Somatic and non-affective symptoms of old age depression: ethnic differences among Chinese, Indians and Malays

Somatic and other non-affective symptomatology characterizes late life depression and contributes to its under-diagnosis, especially in some ethnic groups.

We examined variations in non-affective presentation and its health and functional significance across different ethnic groups of Chinese, Malays and Indians.

We analyzed data from the National Mental Health Survey for Elderly, a population-based cross-sectional study of older adults aged 60 and above (N = 1092).

Compared to the depressed Chinese as the reference group, depressed Malays were more likely to endorse symptoms of appetite decrease (OR = 5.19), sleep disturbances (OR = 2.93), disabling pain (OR = 3.12), psychomotor slowing (OR = 2.73) and anergia (OR = 3.70), while concurrently reporting poorer general health status and greater role limitations resulting from their mental and emotional problems (OR from 2.13 to 3.31). These differences were not influenced by anxiety, dementia or physical comorbidity.

We revealed striking differences in the somatic and non-affective symptomatology of geriatric depression among different Asian ethnic groups. Non-affective symptoms in depression have large health and functional significance and important implications for the diagnosis and management of depression among elderly in primary care.