Characteristics of depressive patients contacting psychiatric services in four cultures. A report from the who collaborative study on the assessment of depressive disorders.

The paper is a report on results obtained in the course of a multi-centre international study on depressive disorders in four countries, which was sponsored and co-ordinated by the World Health Organization. A screen form was developed and tested in order to select depressive patients among psychiatric in-patient and out-patient populations. The patients selected in this way were assessed clinically by experienced investigators using the WHO schedule for Standardized Assessment of Depressive Disorders (SADD). A total of 53 patients were evaluated in the five research centres, and the data were utilized in uni- and multivariate statistical analyses aiming to establish whether similar cases of depression could be found in different cultures, to describe their characteristics and to ascertain the extent to which diagnostic concepts and classification categories could be applied in different settings. The results point to a considerable degree of similarity in depressive symptomatology across the cultures if particular selection criteria are applied, and suggest that broad diagnostic groupings such as 'endogenous' and 'psychogenic' depressions could be used consistently by clinicians working in different cultures.