Depression in North India comparison of symptoms and life events with ocher patient groups

Cross-cultural studies of depression have raised interesting issues in terms of symptoms and diagnosis in patients seeking treatment. To understand the symptom patterns of depression in a clinic population in north India, we studied 75 consecutive patients diagnosed as suffering from depression. They were asked to describe their symptoms, life events in the year before the onset of depression, and family history. Sleep disturbances, low mood and irritability were common symptoms. Suicidal intent was reported by 54% of the sample, and guilt by 56%. Study of family history and life events suggests that in those with a negative family history, the onset of depression was more likely to be related to a significant life event the commonest being family conjunct. The symptoms of this patient group are compared with the symptoms of depression reported from clinical samples in south India, Bombay and the West. North Indian samples have low rates of delusions, whereas Bombay samples reveal low levels of hypochondriasis, agitation, guilt and suicidal thoughts. The roles of cultural factors, family responsibilities and expectations are discussed in relation to depression across cultures. These findings also have implications for the clinical management of patients from the North Indian diaspora presenting with depression.