Depression in the Chinese: the impact of acculturation

BACKGROUND: Studies of depression in the Chinese have long identified low rates and a greater likelihood of somatization, findings which could reflect cultural influences or real differences. We report a study from a western region examining the impact of acculturation on depression to clarify the role of cultural factors. METHOD: In a Sydney-based study, Chinese subjects (n = 385) and a matched control group of 143 non-Chinese subjects completed either a Chinese or English questionnaire assessing state and lifetime depression, attributional style, depression recognition and help-seeking. The impact of acculturation was examined by several strategies. RESULTS: Any tendency by the Chinese to somatize depression appeared to be attenuated by acculturation. State depression levels countered the view that Chinese necessarily deny depression. Lifetime depression rate differences were also attenuated by acculturation, with Chinese subjects being less likely than controls to judge episodes as a distinct disorder and to seek professional help. CONCLUSIONS: Results suggest that Australian Chinese do not differ intrinsically in recognizing and ascribing depressive symptoms, and that the greater the degree of acculturation, the greater the tendency for reporting persistent and impairing depressive episodes.