Manifestation, attribution, and coping with depression among Asian Indians from the perspectives of health care practitioners.

The study explores cultural influences on depression and care outcomes among Asian Indians with depression. Data were collected from interviews of 23 multidisciplinary mental health professionals and retrospective review of 20 medical records of patients. Findings revealed a major influence of social and cultural context in expression of symptoms, illness attribution, help-seeking behaviors, and communication patterns. Religious beliefs and social stigma attached to mental illness contributed to prolonged denial of condition, difficulty in sharing emotional problems with professional caregivers, and delayed professional intervention. The traditional family hierarchy rooted in age and gender inequality interfered with help-seeking behaviors and adherence to prescribed regimen as well as heightened some family conflicts and hindered family adaptation after migration to the United States.