Country variations in depressive symptoms profile in Asian countries: Findings of the Research on Asia Psychotropic Prescription (REAP) studies

Abstract

This study demonstrates that in Asia, despite variations in the initial symptom reported by the patients, across different countries/territories, core depressive symptoms remain the same. Variations have been found in presentation of depressive symptoms with regards to the level of income of countries. Physical or vegetative symptoms were reported more by centers in higher income countries, while depressive cognition and suicidal thoughts/acts were more frequently reported from lower income countries.

Network analysis of the depressive symptom profiles in Asian patients with depressive disorders: Findings from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP‐AD)

“…Thus, as mentioned earlier, the network structure of depressive symptom profiles in Asian patients of high‐income countries may be partly supported by clinical characteristics of Japanese or Korean patients with depressive disorders and influenced by Confucianism or Neo‐Confucianism . Furthermore, the network structure in Asian patients of middle‐income countries may be partly supported by clinical characteristics of Chinese, Indian, or Malaysian patients with depressive disorders . Although completed suicides have been predominant in Chinese women, suicidal ideation has been considered to be an independent factor of depression outside of high‐income countries .…”

“…For example, despite being one country, India has more than 100 different ethnicities and more than eight religions, and Malaysia has more than three ethnicities and more than five different religions . Thus, although these findings cannot be simply explained, they may be partly based on the report that depressive symptom profiles of South Asians were characterized by significant preponderances of loss of interest, poor concentration, and poor appetite compared to those of East and Southeast Asians in other findings of the REAP‐AD survey . In 488 Indian elderly patients with depression, ‘feeling tired or having little energy’ was the most prevalent depressive symptom, followed by ‘not being able to stop or control worry,’ ‘trouble sleeping,’ ‘trouble relaxing,’ ‘worry too much about different things,’ and others .…”

“…In the South or Southeast Asian region, the heterogeneity of the ethnicity and/or culture has been remarkable. For example, despite being one country, India has more than 100 different ethnicities and more than eight religions, and Malaysia has more than three ethnicities and more than five different religions . Thus, although these findings cannot be simply explained, they may be partly based on the report that depressive symptom profiles of South Asians were characterized by significant preponderances of loss of interest, poor concentration, and poor appetite compared to those of East and Southeast Asians in other findings of the REAP‐AD survey .…”

A comparison of clinical characteristics of older adults treated with antidepressants in general and psychiatric hospitals in Asia

“…Because of logistical limitations, no standardized instruments on the presence and severity of depressive symptoms were used. Instead, the presence of 10 core depressive symptoms selected from the National Institute for Health and Care Excellence guidelines, International Classification of Diseases, 10th revision, and Diagnostic and Statistical Manual of Mental Disorders , 4th edition, were used; symptoms included insomnia, appetite change, agitation, fatigue, suicidal ideation, guilt/self‐blame, lack of confidence, low concentration, sadness, and loss of interest . In addition, all the participating countries and territories were divided into high‐income (Hong Kong, Singapore, Japan, Korea, and Taiwan), upper‐middle–income (China, Malaysia, and Thailand), and lower‐middle–income sites (India and Indonesia) according to the The World Bank, 2016 criteria .…”

Cognitive dysfunction in Malaysian patients with major depressive disorder: A subgroup analysis of a multicountry, cross‐sectional study

“…Patients with MDD in Southeast Asia and Western Pacific regions make up almost half of the global MDD population (Friedrich, ). Cognitive impairment in MDD and its correlation to functional disability have been reported in Asia in recent years (Chee et al, ; Kim et al, ; Srisurapanont et al, ). According to recent literature analysis, the prevalence of MDD in Malaysia (8‐12%) is twice as high as the global prevalence, regardless of geographical location (Ng, ).…”