Unipolar depression across cultures: A Delphi analysis of the methodological and conceptual issues confronting the cross-cultural study of depression

Abstract

Abstract The objective of the research is to investigate the epistemological and methodological discrepancies involved in the cross-cultural study of unipolar depression. These discrepancies include the methodological design and measurement of depression and culture, and the epistemological variation in researchers as to whether depression is a universal or socially constructed phenomenon. A Delphi procedure was utilised which enabled a group of eleven culture/depression experts from around the globe to respond to an open-ended questionnaire related to the methodological and epistemological problems confronting the understanding of depression across cultures. Endorsement of these issues and consensus between the Delphi participants to these issues was then assessed by two subsequent questionnaires. The results indicated that when studying depression across cultures, both universal and social constructionist approaches to depression need to be considered. Quantitative measures of depression should include only the universal aspects of depression so meaningful comparisons can be made across cultures. Quantitative information should be supplemented with qualitative descriptions from research collaborators who can provide an emic perspective of depression. Measuring culture should move beyond the scope of using Hofstede’s dimensions which, although measuring some aspects of culture, do not encompass the complexity of cultures. The impact of globalisation means that our knowledge of cultures needs to be regularly reviewed. Cross-cultural, comparative research of depression is much needed but there are many methodological and epistemological issues that need to be addressed.