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Am J Psychiatry 1991; 148:1697-1704
Copyright © 1991 by American Psychiatric Association
New methods in cross-cultural psychiatry: psychiatric illness in Taiwan and the United States
WM Compton 3d, JE Helzer, HG Hwu, EK Yeh, L McEvoy, JE Tipp and EL Spitznagel
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110.
OBJECTIVE: Cross-cultural psychiatric research has suffered from many
methodological shortcomings. To answer some of these shortcomings, the
present study compared rates of psychiatric disorders in Taiwan and the
United States by combining data from both countries into a single data set.
METHOD: Results from large, community-based surveys in the United States
and Taiwan, the National Institute of Mental Health (NIMH) Epidemiologic
Catchment Area survey and the Taiwan Psychiatric Epidemiological Project,
were combined into a single data set. This integration of the data sets was
possible because both surveys used the NIMH Diagnostic Interview Schedule
to ascertain cases. The integrated data sets were then analyzed with
identical algorithms to generate lifetime prevalence rates of psychiatric
disorders according to DSM-III criteria for both the United States and
Taiwan. RESULTS: Lifetime prevalence rates of psychiatric illness in Taiwan
were generally lower than U.S. rates. The rates of any disorder were 21.56%
in Taiwan and 35.55% in the United States (Z = 22.34, p less than 10(-109].
The rates of most specific disorders were lower in Taiwan, and none of the
rates was higher in Taiwan. CONCLUSIONS: While a culturally determined
response bias may have lowered the rates in Taiwan somewhat, the results
appear to be valid. Implications for the future use of structured
diagnostic interviews in cross-cultural research are discussed.
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