp. 267–285.
    1. Kirmayer L, Jarvis GE. Depression across cultures. In: Stein DJ, Kupfer DJ, Schatzberg AF, editors. The American Psychiatric Publishing Textbook of Mood Disorders. Arlington, Va, US: American Psychiatric Publishing; 2006. pp. 699–715.
    1. Andrade L, Caraveo-Anduaga JJ, Berglund P, et al. The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys. International Journal of Methods in Psychiatric Research. 2003;12(1):3–21.
    1. Van Ommeren M, Sharma B, Makaju R, Thapa S, De Jong J. Limited cultural validity of the Composite International Diagnostic Interview’s probe flow chart. Transcultural Psychiatry. 2000;37(1):119–129.
    1. Chung H, Teresi J, Guarnaccia P, et al. Depressive symptoms and psychiatric distress in low income Asian and Latino primary care patients: prevalence and recognition. Community Mental Health Journal. 2003;39(1):33–46.
    1. Kim LS, Chun CA. Ethnic differences in psychiatric diagnosis among Asian American adolescents. Journal of Nervous and Mental Disease. 1993;181(10):612–617.
    1. Leong FTL. Counseling and psychotherapy with Asian-Americans. Review of the literature. Journal of Counseling Psychology. 1986;33(2):196–206.
    1. Meyer OL, Zane N, Cho YI, Takeuchi DT. Use of specialty mental health services by Asian Americans with psychiatric disorders. Journal of Consulting and Clinical Psychology. 2009;77(5):1000–1005.
    1. Alegría M, Chatterji P, Wells K, et al. Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatric Services. 2008;59(11):1264–1272.
    1. Marin H, Escobar JI. Issues in the diagnosis and assessment of mood disorders in minorities. In: Loue S, Sajatovic M, editors. Diversity Issues in the Diagnosis, Treatment, and Research of Mood Disorders. New York, NY, USA: Oxford University Press; 2008. pp. 17–31.
    1. Angel RJ, Williams K. Cultural models of health and illness. In: Cuellar I, Paniagua FA, editors. Multicultural Mental Health. San Diego, Calif, USA: Academic Press; 2000. pp. 25–44.
    1. World Health Organization. The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva, Switzerland: World Health Organization; 1992.
    1. Marsella AJ. The measurement of depressive experience and disorder across cultures. In: Marsella AJ, Hirschfeld RMA, Katz MM, editors. The Measurement of Depression. New York, NY, USA: Guilford Press; 1987. pp. 376–397.
    1. Ryder AG, Yang J, Zhu X, et al. The cultural shaping of depression: somatic symptoms in China, psychological symptoms in North America? Journal of Abnormal Psychology. 2008;117(2):300–313.
    1. Kleinman A. Culture and depression. The New England Journal of Medicine. 2004;351(10):951–953.
    1. Ryder AG, Yang J, Heine SJ. Online Readings in Psychology and Culture. Unit 9, Chapter 3. International Association for Cross-Cultural Psychology; 2002. Somatization vs. psychologization of emotional distress: a paradigmatic example for cultural psychopathology.
    1. Kleinman A. How is culture important for DSM-IV. In: Mezzich JE, Kleinman A, Fabrega H, Parron DL, editors. Culture and Psychiatric Diagnosis: A DSM-IV Perspective. Washington, DC, USA: American Psychiatric Press; 1996. pp. 15–26.
    1. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977:385–401.
    1. Cheung C-K, Bagley C. Validating an American scale in Hong Kong: the Center for Epidemiological Studies Depression Scale (CES-D) The Journal of psychology. 1998;132(2):169–186.
    1. Ying RC, Singer MK. Interpretation of symptom presentation and distress: a Southeast Asian refugee example. Journal of Nervous and Mental Disease. 1995;183(10):639–648.
    1. Edman JL, Danko GP, Andrade N, McArdle JJ, Foster J, Glipa J. Factor structure of the CES-D (Center for Epidemiological Studies Depression Scale) among Filipino-American adolescents. Social Psychiatry and Psychiatric Epidemiology. 1999;34(4):211–215.
    1. Kanazawa A, White PM, Hampson SE. Ethnic variation in depressive symptoms in a community sample in Hawaii. Cultural Diversity and Ethnic Minority Psychology. 2007;13(1):35–44.
    1. Lu A, Bond MH, Friedman M, Chan C. Understanding cultural influences on depression by analyzing a measure of its constituent symptoms. International Journal of Psychological Studies. 2010;2(1):55–70.
    1. Chentsova-Dutton YE, Chu JP, Tsai JL, Rottenberg J, Gross JJ, Gotlib IH. Depression and emotional reactivity: variation among Asian Americans of East Asian descent and European Americans. Journal of abnormal psychology. 2007;116(4):776–785.
    1. Chentsova-Dutton YE, Tsai JL, Gotlib IH. Further evidence for the cultural norm hypothesis: positive emotion in depressed and control European American and Asian American women. Cultural Diversity and Ethnic Minority Psychology. 2010;16(2):284–295.
    1. Canino G, Alegría M. Psychiatric diagnosis—is it universal or relative to culture? Journal of Child Psychology and Psychiatry and Allied Disciplines. 2008;49(3):237–250.
    1. Fabrega H. Cultural and historical foundations of psychiatric diagnosis. In: Mezzich JE, Kleinman A, Fabrega H, Parron DL, editors. Culture and Psychiatric Diagnosis: A DSM-IV Perspective. Washington, DC, USA: American Psychiatric Press; 1996. pp. 3–14.
    1. Fischer AR, Jome LM, Atkinson DR. Reconceptualizing multicultural counseling: universal healing conditions in a culturally specific context. Counseling Psychologist. 1998;26(4):525–588.
    1. Hwang WC, Myers HF, Abe-Kim J, Ting JY. A conceptual paradigm for understanding culture’s impact on mental health: the cultural influences on mental health (CIMH) model. Clinical Psychology Review. 2008;28(2):211–227.
    1. Kitayama S, Duffy S, Uchida Y. Self as cultural mode of being. In: Kitayama S, Cohen D, editors. Handbook of Cultural Psychology. New York, NY, USA: Guilford Press; 2007. pp. 136–174.
    1. Markus HR, Kitayama S. Culture and the self: implications for cognition, emotion, and motivation. Psychological Review. 1991;98(2):224–253.
    1. Marsella AJ, Kaplan A. Cultural considerations for understanding, assessing, and treating depressive experience and disorder. In: Reinecke MA, Davison MR, editors. Comparative Treatments of Depression. New York, NY, USA: Springer; 2002. pp. 47–78.
    1. Marsella AJ. Depressive experience and disorder across cultures. In: Triandis HC, Draguns JG, editors. Handbook of Cross-Cultural Psychology: Psychopathology. Vol. 6. Boston, Mass, USA: Allyn & Bacon; 1980. pp. 237–289.
    1. Marsella AJ. Cultural aspects of depressive experience and disorders. In: Lonner WJ, Dinnel DL, Hayes SA, Sattler DN, editors. Online Readings in Psychology and Culture. Unit 9, Chapter 4. Bellingham, Wash, USA: Center for Cross-Cultural Research, Western Washington University; 2003. .
    1. Leong FTL, Okazaki S, Tak J. Assessment of depression and anxiety in East Asia. Psychological Assessment. 2003;15(3):290–305.
    1. Sue S, Kurasaki KS, Srinivasan S. Ethnicity, gender, and cross-cultural issues in clinical research. In: Kendall PC, Butcher JN, Holmbeck GN, editors. Handbook of Research Methods in Clinical Psychology. 2nd edition. New York, NY, USA: Wiley; 1999. pp. 54–71.
    1. Trzesniewski KH, Donnellan MB, Lucas RE. Secondary Data Analysis: An Introduction for Psychologists. Washington, DC, USA: American Psychological Association; 2011.
    1. Marsella AJ, Sartorius N, Jablensky A, Fenton FR. Cross-cultural studies of depressive disorders: an overview. In: Kleinman A, Good B, editors. Culture and Depression. Berkeley, Calif, USA: University of California; 1985. pp. 299–324.
    1. Marsella AJ, Kinzie D, Gordon P. Ethnic variations in the expression of depression. Journal of Cross-Cultural Psychology. 1973;4:435–458.
    1. Cole ER. Intersectionality and research in psychology. American Psychologist. 2009;64(3):170–180.
    1. Bernstein KS, Lee JS, Park SY, Jyoung JP. Symptom manifestations and expressions among Korean immigrant women suffering with depression. Journal of Advanced Nursing. 2008;61(4):393–402.
    1. Saint Arnault D, Kim O. Is there an Asian idiom of distress? Somatic symptoms in female Japanese and Korean students. Archives of Psychiatric Nursing. 2008;22(1):27–38.
    1. Mui AC, Kang S-Y. Acculturation stress and depression among Asian immigrant elders. Social Work. 2006;51(3):243–255.
    1. Lam RE, Pacala JT, Smith SL. Factors related to depressive symptoms in an elderly Chinese American sample. Clinical Gerontologist. 1997;17(4):57–70.
    1. Kim SY, Wang Y, Deng S, Alvarez R, Li J. Accent, perceptual foreigner stereotype, and perceived discrimination as indirect links between English proficiency and depressive symptoms in Chinese American adolescents. Developmental Psychology. 2011;47(1):289–301.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe