Depression in Brazil and other Latin American countries

Minor psychiatric disorders, specially depression and anxiety, are highly prevalent in Latin American (LA) countries including Brazil. Some important social factors specially present in medium and large LA cities such as violence, migration and homelessness probably contribute to large number of people suffering of different forms of depressive and anxiety disorders. Latin America was colonized about 500 years ago by Spain and Portugal and their cultural identity is still very much influenced by Ibero-American attitudes and beliefs. Probably as a consequence of this situation, depression is usually expressed in LA countries more through somatic symptoms such as headaches, gastrointestinal disturbances, or complaints of "nerves" than through subjective feelings of sadness or guilty. So, depression is much more seen in primary care services than in psychiatric clinics and as in other parts of the World is not recognized. Nevertheless, primary care patients from different cultural backgrounds with somatic complaints due to depression differ in their preferred explanations or attributions for these symptoms. Somatic complaints many times represent just a different idiom of distress related to depression; to understand their origin and role for patients from different cultures will certainly help health professionals to better identify and treat them.