Cross-cultural differences in somatic presentation in patients with generalized anxiety disorder.
Little is known about cultural differences in the expression of distress in anxiety disorders. Previous cross-cultural studies of depression have found a greater somatic focus in Asian populations. We examined anxiety symptoms in patients with generalized anxiety disorder (GAD) in urban mental health settings in Nepal (N = 30) and in the United States (N = 23). Participants completed the Beck Anxiety Inventory (BAI). The overall BAI score and somatic and psychological subscales were compared. While there was no difference in total BAI scores, the Nepali group scored higher on the somatic subscale (i.e. "dizziness" and "indigestion," t[df] = -2.63[50], p < 0.05), while the American group scored higher on the psychological subscale (i.e. "scared" and "nervous," t[df] = 3.27[50], p < 0.01). Nepali patients with GAD had higher levels of somatic symptoms and lower levels of psychological symptoms than American patients with GAD. Possible explanations include differences in cultural traditions of describing distress and the mind-body dichotomy.
Hoge
Elizabeth A
EA
Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA. ehoge@partners.org
Tamrakar
Sharad M
SM
Christian
Kelly M
KM
Mahara
Namrata
N
Nepal
Mahendra K
MK
Pollack
Mark H
MH
Simon
Naomi M
NM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D003431:Cross-Cultural Comparison; D003466:Cultural Characteristics; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000208:ethnology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011603:Psychophysiology; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D014481:United States / Q000208:ethnology; D014505:Urban Population / Q000706:statistics & numerical data