Collaborative Management to Improve Treatment of Depressed Chinese Americans in Primary Care

In European and North American cultures, depression is a well-accepted psychiatric syndrome characterized by specific affective, cognitive behavioral, and somatic symptoms. In many non-European cultures, including Nigerians, Chinese, and Canadian Eskimos, equivalent concepts of depressive disorders are not found.  Studies exploring illness beliefs of depressed among depressed Chinese Americans with a low degree of acculturation have shown that many of them were unaware of, or unfamiliar with the concept of major depressive disorder (MDD).  The discrepancy of illness beliefs between less acculturated Chinese Americans and their physicians has led to under-recognition and under-treatment of MDD among Chinese Americans.  The Culturally Sensitive Collaborative Treatment (CSCT) was designed to improve recognition, acceptability, and adherence to treatment of depression. It includes systematic depression screening in primary care and culturally sensitive psychiatric assessment.