Family Practice Vol. 16, No. 5, 528-533
© Oxford University Press 1999
Comparison of symptoms in Japanese and American depressed primary care patients
Department of Community and Family Medicine, Jichi Medical School, Tochigi, Japan and the Ishibbashi Clinic, Toyko, Japan,
a Department of Family Medicine, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA,
b Department of Community and Family Medicine, Jichi Medical School, Minamikawachi, Tochigi, Japan and the Towamura Clinic, Kochi, Japan.
Dr Waza was an International Fellow in the Department of Family Medicine, Case Western Reserve University when this research was performed.
Dr V Graham, Department of Family Medicine, School of Medicine CWRU, 10900 Euclid Avenue, Cleveland, Ohio 44106-4950, USA.
Background. Depression is a highly prevalent, worldwide problem with multiple social and health consequences. It often presents in primary care with physical symptoms. Little research has been done on cross-cultural expression of depression in primary care. This paper examines the hypothesis that depressed Japanese patients present with more and with more distinct somatic complaints than depressed American patients.
Methods. Data were collected by chart audit for patients with a diagnosis of depression at two sites: Minamikawachi Tochigi, Japan and Cleveland, Ohio, USA. Patient demographics and type and number of presenting symptoms in the two populations were compared. Logistic regression was used to determine whether there were differences between countries in physical symptoms and to adjust for relevant demographic characteristics.
Results. Japanese family physicians charted more somatic complaints from patients diagnosed as depressed than did American family physicians. Specific physical symptoms differed by country: Japanese patients had more abdominal distress, headaches, and neck pain. These symptoms have strong cultural significance for Japanese patients.
Conclusions. This study clearly indicates the prominence and importance of physical symptoms in the presentation of depression in Japanese primary care patients. Their physicians must be alerted to the possibility of depression, especially when patient complaints include abdominal, neck or head pain.
Keywords. Cross-cultural, depression, family medicine, Japan.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. S. Arnault, S. Sakamoto, and A. Moriwaki Somatic and depressive symptoms in female Japanese and american students: a preliminary investigation. Transcultural Psychiatry, June 1, 2006; 43(2): 275 - 286. [Abstract] [PDF]
|
|
|
|
 |
|
 H. Chen, P. J. Guarnaccia, and H. Chung Self-Attention as a Mediator of Cultural Influences on Depression International Journal of Social Psychiatry, September 1, 2003; 49(3): 192 - 203. [Abstract] [PDF]
|
|