Vector Volume 12 Issue 2 - 2018

The public perception of major depressive disorder in
South Asia: a literature review
Review article
Marisse Sonido
Marisse Sonido is currently a 4th year medical student at the University of
New South Wales. She is both an aspiring doctor and writer and has recently
discovered, much to her excitement, that the two are not mutually exclusive.
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Abstract
Aims: To understand: the perception of depression as an illness in South Asia and the language used
to describe it, its perceived aetiology, how individuals with depression are perceived by the community
and the beliefs in the community surrounding the treatment of depression.
Methods: Articles were found through a database search of MedLine, PSYCINFO, and GoogleScholar.
They were included if they discussed depression within the context of a South Asian culture.
Results: Depression is widely understood in South Asia as a disease with primarily somatic presentations
stemming from stresses associated with difficult socioeconomic circumstances. Those with depression
are often stigmatised but they are generally not excluded from the community. Alongside medical
intervention, assistance from family and the community are the most accepted methods of addressing
depression.
Conclusions: South Asian perceptions of depression accord with a psychosocial model of illness.
Incorporating these perceptions is essential to the success of interventions and educational programs
hoping to resonate with a general population and improve communication with health professionals.
Introduction
Depression, suffered by more than 300 million
people worldwide, represents the single greatest
contributor to global non-fatal health loss.[1, 2, 3] Its
impacts are not limited to the Western world. While
developed countries draw much of the research
focus, the South Asian prevalence of depression
was calculated at 26.3% based on primary care
presentations.[1] In India in 2004 it accounted for
a greater number of disability adjusted life years
per 100,000 people than both cancer and diabetes
mellitus combined.[1] Depression is particularly
under-recognised and undertreated in rural areas.[4]
The presentations, sequelae and understandings
of depression are known to depend on culture, a
relationship maintained in the South Asian context.
[5, 6, 7, 8] Existing research highlights significant
differences between developed and developing
world perspectives on the disease—the extent
to which depression is seen as somatic, the role
of socioeconomic factors in its aetiology and
community responsibilities in addressing it.[4] The
strict biomedical conception of depression favoured
by some health professionals may translate poorly
across cultures and pose obstacles to improving
recognition, treatment and education.[9]
This paper aims to discuss general perceptions
of depression in developing countries in South Asia.
It will identify community views on: (1) depression
as an illness, including the way it is described and
presents; (2) its aetiology; (3) opinions about
individuals with depression; and (4) beliefs about
treatment. In synthesising the trends and repeating
themes revealed by research, it hopes to provide a
foundation for tailoring clinical and public health
interventions to a South Asian cultural context.
Methods
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Articles were found through a database search
of MedLine, PSYCINFO, and GoogleScholar using
the following keywords and MESH terms: Mental
Disorders OR Depression; Developing Countries OR
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