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Discuss gender and cultural variations in the prevalence of Major Depressive Disorder This paper will discuss gender and cultural variations in the prevalence of Major Depressive Disorder by focusing on various studies and findings. Major depressive disorder is relatively common, affecting around 15% of people at some time in their life. According to the Department of Health (1990), during the 1980’s, depression accounted for about one-quarter of all psychiatric hospital admissions in the UK. Furthermore, depression is much more common in women than men, having a 1: 10 ratio. Levav (1997) has found the prevalence rate to be to be above average in Jewish males—and there is no difference in prevalence between Jewish men and Jewish women. The difference can suggest that some groups are more vulnerable to depression, but it could also indicate a problem in making reliable diagnosis; having said that, gender and cultural variations are significant factors when considering the prevalence of this disorder. The World Health Organization (1983) has looked at cultural considerations linked to depression and identified common symptoms of depression in four different countries; including Iran, Japan, Canada, and Switzerland. These symptoms were feeling of sadness, loss of enjoyment, anxiety, tension, lack of energy, loss of interest, inability to concentrate, anxiety, tension, lack of energy, among others. Prince (1968) claimed that there was no depression in Africa and many regions of Asia, but found that rates of reported depression rose with westernization in the former colonial countries. Furthermore, Kleinman (1982) showed that in China, somatization served as a typical channel of expression and as a basic component of depressive experience. The Chinese rarely complain of feeling sad or depressed; instead, they refer to these feelings to the body as the medium of distress. Masella (1979) argues that affective symptoms between (sadness, loneliness, isolatin) are typical of individualist cultures. In cultures which are collectivist ( for example those that have larger and more stable social networks to support the individual and where one’s identity is more linked to these groups) somatic symptoms such as headaches are more common. Lastly, Tahassum et al (2000) conducted an interview study about etics/emics of depression by interviewing Pakistanis that lived in the UK. They aimed to answer the question “What are the emics (culturally specific) and etics (culturally universal) aspects of depression?” based on research from the UK Pakistani community. They compared emic definitions of depressive symptoms from the Pakistani community living in the UK with the existing predominant etic (so-called culturally universal) descriptions used by Western psychiatrists that were treating them. All 79 interviews were conducted in family groups because males typically wouldn’t allow females to meet with the researchers alone in their home. Combinations of languages were used (English, Urdu, Punjabi) and only seven of the families allowed the researchers to have the privilege of recording the interviews. The topics included in the interviews were perception of causes for mental disorder, help seeking behavior and the community of status of people with mental disorders. What they found was that 63% viewed aggression as a main symptom of abnormality. Pakistani culture is a collectivist and emphasizes politeness in their social behavior, so aggressive displays are views as abnormal more so than anxious or depression symptoms. However, it is important to keep in mind that this study may have low ecological validity given that the statistics gathered may not be a representative sample. The majority of the males thought a doctor should be consulted for treatment, while fewer females identified a doctor as the first person to consult, but there may be culture barriers to women getting help from doctors, which included language barriers. Many doctors are males, and that many Muslim women have difficulty with hospitalization due to shame brought upon the family. Overall, cross-cultural research has demonstrated that there is a virtually identical core of symptoms present in depression in many different cultures. According to statistical evidence, Williams and Hargreaves (1995) found that women are two to three times more likely to become clinically depressed than men, and are more likely to experience several episodes of depression. It’s a widely held belief that women are naturally more emotional than men, and therefore are more vulnerable to emotional upsets because of hormonal fluctuations. The theory of social factors in depression, which was by Brown and Harris (1978), a study of the social origins of depression was carried out, who examined the relationship between social factors and depression in a group of women from Camberwell in London. They studied women who had received hospital treatment for depression and women who had visited their doctor seeking help for depression. They also studied a general population sample of 458 women aged between 18 and 65 years old. They found, that on average 82% of those who became depressed had recently experienced at least one severe life event or major difficulty, compared to only 33% of those in non-depressed comparison groups. They also found evidence of a pronounced social class effect, at least for married women. Of the working class women in the general population, 23% had been depressed within the past year, compared to only 3% of the middle class women. Along with the working class women, those who had one or more young children were at higher risk of becoming depressed than those who were childless or whose children were older. Women who were currently caring for three children were particularly likely to have experienced a recent depressive period. There was a strong association between risk and marital status, which held across all social classes. Women who were widowed, divorced or separated had relatively high rates of depression. Although there was a strong overall association between depression and the experience of stressful life events, only a minority, about 20% of the women who had experienced severe difficulties became seriously depressed. This suggests that people differ in their vulnerability, and a number of “vulnerability factors” were identified in the study: lack of confidante, early loss of mother before the age of 11, and being unemployed. One of the most protecting factors against depression was found to be the presence of a partner. A research study by Marco Piccinelli, PhD, and Greg Wilkinson of the British Journal of Psychiatry, aims to review putative risk factors leading to gender differences in depressive disorders. Their method was a critical review of the literature, dealing separately with artefactual and genuine determinants of gender differences in depressive disorders. Their results were that although artefactual determinants may enhance a female preponderance to some extent, gender differences in depressive disorders are genuine. At present, adverse experiences in childhood, depression and anxiety disorders in childhood and adolescence, sociocultural roles with related adverse experiences, and psychological attributes related to vulnerability to life events and coping skills are likely to be involved. Genetic and biological factors and poor social support, however, have few or no effects in the emergence of gender differences. Their conclusion was that determinants of gender differences in depressive disorders are far from being established and their combination into integrated aetiological models continues to be lacking. However, although gender differences may play a role in coping with depressive disorders, how people cope with stress in terms of social support is also a factor (from the Bio LOA) and also the importance of individual differences such as Cognitive Styles of type A personality and hardy personalities affect people and depression. In conclusion, cultural and gender considerations in the prevalence of major depressive disorder are important so that the most effective treatments can be developed. As major depressive disorder are relatively common, and can affect around 15% of everybody from all cultures and genders at some time in their life. Furthermore, depression is much more common in women than men, and traditional treatments for men must be adapted to benefit women as well. The difference can suggest that some groups are more vulnerable to depression, but it could also indicate a problem in making reliable diagnosis.