Cultural Dimensions of Psychiatric Diagnosis

Abstract

BackgroundCross-cultural research to examine the cultural validity of diagnostic categories and underlying concepts requires methods that integrate epidemiological and anthropological frameworks.MethodThe Explanatory Model Interview Catalogue (EMIC) and Structured Clinical Interview for DSM–III–R (SCID) were used to study 80 psychiatric out-patients with depressive neurosis at a clinic in south India.ResultsSummarykappa values of 0.75 for the EMIC and 0.68 for the SCID confirmed inter-rater reliability. Comparison of patient explanatory models and SCID diagnoses showed that patients emphasised somatic experience while clinicians emphasised depressive diagnoses. More than half the patients (55%) received a non-specific or dual diagnosis.ConclusionsThese findings raise questions about the distinctiveness of depressive, anxiety, and somatoform (DAS) disorders for this population.