Unique depression symptoms in South Asian patients often missed in UK screenings, Surrey study reveals
The new study, which was conducted at the University of Surrey, advocates for training in culturally specific presentations and diagnosis
Depression symptoms specific to South Asian communities may be overlooked by standard screening tools in the UK, according to a new review led by the University of Surrey.
Published in The British Journal of Psychiatry, the review highlights physical pain, heart-related sensations, and repetitive negative thinking as commonly reported symptoms within South Asian populations.
These symptoms do not appear in the ICD-11 diagnostic criteria widely used in screenings like the Patient Health Questionnaire-9 (PHQ-9).
Part of the NIHR-funded PAPER Study, the review explores ethnic inequalities in depression symptoms and treatment.
The study found that South Asian diaspora populations can experience depression differently from White majority populations.
Symptoms like physical pain, including headaches, body aches, and neck pain, are reported by South Asian individuals as frequently as anhedonia, a primary symptom clinicians look for.
Interestingly, sleep disturbances were equally prevalent among this group.
Symptoms related to the heart, such as feelings of a "sinking heart" or "dead heart" reported by Punjabi, Urdu, and Hindi speakers, reflect expressions that blend metaphor with physical sensation.
Descriptions include sensations perceived physically, such as squeezing, pressure, and breathlessness.
Additionally, repetitive negative thinking—thoughts replaying like a film—was identified as widespread across studies, although not featured in ICD-11 criteria.
This symptom can be connected to aspects of trauma, such as migration and intergenerational experience.
Given South Asian groups comprise the largest ethnic minority population in the UK, the research pointed out disparities in depression diagnosis and treatment.
Previous studies show Pakistani women in the UK consult GPs more often than White counterparts but receive less depression treatment.
The review suggests cultural differences in depression symptoms and rigid screening tool criteria may contribute to these healthcare gaps.
It proposes that GPs consider non-ICD-11 somatic symptoms in South Asian patients when assessing for depression.
The research advocates for training in culturally specific presentations and diagnosis, guided by cultural humility, as opposed to strict adherence to standardised criteria.