Some issues in the diagnosis of depression in China

In China, the diagnosis of depression is made much less frequently than in the West, likely because there is a somewhat lower prevalence rate and because of other factors related to culture and to the development of Chinese psychiatry. Some of the relevant factors are: 1) depressed patients often avoid seeking help because of the stigma of mental disorder; 2) many patients seek help from practitioners of Traditional Chinese Medicine; 3) depression is often diagnosed as schizophrenia because of diagnostic criteria that are broader for schizophrenia and narrower for affective disorder than in the West; and 4) somatization is more frequent in China and many depressives receive the label "neurasthenia".