Cultural dimensions of psychiatric diagnosis. A comparison of DSM-III-R and illness explanatory models in south India.
BACKGROUND
Cross-cultural research to examine the cultural validity of diagnostic categories and underlying concepts requires methods that integrate epidemiological and anthropological frameworks.


METHODS
The Explanatory Model Interview Catalogue (EMIC) and Structured Clinical Interview for DSM-III-R (SCID) were used to study 80 psychiatric out-patients with depressive neurosis at a clinic in south India.


RESULTS
Summary kappa values of 0.75 for the EMIC and 0.68 for the SCID confirmed interrater reliability. Comparison of patient explanatory models and SCID diagnoses showed that patients emphasised somatic experience while clinicians emphasised depressive diagnoses. More than half the patients (55%) received a non-specific or dual diagnosis.


CONCLUSIONS
These findings raise questions about the distinctiveness of depressive, anxiety, and somatoform (DAS) disorders for this population.
Weiss
M G
MG
Department of Psychiatry, University of Toronto, Canada.
Raguram
R
R
Channabasavanna
S M
SM
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D003906:Developing Countries; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008519:Medicine, Traditional; D008875:Middle Aged; D010348:Patient Care Team; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D013001:Somatoform Disorders / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology