Cultural Differences In The Development Of The Concept Of Neurasthenia And Depression

Neurasthenia and depression are diseases concept that derived from Western culture, each has a long history of development before introduced to China. At the beginning of the20th century, neurasthenia and depression were introduced to China, where their fate had a dramatic change. There was huge controversy about the findings of the epidemiological and clinical diagnosis of these two concepts. This paper attempts to explore the cultural differences between the concept of neurasthenia and depression from the development of them and the changes in diagnostic criteria in the different cultural backgrounds.First, the paper introduces somatical and psychological perspective to explore the cultural differences in the development of the concept of neurasthenia and depression. The writer combs the history of the development of the concept of neurasthenia and depression and diagnostic criteria changes in the context of Chinese and Western cultures. From this view, at the early stage both neurasthenia and depression are stressed body-spiritual orientation, but in the subsequent development the concept of neurasthenia was more and more understood as a physical disease with somatical symptoms and changed from the body-spiritual to spirit-somatical orientation. At the same time, the concept of depression was more and more associated with the psychological symptoms and emotional state of the individual, which was transited into a concept of mental illness. In the paper the writer points out that the concept of neurasthenia in Chinese society is different from the concept of somatization and somatization disorder in the western culture, it does not mean the somatization of depression, either. The dispute of the disease concept means that the Chinese and Western cultures have a different conception of the body and the concept of disease. The Western philosophy pursues the subject-object duality tradition, the spirit self takes precedence over the physical self, this view has led to a strict distinction between medicine physical disease and mental illness. It is under the influence of this dualistic view of the body and mind that the concept of neurasthenia and depression shift to an emphasis on psychological symptoms by emphasizing the physical symptoms. In contrast, in Chinese culture and traditional medicine there is no strict distinction between physical self and mental self, but view them as a two interrelated and it is also inter-linked with the social environment as a unified whole. Psychosomatic monistic thinking runs through in the development history of Chinese culture and traditional medicine and it is no use to distinguish mental illness and physical illness. TCM Classification of Diseases is unlike that in the West, It is as a metaphor based on language representation of the Viscera theory.Second, the writer attempts to explore the cultural differences between these two concepts from the classification system and diagnostic criteria of mental illness which is in the clinical application. In China, due by the West, especially the U.S. mental illness classification system and diagnostic criteria, there was a huge controversy about the concept of neurasthenia and depression both in theory and in clinical diagnosis. There was an obvious somatization process change about neurasthenia to depression in Chinese society. The conceptualization of mental illness and diagnostic criteria means to make the corresponding provisions about the normal and abnormal behavior, the social norms of interaction with others and the nature of the disease. But in fact, from a cross-cultural perspective, Western mental illness diagnosis system is ontology based and upholds the basic viewpoints of dualism, when one uses the Western diagnostic criteria in another culture, it means that one must be able to find the similar symptoms of the disease in these two cultures, however these symptoms do not necessarily constitute a disease in the standardized diagnostic criteria. The language categories and scientific-objective epistemology attitude which are used in DSM system means that the universality of mental illness. This disease classification ignores the personality characteristics of the patients, did not consider the patient’s motivation, intentions, social status, power, values, ethics and goals in life which would have a certain impact on the understanding of the concept of disease and the presentation of the symptoms. Such personal characteristics neglected and minimized obviously caters to the personality concept in the western society which stressed individualism and independence, but there is another self-characteristics in the Asian culture, which emphasizes interdependence and collectivism, so when the western diagnostic criteria is used in the Asian cultures, it may suffer a certain cultural adaptability.The main structure of the paper is divided into four parts:Chapters Ⅰ and Ⅱ as a fundamental part of the thesis, the writer cards the development history about the concept of neurasthenia and depression in East and Western culture from the perspective of concept development and diagnostic criteria change and lays the groundwork for subsequent theoretical analysis; in Chapter Ⅲ the writer introduces a psychological and somatic perspective to interpret the cultural differences between these two concepts by detailed analysis of the cultural difference between neurasthenia and somatization, neurasthenia, somatization disorder, neurasthenia and the somatiztion of depression. The writer believe that the dispute of the disease concept means that the Chinese and Western cultures have a different conception of the body and the concept of disease; in Chapter IV the writer attempt to interpret the cultural and clinical diagnosis differences between these two concepts from the point of view of the classification system and diagnostic criteria of mental illness in Western culture, there was an obvious somatization process change about neurasthenia to depression in Chinese society. But in fact, when the western diagnostic criteria is used in the Asian cultures, it may suffer a certain cultural adaptability.