title: Concepts and causation of depression: a cross-cultural study of the beliefs of older adults.
abstract: OBJECTIVE
  This U.K. study explored how older adults with depression (treated and untreated) and the general older population conceptualize depression. A multicultural approach was used that incorporated the perspectives of Black Caribbean, South Asian, and White British older adults. The study sought to explore and compare beliefs about the nature and causes of depression, and to suggest ways in which these beliefs act to facilitate or deter older people from accessing treatment.
  
  
  METHODS
  One hundred and ten in-depth separate interviews were conducted for 45 White British, 33 South Asian, and 32 Black Caribbean individuals. The interviews explored what the word depression meant to participants, and their beliefs regarding depression's causes.
  
  
  RESULTS
  Depression was often viewed as an illness arising from adverse personal and social circumstances that accrue in old age. White British and Black Caribbean participants defined depression in terms of low mood and hopelessness; South Asian and Black Caribbean participants frequently defined depression in terms of worry. Those receiving antidepressants were more likely to acknowledge psychological symptoms of depression. Differences in attribution were found between the ethnic groups.
  
  
  CONCLUSIONS
  A social model of depression is closer to the beliefs of older people than the traditional medical model. Culturally appropriate inquiries about recent life events could be used to facilitate discussion about depression. Our data suggest that many older adults would respond to probing by primary care physicians about their mood. Health and social care professionals need to be sensitive to the language of depression used by different ethnic groups.
authors.affiliation: PO26, Section of Mental Health and Ageing, Health Services Research Department, The David Goldberg Centre, The Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. v.lawrence@iop.kcl.ac.uk
authors.forename: Vanessa
authors.initials: V
authors.lastname: Lawrence
authors.forename: Joanna
authors.initials: J
authors.lastname: Murray
authors.forename: Sube
authors.initials: S
authors.lastname: Banerjee
authors.forename: Sara
authors.initials: S
authors.lastname: Turner
authors.forename: Kuljeet
authors.initials: K
authors.lastname: Sangha
authors.forename: Richard
authors.initials: R
authors.lastname: Byng
authors.forename: Dinesh
authors.initials: D
authors.lastname: Bhugra
authors.forename: Peter
authors.initials: P
authors.lastname: Huxley
authors.forename: Andre
authors.initials: A
authors.lastname: Tylee
authors.forename: Alastair
authors.initials: A
authors.lastname: Macdonald
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D003469:Culture; D003863:Depression / Q000209:etiology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D006113:United Kingdom