Recognition of depressive symptoms by Chinese subjects: The influence of acculturation and depressive experience

BackgroundWe have previously found that the level of acculturation in Chinese subjects influences reporting of depression. It is not clear to what extent such differences in reporting are a consequence of differences in the recognition of depressive symptoms. This study examined the influence of acculturation and personal depressive experience on recognition of depressive symptoms in a sample of Chinese subjects and controls in a western region.MethodA 35-item Depressive Symptom Questionnaire was given to 385 Chinese subjects, grouped according to their language preference, and 143 non-Chinese Controls all recruited from general practices. Subjects rated recognition of symptoms on a 3-point scale according to the likelihood of someone who had depression experiencing each of the 35 symptoms. Three symptom dimensions were extracted using factor analysis: core, cognitive and somatic symptoms. The influence of acculturation and previous experience of depression on these symptom dimensions was examined.ResultsThe level of acculturation in the Chinese influenced the recognition of ‘somatic’ and ‘cognitive’ symptoms, but the Chinese groups did not differ from Controls in recognition of ‘core’ symptoms. Previous experience of depression led to greater recognition of all three dimensions of symptoms, regardless of level of acculturation.ConclusionsWesternized Chinese, despite varying levels of acculturation, appeared capable of recognizing depressive symptoms as well as Control subjects. This suggests that the influence of acculturation on reporting on depressive symptoms may be due to factors other than the recognition of depression. This study has implications for the early detection of depression among the Chinese in differing geographical regions.