Ethical and cultural considerations in delivering psychiatric diagnosis: reconciling the gap using MDD diagnosis delivery in less-acculturated Chinese patients. Transcult Psychiatry 2008;45:531–552

Abstract Talking to patients from diverse cultural backgrounds about their psychiatric disorders requires knowledge of one’s own culture, the patients ’ cultures, and the ways in which they might interact, both in positive and unexpectedly negative ways. In this paper, we discuss the issues raised by discussing psychiatric diagnoses with Chinese-Americans who hold traditional illness beliefs and are not familiar with Western concep-tions of psychiatric disorders. We explore how cultural values influence this aspect of medical practice, and suggest practical approaches to communi-cating the diagnosis of major depressive disorder in a culturally sensitive manner. Our clinical approach is to develop co-constructed illness narra-tives with patients, and to aid this process by reframing different elements of the clinical process into more culturally resonant forms. The following steps are suggested: 1) elicit patient’s illness beliefs; 2) understand and acknowledge multiple explanatory models; 3) contextualize depressive Vol 45(4): 531–552 DOI: 10.1177/1363461508100781 www.sagepublications.com Copyright © 2008 McGill University transcultural psychiatr