Exploring the association between depression and shenjing shuairuo in a population representative epidemiological study of Chinese adults in Guangzhou, China

Abstract

Traditional mental illness concepts remain prevalent in China. Shenjing shuairuo (i.e., neurasthenia), a depressive-like syndrome less favored in Western psychiatric nosology, has a long tradition of acceptance among Chinese lay people. The concept may be more easily accepted in China due to the culturally informed view of the importance of harmony between mind and body and is consistent with Traditional Chinese Medicine. The goals of this study were to estimate the prevalence of shenjing shuairuo, the overlap between shenjing shuairuo and depression, and whether these two disorders share correlates. Data was obtained from 751 Chinese adults using stratified random sampling. Spatial epidemiological methods were utilized with face-to-face interviews conducted in Guangzhou, China. The Patient Health Questionnaire (PHQ-9) and the neurasthenia criteria from ICD-10 measured depression and shenjing shuairuo. The prevalence of depression and shenjing shuairuo were 5.3% and 15.4%, respectively. Participants with depression were nearly six times more likely to have shenjing shuairuo. Women were more likely than men to have comorbid depression and shenjing shuairuo. Poorer health was reported across disorders. Those with shenjing shuairuo were more likely to report medical diagnoses. Longer sleep latency was reported for those with shenjing shuairuo and those with depression reported fewer hours of sleep and lower sleep quality. Those with depression alone reported the poorest sleep. Significant diagnostic overlap and few distinct correlates were observed. Nevertheless, the difference in prevalence and acceptance among non-professionals suggests that shenjing shuairuo is a useful category of distress among Chinese adults in Southern China.