Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment.

TLDR

Culture‑specific symptoms, especially somatic expressions, can lead to underrecognition or misidentification of psychological distress and unnecessary diagnostic procedures. The article reviews cultural variations in depression and anxiety presentation and urges clinicians to decode somatic and dissociative symptoms as part of a broader language of distress. The authors conduct a review of existing literature on cultural differences in depressive and anxiety symptomatology. Recent research shows that somatization is ubiquitous across cultures, challenging the notion that it is limited to non‑Western populations, and highlights implications for diagnosis and treatment in diverse settings.

Abstract

This article reviews cultural variations in the clinical presentation of depression and anxiety. Culture-specific symptoms may lead to underrecognition or misidentification of psychological distress. Contrary to the claim that non-Westerners are prone to somatize their distress, recent research confirms that somatization is ubiquitous. Somatic symptoms serve as cultural idioms of distress in many ethnocultural groups and, if misinterpreted by the clinician, may lead to unnecessary diagnostic procedures or inappropriate treatment. Clinicians must learn to decode the meaning of somatic and dissociative symptoms, which are not simply indices of disease or disorder but part of a language of distress with interpersonal and wider social meanings. Implications of these findings for the recognition and treatment of depressive disorders among culturally diverse populations in primary care and mental health settings are discussed.