Abstract
Standard psychiatric criteria for depression developed in the United States and United Kingdom are increasingly used worldwide to establish the prevalence of clinical disorders and to help develop services. However, these approaches are rarely sensitive to local and cultural expressions of symptoms or beliefs about treatment. Mismatch between diagnostic criteria and local understanding may result in underreporting of depression and underutilization of services. Little such research has been conducted in Malaysia, despite the acknowledged high rate of depression and low access to services. This study examines depression in Moslem Malay women living in Johor Bahru, Southern Peninsular Malaysia, to explore depression symptoms using the Structured Clinical Interview for DSM-IV. The 61 women interviewed were selected on the basis of high General Health Questionnaire scores from a large questionnaire survey of 1,002 mothers. The illustrative analysis looks at descriptions of depressed mood, self-depreciation and suicidal ideation, as well as attitudes toward service use. The women gave full and open descriptions of their emotional symptoms, easily recognizable by standard symptom categories, although somatic symptoms were commonly included, and the spiritual context to understanding depression was also prevalent. However, few women had knowledge about treatment or sought medical services, although some sought help from local spiritual healers. Attending to such views of depression can help develop services in Malaysia.
Similar content being viewed by others
References
Abdul Hamid, A. R., and S. M. A. Hatta 1996 A Validation Study of the Malay Language General Health Questionnaire (GHQ-30). Malaysian Psychiatry 4:36–37.
Abdul-Kadir, N. 2009 The Psychosocial Study of Depression in a Community-Based Sample of Single and Married Mothers in Malaysia. Unpublished doctoral dissertation. Royal Holloway, University of London.
Andajani-Sutjahjo, S., L. Manderson, and J. Asbury 2007 Complex Emotions, Complex Problems: Understanding the Experiences of Perinatal Depression Among New Mothers in Urban Indonesia. Culture, Medicine and Psychiatry 31:101–122.
Angermeyer, M. C., and H. Matschinger 2003 Public Beliefs About Schizophrenia and Depression: Similarities and Differences. Social Psychiatry and Psychiatric Epidemiology 38:526–534.
Areán, P. A., and B. L. Cook. 2002 Psychotherapy and Combined Psychotherapy/Pharmacotherapy for Late Life Depression. Society of Biological Psychiatry 52:293–303.
Australian Bureau of Statistics 2001 http://www.abs.gov.au.
Barsky, A. J. 1992 Amplification, Somatisation, and the Somatoform Disorders. Psychosomatics 33:28–34.
Battachaya, D. P. 1986 Pagalani: Europsychiatric Knowledge in Bengal. New York: Syracuse University Press.
Beliappa, J. 1991 Illness or Distress? Alternative Models of Mental Health. London: Confederation of Indian Organizations.
Berger, M., T. H. Wagner, and L. C. Baker 2005 Internet Use and Stigmatized Illness. Social Sciences and Medicine 61:1821–1827.
Bhui, K., and D. Bhugra 2001 Transcultural Psychiatry: Some Social and Epidemiological Research Issues. International Journal of Social Psychiatry 47:1–9.
Binitie, A. 1975 A Factor-Analytic Study of Depression Across Cultures (African and European). British Journal of Psychiatry 127:559–563.
Brown, G., and T. O. Harris 1978 Social Origins of Depression. London: Tavistock.
Butcher JN, Mineka S, Hooley JM 2004 Abnormal Psychology. Pearson Eduction, Allyn & Bacon, Boston.
Cartwright, A., and R. Anderson 1981 General Practice Revisited. London: Tavistock.
Chaaya, M., A. M. Sibai, R. Fayad, and Z. El-Roueiheb 2007 Religiosity and Depression in Older People: Evidence from Underprivileged Refugee and Non-refugee Communities in Lebanon. Aging Mental Health 11:37–44.
Crabtree, S. A., and G. Chong 2000 Mental Health and Citizenship in Malaysia. International Social Work 43:217–226.
Currer, C. 1984 Pathan Women in Bradford—Factors Affecting Mental Health with Particular Reference to the Effects of Racism. International Journal of Social Psychology 30:72–76.
Deva, M. P. 2004 Malaysia Mental Health Country Profile. International Review of Psychiatry 16:167–176.
Fazil, O., and R. Cochrane 1998 The Cultural Dimensions in a Causal Model of Depression. Fourteenth International Congress of Cross Cultural Psychology, Bellingham, WA.
Fernando, S. 1990 The Sorrows in My Heart—South Asian Women in the U.K. and Depression. Paper presented at the British Sociological Association conference, Edinburgh, UK.
First, M.B., R.L. Spitzer, M. Gibbon, and J.B.W. Williams 1996 Structured Clinical Interview for Axis 1 DSM-IV: Disorders Research Version-Patient Edition (SCID-I/P, Version 2.0). New York: New York State Psychiatric Institute, Biometrics Research Department.
