Cross-cultural Differences in the Presentation of Depressive Symptoms

Epidemiological studies show that China has a lower prevalence rate of major depression than that of Western countries. The disparity in prevalence is commonly attributed to the tendency of Chinese to somatize depression. Empirical evidence of Chinese somatization has yielded mixed results. The present study thus aimed to 1) examine differences in somatic and psychological symptom reporting between Chinese from Macau and Americans in America and 2) identify cultural and psychological variables that would predict somatization. Independent and interdependent self-construals, sociotropy, and emotional approach coping were hypothesized to predict somatization of depression. Participants included 353 Chinese and 491 American college students who completed self-report measures online. Contrary to prediction, results indicated that Americans endorsed a higher proportion of somatic symptoms than Chinese did. Sociotropy predicted both relative endorsement and severity of somatic symptoms for the American sample, whereas emotional expression coping was related to somatization in the Chinese sample. The findings challenge the common assumption of greater Chinese somatization and highlight the importance of context in understanding the relationships between somatization and cultural and psychological variables. Implications of the present study and future directions are discussed

Chinese children\u27s evaluation of authority\u27s responses to social events

Chinese children\u27s conceptualization of moral, conventional and personal events and their judgments of authority were examined by assessing their evaluation of authority\u27s responses to these acts. Seventy-two Macau children from second, fifth and eighth grades made judgments of permissibility of acts, personal jurisdiction, and obedience to rules regarding these events and then rated moral, conventional and filial duty reasons provided by parents in response to these events. Findings were that children made distinctions among these events. They also rated moral reasons as the best response to moral transgressions. Children rated both moral reasons and conventional reasons more positively than duty reasons to conventional transgressions, whereas they preferred moral and duty reasons to personal events. The results suggest that children\u27s evaluations of responses are based on their conceptualization of these events and children take into account the content of the social events in their judgments of authority

Immune-Related Endocrine Dysfunctions in Combined Modalities of Treatment: Real-World Data

The number of immune-related endocrine dysfunctions (irEDs) has concurrently increased with the widespread use of immunotherapy in clinical practice and further expansion of the approved indications for immune checkpoint inhibitor (ICI) in cancer management. A retrospective analysis was conducted on consecutive patients ≥18 years of age with advanced solid malignancies who had received at least one dose of anti-programmed cell death protein 1 (anti-PD-1) and/or anti-CTLA4 antibodies between January 2014 and December 2019 at a university hospital in Hong Kong. Patients were reviewed up to two months after the last administration of an ICI. The types, onset times and grades of irEDs, including hypothyroidism, hyperthyroidism, adrenal insufficiency and immune-related diabetes mellitus, were recorded. Factors associated with irEDs were identified using multivariate analysis. A total of 953 patients (male: 603, 64.0%; median age: 62.0 years) were included. Of these, 580 patients (60.9%) used ICI-alone, 132 (13.9%) used dual-ICI, 187 (19.6%) used an ICI combined with chemotherapy (chemo + ICI), and 54 (5.70%) used immunotherapy with a targeted agent (targeted + ICI). A significantly higher proportion of patients using targeted + ICI had irEDs and hypothyroidism; in contrast, a higher proportion of patients using dual-ICI had adrenal insufficiency. There was no significant difference in the incidence of irED between the younger (<65 years) and older (≥65 years) patients. Using logistic regression, only treatment type was significantly associated with irEDs. Notably, older patients had a higher risk of having immune-related diabetes mellitus. This large, real-world cohort demonstrates that targeted + ICI has a higher risk of overall irED and hypothyroidism. Immunotherapy is safe and well-tolerated regardless of age, but close monitoring of fasting glucose is essential in older populations