Differences in psychiatric symptoms among Asian patients  with depression: a multi-country cross-sectional study.
OBJECTIVE
The aim of this study was to compare the symptomatic and clinical features of depression among five groups of patients with major depressive disorder (MDD) living in China, Korea, Malaysia/Singapore, Taiwan, and Thailand.


METHODS
Consecutive consenting adults (aged 18-65) who met DSM-IV criteria for non-psychotic MDD – based on the Mini International Neuropsychiatric Interview – and who were free of psychotropic medication were evaluated in a cross-sectional study. Depressive symptoms were evaluated using the 10-item Montgomery–Asberg Depression Rating Scale (MADRS) and the 13-item depression subscale of the Symptoms Checklist 90-Revised (SCL-90-R). In addition, the 10-item SCL-90-R Anxiety Subscale was completed. ancova were conducted, adjusting for confounders: age, completion of secondary education, marital status, work status, religion, index episode duration, and depressive severity. For the magnitude of differences, a threshold of 0.10 was taken as the minimum effect size representing clinical significance, and an effect size of 0.25 was considered moderate.


RESULTS
Four MADRS symptoms differentiated these five groups, the most prominent being ‘lassitude’ and ‘inner tension’. Nine SCL-90-R depression items also differentiated the groups, as did eight SCL-90-R Anxiety Subscale items. The MADRS lassitude item had the largest effect size (0.131). The rest of those statistically significant differences did not exceed 0.10.


CONCLUSIONS
MDD is more similar than different among outpatients in these diverse Asian countries. The between-country differences, while present and not due to chance, are small enough to enable the use of common clinician and self-report rating scales in studies involving Asians with MDD from various ethnic backgrounds.
Ahmad H
AH
Sulaiman
Dianne
D
Bautista
Chia-Yih
CY
Liu
Pichet
P
Udomratn
Jae Nam
JN
Bae
Yiru
Y
Fang
Hong C
HC
Chua
Shen-Ing
SI
Liu
Tom
T
George
Edwin
E
Chan
Si
S
Tian-mei
Jin Pyo
JP
Hong
Manit
M
Srisurapanont
A John
AJ
Rush
D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People / Q000523:psychology*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005202:Asia, Eastern; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D012720:Severity of Illness Index; D055815:Young Adult