© 2007 President and Fellows of Harvard College
Rethinking Depression: An Ethnographic Study
of the Experiences of Depression Among Chinese
Dominic T. S. Lee, MD, MRCPsych, Joan Kleinman, MA, and Arthur Kleinman, MD
Relative to studies of patients in the West, little research has focused on the lived experiences of patients
with mental illness in non-Western societies. The current understanding of the phenomenology
of depression and other psychiatric disorders is almost entirely based on studies of Western populations.
The objective of the present study was to examine the experiences of depressive disorders
among contemporary Chinese in Guangzhou (Canton), China. A total of 40 patients who had significant
depressive symptoms were recruited using quota sampling from the outpatient department of
a regional mental health service. The depressive experiences of participants were examined by openended,
in-depth, ethnographic interviews. The interviews were taped, transcribed, and translated.
Content analysis was conducted on both the Chinese and English transcripts. A total of six categories
of affective experiences were identified among the participants. Indigenous affective lexicons,
embodied emotional experiences, implicit sadness, preverbal pain, distress of social disharmony, and
centrality of sleeplessness were regularly observed among the informants. Our findings suggest that
psychiatric textbooks and diagnostic systems do not cover the full range of depressive symptoms
experienced among contemporary Chinese. More studies are needed to examine how depression is
differentially experienced globally—a crucial step in making professional diagnosis, treatment, and
research more broadly applicable across cultures. (HARV REV PSYCHIATRY 2007;15:1–8.)
Keywords China, culture, depression, ethnography, illness experience
From the Department of Social Medicine, Harvard University; Department
of Psychiatry, Chinese University of Hong Kong (Dr. Lee).
Original manuscript received 17 October 2005, accepted for publication
subject to revision 9 January 2006; revised manuscript received
1 August 2006.
Dominic T. S. Lee, MD, Department of Psychiatry, Chinese University
of Hong Kong, Shatin, Hong Kong, China. Email: tak lee@hms.
harvard.edu or dominiclee@cuhk.edu.hk
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