Culture, Medicine and Psychiatry

, Volume 23, Issue 3, pp 349–380

Diagnosis Postponed: Shenjing Shuairuo and the Transformation of Psychiatry in Post-Mao China

  • Sing Lee

DOI: 10.1023/A:1005586301895

Cite this article as:
Lee, S. Cult Med Psychiatry (1999) 23: 349. doi:10.1023/A:1005586301895


Building on Arthur Kleinman's seminal work in Hunan, this paper examines the social context in which shenjing shuairuo (neurasthenia), a ubiquitous psychiatric disease in China prior to 1980, is contested, marginalized, and reconstituted as the popular Western disease of depression among academic psychiatrists in urban China. It is argued that this dramatic change of diagnostic labelling is not only based on empirical evidence. Rather, it is also a product of interests and strategies that are themselves embedded in a confluence of historical, social, political, and economic forces. Specifically, China's open door policy, the hegemony of DSM discourse, the depoliticization of experience, and the transnational commercialization of suffering have all played a role in creating the new-found disease of depression. As a new social construct in China, depression may serve different social functions for different institutional groups, such as drug companies' marketing of new antidepressant therapy, and academic psychiatrists' effort to render the study of suicide more admissible to the state. Because of the government's budgetary limitations and drastic changes in health care financing, however, global diagnostic technology and markets for drugs merely reinforce people's markedly unequal access to health care, which is but one facet of the pervasive social inequity that is China nowadays.

Copyright information

© Kluwer Academic Publishers 1999

Authors and Affiliations

  • Sing Lee
    • 1
  1. 1.Department of PsychiatryThe Chinese University of Hong KongHong Kong, P.R.C