Fones, S. C. L., E. H. Kua, and S. M. Ko 1998 Studying the Mental Health of a Nation. Singapore Medical Journal 39:251–255.
Gleen, C. L. 1997 Relationship of Mental Health to Religiosity. McGill Journal of Medicine 3:86–92.
Goldberg, D.P. 1978 Manual of the General Health Questionnaire. Slough: National Foundation for Educational Research.
Goodman, B., and A. Kleinman 1985 Culture and Depression. Pp. 491–506 in Culture and Depression: Studies in Anthropology and Cross-cultural Psychiatry of Affect and Disorder. A. Kleinman and B. Good, eds. Berkeley: University of California Press.
Guze, S. B., and E. Robins 1970 Suicide and Primary Affective Disorders. British Journal of Psychiatry 117:437–438.
Haque, A. 2005 Mental Health Concepts and Program Development in Malaysia. Journal of Mental Health 14:183–195.
Hamdi, E., Y. Amin, and M. T. Abou-Salleh 1997 Problems in Validating Endogenous Depression in the Arab Culture by Contemporary Diagnosis Criteria. Journal of Affective Disorders 44:131–143.
Hobbs, P., C. Ballinger, and B. Greenwood 1984 Factor Analysis and Validation of General Health Questionnaire in Men: A General Practice Survey. British Journal of Psychiatry 144:270–275.
Hussain, F., and R. Cochrane 2004 Depression in South Asian Women Living in the UK: A Review of the Literature with Implications for Service Provision. Transcultural Psychiatry 41:253–270.
Jho, M. 2001 Study on the Correlation Between Depression and Quality of Life for Korean Women. Nursing and Health Sciences 3:131–137.
Jorm, A. F. 2000 Mental Health Literacy: Public Knowledge and Beliefs About Mental Disorders. British Journal of Psychiatry 177:396–401.
Jorm, A. F., A. E. Korten, P. A. Jacomb, H. Christensen, B. Rodgers, and P. Pollitt 1997 Mental Health Literacy. Medical Journal of Australia 166:182–186.
Kleinman, A. 1982 Neurasthenia and Depression: A Study of Somatization and Culture in China. Culture, Medicine and Psychiatry 6:117–190.
Lawrence, V., J. Murray, S. Banerjee, S. Turner, K. Sangha, R. Byng, D. Bhugra, P. Huxley, A. Tylee, and A. Macdonald 2006 Concepts and Causation of Depression: A Cross-cultural Study of the Beliefs of Older Adults. Gerontologist 46:23–32.
LSE: The Depression Report 2006 http://www.statistics.gov.uk.
Malaysia Ministry of Health 2005 Annual Report Ministry of Health Malaysia 2004. Luala Lumpur: MMH.
Malaysia Ministry of Health and Malaysian Psychiatry Association 1999 A Consensus Statement on Management of Depression. Kuala Lumpur: MMH and MPA.
Maniam, T. 1996 Validation of the General Health Questionnaire (GHQ-30) for a Malaysian Population. Malaysian Journal of Psychiatry 4:25–32.
Mihanović, M., G. Babić, S. Kezić, I Sain, and C. Loncar 2005 Anthropology and Psychiatry. Collegium Antropologicum 29:747–751.
Morley, S., A. C. William, and S. Black 2002 A Confirmatory Factor Analysis of the Beck Depression Inventory in Chronic Pain. Pain 19: 298.
Muhwezi, W.W., H. Ågren, S. Neema, S. Musisi, and A.K. Maganda 2007 Life Events and Depression in the Context of the Changing African Family: The Case of Uganda. Official Journal of World Association of Cultural Psychiatry 10–26.
Mumford, D. B., K. Saeed, I. Ahmad, S. Latif, and M. H. Mubbashar 1997 Stress and Psychiatric Disorder in Rural Punjab. British Journal of Psychiatry 170:473–478.
Murray, C. J. L., and A. D. Lopez 1997 Mortality by Cause for Eight Regions of the World: Global Burden of Disease Study. Lancet 349:1269–1276.
Okulate, G. T., M. O. Olayinka, and B. E. Jones 2004 Somatic Symptoms in Depression: Evaluation of Their Diagnostic Weight in an African Setting. British Journal of Psychiatry 184:422–427.
Parker, G., Y. C. Cheah, and K. Roy 2001a Do Chinese Somatise Depression? A Cross-cultural Study. Social Psychiatry and Psychiatric Epidemiology 36: 287–293.
Parker, G., Gladstone, G. and Chee, K.T. 2001b Depression in the Planet’ Largest Ethnic Group: The Chinese. American Journal Psychiatry 158: 857–864.
Passik, S. D., J. C. Lundberg, B. Rosenfield, K. L. Kirsh, K. Donaghy, D. Theobald, E. Lundberg, and W. Dugan 2000 Factor Analysis of the Zung Self-Rating Depression Scale in a Large Ambulatory Oncology Sample. Psychosomatics 41:121–127.
