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Depression in the planet's largest ethnic group: the Chinese.

OBJECTIVE: The authors reviewed the evidence for the claim that the Chinese tend to deny depression or express it somatically, examined the possible determinants of those characteristics, and explored implications of the findings for the diagnosis and management of depression in China and for psychiatry in the WEST: METHOD: This paper reviews and interprets original studies and literature reviews considering emotional distress, depression, neurasthenia, and somatization in Chinese subjects. RESULTS: Interpretation of the literature is complicated by the considerable heterogeneity among people described as "the Chinese" and by numerous factors affecting collection of data, including issues of illness definition, sampling, and case finding; differences in help-seeking behavior; idiomatic expression of emotional distress; and the stigma of mental illness. Despite difficulties in interpreting the literature, the available data suggest that the Chinese do tend to deny depression or express it somatically. CONCLUSIONS: The existing evidence supports the hypothesis that the Chinese tend to deny depression or express it somatically. However, Western influences on Chinese society and on the detection and identification of depression are likely to have modified the expression of depressive illness quite sharply since the early 1980s. Analyzing these changes may provide useful insight into the evolution of the diagnosis of depression in Western and other cultures.

Acculturation↗

Interrelationships between the precautionary principle, prediction strategies, and sustainable use of the planet.

In this article, I examine the relationships between new concepts of human activity in the environment and several prevention strategies used to plot a course toward sustainable use. Natural capitalism and industrial ecology are relatively new concepts that provide a framework for environmental management. Although the precautionary principle puts into policy a determination to prevent environmental damage before it occurs, natural capitalism and industrial ecology go beyond the prevention of environmental damage to the optimization of environmental interactions. The risk assessment tools necessary for preventive management continue to be essential. However, additional tools are needed to go beyond prevention to optimization. A holistic, scientific approach to the human place within the environment is needed, including both interdisciplinary and large-scale research.

Capitalism↗