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Cultural Dimensions of Psychiatric Diagnosis

A Comparison of DSM–III–R and Illness Explanatory Models in South India

Published online by Cambridge University Press:  02 January 2018

Mitchell G. Weiss*
Affiliation:
Department of Psychiatry, University of Toronto, and Toronto Hospital
R. Raguram
Affiliation:
National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore
S. M. Channabasavanna
Affiliation:
NIMHANS, Bangalore, India
*
Professor M. G. Weiss, Clark Institute, 250 College Street, Toronto, Canada M5T 1R8

Abstract

Background

Cross-cultural research to examine the cultural validity of diagnostic categories and underlying concepts requires methods that integrate epidemiological and anthropological frameworks.

Method

The 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.

Results
Summary

kappa 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.

Conclusions

These findings raise questions about the distinctiveness of depressive, anxiety, and somatoform (DAS) disorders for this population.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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