title: Country variations in depressive symptoms profile in Asian countries: Findings of the Research on Asia Psychotropic Prescription (REAP) studies.
abstract: BACKGROUND
  This study was to assess differences in the symptom profile of depressive illness across various countries/territories in Asia. The study was a part of the Research on Asia Psychotropic Prescription project. The participating countries/territories include China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Singapore, Taiwan, and Thailand.
  
  
  METHODS
  The pattern of depressive symptoms in 1,400 subjects with depressive disorder from 42 psychiatric centers in 10 Asian countries/territories was assessed. We collected information on socio-demographic and clinical characteristics with a standardized protocol and data collection procedure.
  
  
  RESULTS
  The most common presentations of depressive symptoms were persistent sadness, loss of interest, and insomnia. Similar findings were found regardless of the region, country, or its income level. Patients with depressive disorder from high-income countries presented significantly more with vegetative symptom cluster (P < 0.05), while those from the upper middle-income countries had significantly more with both mood (P < 0.001) and cognitive symptom clusters (P < 0.01). In lower middle-income countries, patients with depressive symptoms had significantly less mood symptom cluster (P < 0.001) but significantly more cognitive symptom cluster (P < 0.05).
  
  
  CONCLUSIONS
  This study demonstrates that in Asia, despite variations in the initial symptom reported by the patients, across different countries/territories, core depressive symptoms remain the same. Variations have been found in presentation of depressive symptoms with regards to the level of income of countries. Physical or vegetative symptoms were reported more by centers in higher income countries, while depressive cognition and suicidal thoughts/acts were more frequently reported from lower income countries.
authors: Department of Psychiatry & Mental Health, Kuala Lumpur Hospital, Kuala Lumpur, Kuala Lumpur, Malaysia.
authors: Kok-Yoon
authors: KY
authors: Chee
authors: Department of Psychiatry, King George's Medical University, Chowk, Lucknow, India.
authors: Adarsh
authors: A
authors: Tripathi
authors: Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Ajit
authors: A
authors: Avasthi
authors: Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan.
authors: Mian-Yoon
authors: MY
authors: Chong
authors: Faculty of Health Sciences, University of Macau, Macao SAR, China.
authors: Yu-Tao
authors: YT
authors: Xiang
authors: Institute of Mental Health, Buangkok View, Buangkok Green Medical Park, Singapore.
authors: Kang
authors: K
authors: Sim
authors: Department of Psychiatry, Peking University Institute of Mental Health, Beijing, China.
authors: Tian-Mei
authors: TM
authors: Si
authors: Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.
authors: Shigenobu
authors: S
authors: Kanba
authors: Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, China.
authors: Yan-Ling
authors: YL
authors: He
authors: Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea.
authors: Min-Soo
authors: MS
authors: Lee
authors: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.
authors: Helen
authors: H
authors: Fung-Kum Chiu
authors: Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan.
authors: Shu-Yu
authors: SY
authors: Yang
authors: Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.
authors: Hironori
authors: H
authors: Kuga
authors: Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors: Pichet
authors: P
authors: Udormatn
authors: Department of Psychiatry, Pushpagiri Medical College, Thiruvalla, India.
authors: Roy A
authors: RA
authors: Kallivayalil
authors: Department of Psychiatry, Hasanuddin University Faculty of Medicine, Makassar, Sulawesi Selatan, Indonesia.
authors: Andi J
authors: AJ
authors: Tanra
authors: Dr. Soetomo Hospital - Faculty of Medicine, Airlangga University, Jawa Timur, Indonesia.
authors: Margarita
authors: M
authors: Maramis
authors: Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors: Sandeep
authors: S
authors: Grover
authors: Department of Psychiatry & Mental Health, Tengku Ampuan Rahimah Hospital, Selangor, Malaysia.
authors: Loi-Fei
authors: LF
authors: Chin
authors: Department of Psychiatry & Mental Health, Kajang Hospital, Selangor, Malaysia.
authors: Rahima
authors: R
authors: Dahlan
authors: Department of Psychiatry & Mental Health, Sultan Abdul Halim Hospital, Kedah, Malaysia.
authors: Mohd Fadzli
authors: MF
authors: Mohamad Isa
authors: Department of Psychiatry, Universiti Kuala Lumpur Royal College of Medicine, Perak, Malaysia.
authors: Esther Gunaseli M
authors: EG
authors: Ebenezer
authors: Mesra Hospital, Sabah, Malaysia.
authors: Norhayati
authors: N
authors: Nordin
authors: Departments of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taiwan.
authors: Winston W
authors: WW
authors: Shen
authors: Department of Psychiatry, Kobe University, Kobe, Japan.
authors: Naotaka
authors: N
authors: Shinfuku
authors: Department of Pharmacology, National University of Singapore, Singapore.
authors: Chay-Hoon
authors: CH
authors: Tan
authors: Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.
authors: Norman
authors: N
authors: Sartorius
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001208:Asia / Q000453:epidemiology; D002648:Child; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: Asian; income; region; transcultural psychiatry