Social Origins of Distress and Disease: Depression, Neurasthenia, and Pain in Modern China

Neurasthenia (ironically, a Western import) is a common diagnosis in the Peoples' Republic of China, but in the United States it is no longer even included inDSM-III. Conversely, depression in various forms is probably the most frequently diagnosed psychiatric condition in the United States. Although it is recognized in the Peoples' Republic of China, it is an uncommon diagnosis. Building on this discrepancy, Arthur Kleinman, a psychiatrist and anthropologist, has constructed a wide-ranging discussion of the various ways in which human distress is configured in different social and cultural settings. The empirical center of the book is a study of 100 consecutive patients diagnosed at the Hunan Medical College as having neurasthenia. Of these, 93 metDSM-IIIcriteria for depression, including 87 diagnosed as having a major depressive disorder. Does this mean that Western psychiatry has the answers and that the Chinese are ignorant or behind the times in