title: Stressful life events preceding the onset of depression in Asian patients with major depressive disorder.
abstract: BACKGROUND
  Previous studies have identified the significant role of stressful life events in the onset of depressive episodes. However, there is a paucity of cross-national studies on stressful life events that precede depression.
  
  
  OBJECTIVE
  We aimed to compare types of stressful life events associated with the onset of depressive episodes in patients with major depressive disorder (MDD) in five Asian countries.
  
  
  METHODS
  A total of 507 outpatients with MDD were recruited in China (n = 114), South Korea (n = 101), Malaysia (n = 90), Thailand (n = 103) and Taiwan (n = 99). All patients were assessed with the Mini-International Neuropsychiatric Interview and the List of Threatening Experiences. The prevalence of each type of stressful life events was calculated and compared between each country.
  
  
  RESULTS
  The type of stressful life event that preceded the onset of a depressive episode differed between patients in China and Taiwan and those in South Korea, Malaysia and Thailand. Patients in China and Taiwan were less likely to report interpersonal relationship problems and occupational/financial problems than patients in South Korea, Malaysia and Thailand.
  
  
  CONCLUSIONS
  Understanding the nature and basis of culturally determined susceptibilities to specific stressful life events is critical for establishing a policy of depression prevention and providing effective counseling services for depressed patients.
authors.affiliation: Department of Psychiatry, Seoul National Hospital, Seoul, South Korea.
authors.forename: Subin
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Hatim
authors.affiliation: Peking University Institute of Mental Health, Beijing, China.
authors.forename: Tian-Mei
authors.initials: TM
authors.lastname: Si
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Seoul, South Korea.
authors.forename: Hong Jin
authors.initials: HJ
authors.lastname: Jeon
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Manit
authors.initials: M
authors.lastname: Srisurapanont
authors.affiliation: Singapore Clinical Research Institute, Singapore Duke-National University of Singapore, Singapore.
authors.forename: Dianne
authors.initials: D
authors.lastname: Bautista
authors.affiliation: Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Shen-ing
authors.initials: SI
authors.lastname: Liu
authors.affiliation: Institute of Mental Health, Woodbridge Hospital, Singapore.
authors.forename: Hong Choon
authors.initials: HC
authors.lastname: Chua
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Seoul, South Korea suhurhong@gmail.com.
authors.forename: Jin Pyo
authors.initials: JP
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000523:psychology*; D002681:China; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010045:Outpatients; D056910:Republic of Korea; D012307:Risk Factors; D013624:Taiwan; D013785:Thailand; D055815:Young Adult
keywords: Major depressive disorder; adversity; transcultural psychiatry