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Major Depressive Disorder (MDD) is a widespread and debilitating condition, yet its prevalence and manifestation vary significantly across cultures. This paper compares MDD in China and the United States, highlighting key cultural, diagnostic, and treatment-related differences. Although Western countries such as the US report higher prevalence rates of MDD, this disparity may reflect differences in emotional processing, social norms, help-seeking behaviours, and diagnostic systems rather than actual differences in mental health burden. In the US., cultural expectations of positivity and individual emotional responsibility may exacerbate depressive symptoms through avoidance and rumination. In contrast, Chinese cultural norms rooted in Confucianism promote emotional fluidity and contextualisation, which may buffer some depressive risk but also contribute to underreporting due to stigma. Differences in diagnostic criteria and terminology, such as the continued use of “neurasthenia” in China, further complicate prevalence comparisons. While both countries rely on pharmacological and psychological treatments such as CBT and SSRIs, China also integrates Traditional Chinese Medicine. Despite distinct approaches, shared features such as gender differences in prevalence and stigma around perceived controllability persist. This paper calls for culturally sensitive mental health models that account for both universal and culture-specific factors in understanding and addressing MDD.
Chen et al. (Sun,) studied this question.