Consensus statement on transcultural issues in depression and anxiety fromthe International Consensus Group on Depression and Anxiety

Objective: To provide primary care physicians with a better understanding o f transcultural issues in depression and anxiety. Participants: The 4 membe rs of the International Consensus Group on Depression and Anxiety were Jame s C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Five faculty invited by the chair also participated: Laurence J. K irmayer, Jean-Pierre Lepine, Keh-Ming Lin, Osamu Tajima, and Yutaka One. Ev idence: The consensus statement is based on the 5 review articles that are published in this supplement and the scientific literature relevant to the issues reviewed in these articles. Consensus process: Group meetings were h eld over a 2-day period. On day 1, the group discussed the review articles, and the chair identified key issues for further debate. On day 2, the grou p discussed these issues to arrive at a consensus view. After the group mee tings, the consensus statement was drafted by the chair and approved by all attendees. Conclusion: The consensus statement underlines the prevalence o f depression and anxiety disorders across all cultures and nations while re cognizing that cultural differences exist in symptom presentation and preva lence estimates. In all countries, the recognition of depression by clinici ans in the primary care setting is low (generally less than 50%), and the c onsensus group recommends a 2-step process to aid the recognition and diagn osis of depression. In line with the low recognition of depression and anxi ety disorders is the finding that only a small proportion of patients with depression or anxiety are receiving appropriate treatments for their condit ion. Biological diversity across ethnic groups may account for the differen tial sensitivity of some groups to psychotropic medication, but this area r equires further investigation.