CULTURAL DIFFERENCES IN THE EXPRESSION OF DEPRESSION ASSESSED WITH THE HAMILTON SCALE

Abstract

Major Depressive Disorder (MDD), affects 121 million people in the world according to WHO. This is a major health issue which affects people worldwide hence a cross-national approach is needed to better understand the nature of MDD. A psychiatric clinical interview serves to identify the depressive symptoms, stablish a diagnostic and apply a treatment intervention. During such interview, the clinician needs to explore the patient and obtain the answers that will lead to symptoms’ identification. It is therefore crucial to conduct a correct assessment exercise as the diagnostic and subsequent treatment will depend on the outcome of the interview. When working in transcultural settings, it is fundamental to be aware of the potential distinct expressions of depression from the patient. Likewise, the way the assessor interprets patient’s responses can be mediated as well by his/her own cultural background. Clinician needs to have robust cultural competences. A psychiatric interview is therefore a 2 ways interaction with two critical aspects which might vary depending on the cultural background: - Patient: How depression is expressed - Clinician: How depression is assessed METHODOLOGY This project approaches both sides of the clinical interview with two differentiated studies: STUDY 1: Assessment of depression; STUDY 2: Expression of depression STUDY 1: Psychiatrists from different countries will assess the very same clinical interview, in a videotaped format, as part of the Rater Training program in a large multi-national clinical trial with MDD patients. The assessment tool will be the HAMD, 17 items version. STUDY 2: MDD patients attending to the Psychiatry Transcultural Unit of Hospital Vall d’Hebron will be assessed with the HAMD17. A subjective depression assessment will be done by subjects completing the CDS. Most of these patients reside in Barcelona but are originally from foreign countries. Acculturation attitude will be captured with ACM

Date of Award	14 Jun 2022
Original language	English
Supervisor	Miguel Casas Brugue (Director)