Culture, somatization, and psychological distress: symptom presentation in South Indian patients from a public psychiatric hospital.
BACKGROUND
A number of clinical research studies have found evidence that patients from Western and non-Western countries express both somatic and psychological symptoms. Although somatic and psychological symptoms appear to coexist, patients may express more of one type of symptom, somatic or psychological, over the other depending upon the nature of the illness and the patients' psychosocial contexts.


METHODS
The present study investigated the influence of Westernization, stigma, severity of symptoms, and other factors on the symptom presentation of 60 South Indian psychiatric patients, using both open-ended and symptom-directed interviewing methods. Symptom presentation was explored in terms of a balance of psychological and somatic symptoms.


RESULTS
Participants predominantly emphasized somatic symptoms as their first spontaneously reported symptom. More Westernized participants and those with higher symptom severity scores tended to present a more psychological balance of symptoms. Participants with a greater concern about stigma tended to present a more somatic balance of symptoms.


CONCLUSIONS
The findings suggest that several factors, including the Westernization that occurs in non-Western countries as a result of globalization, can impact an individual's expression of distress.
Institute for Healthcare Studies, Northwestern University, Chicago, IL 60611, USA. deepa-rao@northwestern.edu
D
D
Rao
M
M
Young
R
R
Raguram
D000328:Adult; D003431:Cross-Cultural Comparison; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006778:Hospitals, Psychiatric; D006779:Hospitals, Public; D006801:Humans; D007194:India; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology*; D008875:Middle Aged; D019222:Mind-Body Relations, Metaphysical; D010044:Outpatient Clinics, Hospital; D010552:Personality Assessment; D011287:Prejudice; D012922:Social Change; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology