Cross-cultural insights into psychosomatic symptoms, depression, and anxiety: A comparative study of China and Pakistan

Abstract

Psychosomatic refers to an illness in which stress causes or exacerbates physical symptoms, and it may occur in transient or along with more acute mood disorders. The current study aimed to enhance understanding of the prevalence and cultural factors affecting psychosomatic symptoms, depression, and anxiety in China and Pakistan. A comparative cross-cultural study was conducted using a non-probability sampling technique. A total of 1633 samples were collected, including 598 healthy controls (300 from China and 298 from Pakistan) and 1035 patients (521 from China and 514 from Pakistan). Three assessment tools were utilized: Psychosomatic symptom scale (PSSS), patient health questionnaire-9, and generalized anxiety disorder-7. There were significant differences in the symptoms of patients and control groups with psychosomatic symptoms, depression, and anxiety in both countries. Post hoc testing revealed that Pakistani patients with mood disorders reported more psychosomatic symptoms than Chinese patients (p<0.001), whereas the Chinese control group had more psychosomatic symptoms than the Pakistani control group (p=0.001). Analysis of PSSS ratings in Chinese patients demonstrated a strong correlation between “depressed mood” and “loss of interest.” Pakistani PSSS displayed strong correlations on the somatic subscale and psychological subscale. In the present study, Pakistani patients exhibited higher levels of psychosomatic complaints, depression, and anxiety compared to Chinese patients. Notably, network analysis reveals that Pakistani patients displayed more physical symptoms, whereas Chinese patients experienced more psychological symptoms.

Keywords

Psychosomatics / Depression / Anxiety / Cross-cultural / China / Pakistan / Network analysis

Acknowledgments

The authors acknowledge the participants who participated in the study.

Funding

None.

Conflict of interest

Yonggui Yuan is the Editor-in-Chief and Wenhao Jiang is the Associate Editor of this journal, but were not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. Separately, other authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.

Author contributions

Conceptualization: Yonggui Yuan, Wenhao Jiang, S. Mudasser Shah

Formal analysis: S. Mudasser Shah, Chenguang Jiang, Wenhao Jiang

Investigation: S. Mudasser Shah

Methodology: S. Mudasser Shah

Writing-original draft: S. Mudasser Shah, Chand Taneja

Writing-review & editing: Yonggui Yuang, Chand Taneja, Wei Xu, Sun Taipeng, Chen Gang, Tianyu Wang, Wenhao Jiang

Ethics approval and consent to participate

The study was approved by the ethical committee of Zhongda Hospital at the Southeast University, Nanjing, Jiangsu, China (registration no. 2021ZDSYLL347-P01). All participants signed an informed consent form before participation.

Consent for publication

The informed consent forms were completed and signed by all participants in our study.

Availability of data

Data will be available upon request from the corresponding authors.

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