Asian Journal of Psychiatry
Volume 13, 2015, Pages 16-22

Illness beliefs of Chinese American immigrants with major depressive disorder in a primary care setting (Article)

Chen J.A.* , Hung G.C.L. , Parkin S. , Fava M. , Yeung A.S.
  • a Massachusetts General Hospital, Depression Clinical and Research Program, 1 Bowdoin Square 6th Floor, Boston, MA 02114, United States, South Cove Community Health Center, Department of Behavioral Health, 885 Washington St., Boston, MA 02111, United States, Harvard Medical School, 25 Shattuck St., Boston, MA 02115, United States
  • b Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States, Department of Addiction Medicine, Taipei City Psychiatric Center, Taipei City Hospital, Taiwan
  • c Massachusetts General Hospital, Depression Clinical and Research Program, 1 Bowdoin Square 6th Floor, Boston, MA 02114, United States
  • d Massachusetts General Hospital, Depression Clinical and Research Program, 1 Bowdoin Square 6th Floor, Boston, MA 02114, United States, Harvard Medical School, 25 Shattuck St., Boston, MA 02115, United States
  • e Massachusetts General Hospital, Depression Clinical and Research Program, 1 Bowdoin Square 6th Floor, Boston, MA 02114, United States, South Cove Community Health Center, Department of Behavioral Health, 885 Washington St., Boston, MA 02111, United States, Harvard Medical School, 25 Shattuck St., Boston, MA 02115, United States

Abstract

Underutilization of mental health services in the U.S. is compounded among racial/ethnic minorities, especially Chinese Americans. Culturally based illness beliefs influence help-seeking behavior and may provide insights into strategies for increasing utilization rates among vulnerable populations. This is the first large descriptive study of depressed Chinese American immigrant patients' illness beliefs using a standardized instrument. 190 depressed Chinese immigrants seeking primary care at South Cove Community Health Center completed the Explanatory Model Interview Catalogue, which probes different dimensions of illness beliefs: chief complaint, labeling of illness, stigma perception, causal attributions, and help-seeking patterns. Responses were sorted into categories by independent raters and results compared to an earlier study at the same site and using the same instrument. Contrary to prior findings that depressed Chinese individuals tend to present with primarily somatic symptoms, subjects were more likely to report chief complaints and illness labels related to depressed mood than physical symptoms. Nearly half reported they would conceal the name of their problem from others. Mean stigma levels were significantly higher than in the previous study. Most subjects identified psychological stress as the most likely cause of their problem. Chinese immigrants' illness beliefs were notable for psychological explanations regarding their symptoms, possibly reflecting increased acceptance of Western biomedical frameworks, in accordance with recent research. However, reported stigma regarding these symptoms also increased. As Asian American immigrant populations increasingly accept psychological models of depression, stigma may become an increasingly important target for addressing disparities in mental health service utilization. © 2014 Elsevier B.V.

Author Keywords

Major depressive disorder culture Chinese American Stigma Illness beliefs

Index Keywords

descriptive research cultural anthropology depression immigrant primary medical care mental health service attitude to mental illness Stereotyping human middle aged controlled study mental stress priority journal randomized controlled trial Aged illness behavior Mental Health Services ethnology physical disease United States Humans migrant psychology Asian Americans male Emigrants and Immigrants Asian American female Social Stigma stigma Article help seeking behavior major clinical study adult exploratory research utilization patient attitude Patient Acceptance of Health Care Depressive Disorder, Major major depression primary health care Culture
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84926337100&doi=10.1016%2fj.ajp.2014.12.005&partnerID=40&md5=ab20f439807070caf85c9177d7dc3daf
DOI: 10.1016/j.ajp.2014.12.005
ISSN: 18762018
Cited by: 20
Original Language: English