The British Journal of Psychiatry (2009) 194: 326-333. doi: 10.1192/bjp.bp.108.050906
© 2009 The Royal College of Psychiatrists
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International and indigenous diagnoses of mental disorder among Vietnamese living in Vietnam and Australia

Zachary Steel, PhD, MClinPsychol and Derrick Silove, MD, MB ChB(HonsI), FRANZCP

Centre for Population Mental Health Research and Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, Australia

Nguyen Mong Giao, MD, MB ChB

Department of Psychiatry, Formula

Formula

University, Vietnam

Thuy Thi Bich Phan, MD, Mb ChB and Tien Chey, MAppStat, BSc

Centre for Population Mental Health Research and Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, Australia

Anna Whelan, PhD, BA(HonsI)

School of Public Health and Community Medicine, University of New South Wales, Australia

Adrian Bauman, PhD, FAFPHM

School of Public Health, Sydney University, Australia

Richard A. Bryant, PhD, MPsychol

University of New South Wales, Australia

Correspondence: Zachary Steel, Centre for Population Mental Health Research, Level 1, Mental Health Centre, The Liverpool Hospital, Cnr Forbes and Campbell Streets, Liverpool NSW 2170, Australia. Email: z.steel{at}unsw.edu.au

Declaration of interest

None.

Funding

This research was supported in part by an Australian National Health and Medical Research Council Program Grant (300304).

Background

Whether the prevalence rates of common mental disorders can be compared across countries depends on the cultural validity of the diagnostic measures used.

Aims

To investigate the prevalence of Western and indigenously defined mental disorders among Vietnamese living in Vietnam and in Australia, comparing the data with an Australian-born sample.

Method

Comparative analysis of three multistage population surveys, including samples drawn from a community living in the Mekong Delta region of Vietnam (n=3039), Vietnamese immigrants residing in New South Wales, Australia (n=1161), and an Australian-born population (n=7961). Western-defined mental disorders were assessed by the Composite International Diagnostic Interview (CIDI) 2.0 and included DSM–IV anxiety, mood and substance use disorders as well as the ICD–10 category of neurasthenia. The Vietnamese surveys also applied the indigenously based Phan Vietnamese Psychiatric Scale (PVPS). Functional impairment and service use were assessed.

Results

The prevalence of CIDI mental disorders for Mekong Delta Vietnamese was 1.8% compared with 6.1% for Australian Vietnamese and 16.7% for Australians. Inclusion of PVPS mental disorders increased the prevalence rates to 8.8% for Mekong Delta Vietnamese and 11.7% for Australian Vietnamese. Concordance was moderate to good between the CIDI and the PVPS for Australian Vietnamese (area under the curve (AUC)=0.77) but low for Mekong Vietnamese (AUC=0.59). PVPS- and CIDI-defined mental disorders were associated with similar levels of functional impairment.

Conclusions

Cultural factors in the expression of mental distress may influence the prevalence rates of mental disorders reported across countries. The findings have implications for assessing mental health needs at an international level.


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