Abstract
Traditional Chinese medicine (TCM) is an alternative medical system utilised by many Chinese. However, the knowledge of TCM concepts of depression is limited amongst clinicians with training in Western biomedicine. The purpose of this study was to obtain a better understanding of the conceptualisation of depression from a group of TCM practitioners. Semi-structured interviews in Chinese were carried out with 10 TCM practitioners in Hong Kong. A case description of major depression disorder (MDD) was used as a basis. Interview texts were transcribed, translated and analysed using qualitative content analysis. Most informants identified the case as a depression pattern, a term that lacked clear definition and standardised criteria. The mechanism of disease for MDD symptoms were regarded to be liver-qi dysregulation and an imbalance of yin and yang. The TCM practitioners implemented individualised diagnosis, treatment, and a holistic concept without clear distinction between the mind and the body. This contrasted with the biomedical tradition of separating psychologisation and somatisation. The meanings given to the concept of depression did not correspond with current DSM or ICD definitions, and the TCM normativity can result in variations in explanatory models.
Highlights
About 90% of all patients globally are of non-Caucasian origin (Lee, Kleinman, and Kleinman 2007)
What do Traditional Chinese medicine (TCM) practitioners utilise as explanatory models (EM)? EM refer to how a person perceives, interprets, expresses, explains symptoms and experiences, while they influence the treatment process (Kleinman 1978)
There was a general acceptance of judging the same symptoms differently, and the diagnostic criteria of major depression disorder in ICD and DSM were not to be equated with the diagnostic parameters of TCM depression pattern
Summary
About 90% of all patients globally are of non-Caucasian origin (Lee, Kleinman, and Kleinman 2007). Cross-cultural psychiatry has been an important subject for research since the term was coined by Arthur Kleinman in the late 1970s (Kleinman 1977), and has evolved to become the concept of cultural psychiatry today as recognition of the broad nuances of illness presentation, patient experiences and medical interpretations world-wide. Descriptions of TCM theories and definitions are found in various TCM textbooks, most of which are written in Chinese by small groups of senior practitioners basing their work on ancient scripts and individual experiences. All of this makes it difficult for psychiatric professionals in Western countries to gain insight into TCM. For a better understanding, learning about the EM of TCM practitioners is important
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