Depression Across Cultures

Comments have been frequently made on the differences in the symptomatological pattern of depression in different cultural groups. Kraepelin (1921), in his study on the incidence of depressive illness in Asian countries, mentioned that depression in Java was characterized almost exclusively by excitement and confusion and that ideas of sin and suicidal tendencies were absent. Carothers (1958) could not elicit feelings of guilt or self abasement in depression among the Africans of Kenya. Lambo (1956), of Nigeria, thought that the rarity of depression observed by many workers in African countries might be due to erroneous diagnosis, and that most of the cases remain concealed by the label of ‘neurasthenia’. Out of fifteen cases of definite affective psychosis seen by him only one showed guilt feelings, self-condemnation and anticipation of punishment. Multiple somatic features, phobic and obsessional symptoms and anxiety were common. Yap (1965), commenting on the findings of various workers about depression in African countries, states ‘there is agreement among these authors on the rarity of outspoken affective illness, lightness and short duration of depression with an absence of ideas of sin and guilt, the relative frequency of manic pictures, the common association with confusional symptoms, and a very low suicide rate.’ He also refers to Pfeiffer's findings about the frequency of hypochondriacal depression in the Chinese. The absence of delusions of sin in Chinese as well as in Japanese depressives has also been noted by Yap (1958). On the other hand, Eaton and Weil (1955), in a study concerning the Hutterites, have reported a high incidence of guilt-ridden depression.