Discuss Cultural and Gender
Variations in Prevalence of
Disorders
By Mr Daniel Hansson
Prevalence - Anorexia
• Lifetime prevalence of Anorexia nervosa in
females is 0.5%
• 10 times more likely in females than in males
• More common in western societies but is
increasing in eastern societies
Gender Differences in Prevalence of
Depression
• Women – 10-25%
• Men – 5-12%
• The National comorbidity study: 1.7
American woman for every man has experienced
at least one episode of depression. Roughly the
same ratio has been found in recent studies in
nine other countries, including Canada, Brazil,
Germany and Japan
Cultural Differences in Prevalence of
Depression
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Seattle, Washington: 6.3 %
China: 4 %
Verona, Italy: 4.7 %
Groningen, Germany: 15.9 %
Manchester, United Kingdom: 16.9 %
Ankara, Turkey: 11.6 %
Nagasaki, Japan: 2.6 %
Why are There Cultural Differences
in Prevalence of Disorders?
• Different cultures have different concepts of
what is abnormal behavior
• Social problems/pressures and cultural
differences may lead to a higher prevalence of
disorders in some cultures
Different cultures have different
concepts of what is abnormal
behavior
• Okello and Ekblad (2006): In Uganda depression is seen as “illness of
thoughts” and not a biological illness. Therefore, it is believed that depressed
do not need medicine, unless the disorder is chronic or recurring.
• Cooper et al (1972): New York psychiatrists are twice as likely to diagnose
patients with schizophrenia than London psychiatrists, who in turn are twice
as likely to diagnose mania or depression when shown the same videotaped
clinical interviews.
• Different countries use different diagnostic tools: E.g. ICD-10, CCMD,
DSM-IV-TR
• Homosexuality was considered to be abnormal until DSM-III (1980). It is still
considered abnormal in many countries.
• Unmarried mothers in Britain and political dissidents in the Soviet unions
were once confined to institutions for abnormality. The tendency for
American black slaves in the 1800s to try flee captivity was considered to be a
mental illness. It is claimed that psychiatry also have been used to silence
political dissidents in China (e.g. the Falungong movement)
Social problems/pressures and cultural
differences may lead to higher a
prevalence of disorders in some cultures
• Becker (1995): After the introduction of television in
Fiji, eating disorders in women increased
• Suicide is more common in poorer countries
• Chiao & Blinsky (2010): Depression is associated
with individualism. Individualism is negatively
correlated with the frequency of the short allele related
to serotonin transporters
• In cultures with high levels of community, religiosity,
and traditional family roles, depression is less prevalent
(e.g. Wu and Anthony 2000)
Why are there gender differences in
prevalence of disorders?
• The are genetic differences between men and
women in susceptibility for a disorder
• There are cultural differences in expectations of
men and women which contribute to different
disorders
The are genetic differences between men
and women in susceptibility to a disorder
• Zubenko: Some chromosomes are more likely
to contain genes that promote depression. These
chromosomes are more common in women
than men.
There are cultural differences in expectations
of men and women which contributes to
different disorders
• Becker (1995): After the introduction of
television in Fiji, eating disorders in women
increased
• Bulimia and anorexia are most common among
upper and middle class Caucasian women.