Somatic presentations of distress in China

Objective: Somatic presentations of distress are common cross-culturally and are thought to predominate in Asian cultures such as that of China. From an etic perspective, researchers utilizing empirically validated standardized assessment measures find that somatic symptoms are no more common in individuals of Chinese descent than they are in individuals of European descent. In contrast, patient presentations are heavily influenced by culture and are associated with patterns of illness behavior. The objective of the current review is to determine the culture-specific factors contributing to somatic presentations and descriptions of distress in China. Method: The current review was based on a literature search of PubMed and PsychInfo using the terms ‘China,’ ‘Asia,’ ‘somatoform,’ ‘somatization,’ and ‘psychogenic.’ Results: Factors contributing to somatic presentations of distress in China include stigma and help-seeking behavior, and assessment approaches that ignore culture-specific patterns of symptom reporting, fail to incorporate somatic metaphor and Chinese conceptualizations of distress that emphasize bodily sensation, and ignore the role that culture-specific normative data and culture specific response patterns may produce on assessment results. Conclusions: From an emic perspective, there are numerous factors contributing to the appearance of a predominantly somatic presentation of distress in China. Implications for clinical practice are discussed.