CULTURAL DIMENSIONS OF PSYCHIATRIC-DIAGNOSIS - A COMPARISON OF DSM-III-R AND ILLNESS EXPLANATORY MODELS IN SOUTH-INDIA

Background. Cross-cultural research to examine the cultural validity o f diagnostic categories and underlying concepts requires methods that integrate epidemiological and anthropological frameworks. Method. The Explanatory Model Interview Catalogue (EMIC) and Structured Clinical I nterview for DSM-III-R (SCID) were used to study 80 psychiatric out-pa tients with depressive neurosis at a clinic in south India. Results. S ummary kappa values of 0.75 for the EMIC and 0.68 for the SCID confirm ed interrater reliability. Comparison of patient explanatory models an d SCID diagnoses showed that patients emphasised somatic experience wh ile clinicians emphasised depressive diagnoses. More than half the pat ients (55%) received a non-specific or dual diagnosis. Conclusions. Th ese findings raise questions about the distinctiveness of depressive, anxiety, and somatoform (DAS) disorders for this population.