Patel, V. 2001 Cultural Factors and International Epidemiology. British Medical Bulletin 57:33–45.
Patel, V., J. Pereira, and H. Mann 1998 Somatic and Psychological Models of Common Mental Disorder in Primary Care in India. Psychological Medicine 28:135–143.
Patel, V., M. Abas, J. Broadhead, C. Todd, and A. Reeler 2001 Depression in Developing Countries: Lessons from Zimbabwe. British Medical Journal 322:482–848.
Pfeiffer, W. 1968 The symptomatology of Depression Viewed Transculturally. Transcultural Psychiatric Research Review 5:102–142.
Pridmore, S., and M. I. Pasha 2004 Psychiatry and Islam. Australian Psychiatry 12:380–385.
Rastogi, V. S., R. C. Jindal, M. P. Gupta, S. S. Rana, and S. Singhal 1976 Somatic Symptoms in Neuroses: A Cross Cultural Study. Indian Journal of Psychiatry 18:103–108.
Razali, S. M., and A. M. Hamzah 1999 Case Vignette in a Community-Based Study. American Journal of Psychiatry 156:158.
Razali, S. M., U. A. Khan, and C. I. Hasanah 1996 Belief in Supernatural Causes of Mental Illness Among Malay Patients: Impact on Treatment. Acta Psychiatrica Scandinavica 94:229–233.
Rodrigues, M., V. Patel, S. Jaswal, and N. de Souza 2003 Listening to Mothers: Qualitative Studies on Motherhood and Depression from Goa, India. Social Science and Medicine 57:1797–1806.
Ryder, A. G., J. Yang, X. Zhu, S. Yao, J. Yi, S. J. Heine, and R. M. Bagby 2008 The Cultural Shaping of Depression: Somatic Symptoms in China, Psychological Symptoms in North America? Journal of Abnormal Psychology 117:300–313.
Sakamoto, S., and M. Kambara 1998 A Longitudinal Study of the Relationship Between Attributional Style, Life Events, and Depression in Japanese Undergraduate. Journal of Social Psychology 138(2):229–240.
Shaik, N. M., and S. M. M.Abbasi 1981 Women in Muslim Society. Karachi, Pakistan: International Islamic.
Shibre, T., A. Negash, G. Kullgren, D. Kebede, A. Alem, A. Fekadu, D. Fekadu, G. Medhin, and L. Jacobsson 2001 Perception of Stigma Among Family Members of Individuals with Schizophrenia and Major Affective Disorders in Rural Ethiopia. Social Psychiatry and Psychiatric Epidemiology 36:299–303.
Simon, G. E., M. Vonkorff, M. Piccinelli, C. Fullerton, and J. Ormel 1999 An International Study of the Relation Between Somatic Symptoms and Depression. New England Journal of Medicine 341:1329–1335.
Statistics Canada 2002 http://www.statcan.ca.
Tan, E. 1977 The Presentation of Affective Symptoms in Non-Western Countries. In: Handbook of Studies on Depression. G. D. Burrows, ed. London: Excerpta Medica, Pp. 123–133.
Trivedi, J. K., M. Mishra, and A. Kendurkar 2007 Depression Among Women in the South-Asian Region: The Underlying Issues. Journal of Affective Disorders 102:219–225.
U.S. Department of Health and Human Services 1991 http://mentalhealth.samhsa.gov.
Wan Mahmud, W. M. R., S. Shariff, and M. J. Yaacob 2002 Postpartum Depression: A Survey of the Incidence and Associated Risk Factors Among Malay Women in Beris Kubor Besar, Bachok, Kelantan. Malaysian Journal of Medical Science 9(1):41–48.
Webb-Johnson, A. 1995 A Cry for Change. London: Confederation of Indian Organizations.
Ying, Y., J. L.Tsai, Y. Yeh, and J. S. Huang 2000 The Conception of Depression in Chinese American College Students. Cultural Diversity and Ethnic Minority Psychology 6:183–195.
Zisook, S., and K. S. Kendler 2007 Is Bereavement-Related Depression Different Than Non-Bereavement-Related Depression? Psychological Medicine 37:779–794.
Zisook, S., K. Shear, and K. S. Kendler 2007 Validity of the Bereavement Exclusion Criterion for the Diagnosis of Major Depressive Episode. World Psychiatry 6:102–107.
Zuraida, N. Z., and R. Parameswaran 2007 Prevalence of Depression Among Patients with Headache in Kuala Lumpur. Malaysian Journal of Psychiatry 16:No. 2.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Abdul Kadir, N.B., Bifulco, A. Malaysian Moslem Mothers’ Experience of Depression and Service Use. Cult Med Psychiatry 34, 443–467 (2010). https://doi.org/10.1007/s11013-010-9183-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11013-010-9183-x