Stress, Support and Neurasthenia among Chinese Americans in Los Angeles: An Epidemiological Study

Stress, Support and Neurasthenia among Chinese Americans in Los Angeles: An Epidemiological Study

This study examined the effect of perceived stress and social support on ICD-10 defined neurasthenia (NT) in Chinese-Americans. Method: This community epidemiological survey involved a total of 1,747 Chinese-Americans who were selected with a stratified cluster sampling method. An enhanced CIDI, supplemented with a newly constructed NT module, was used for establishing psychiatric diagnoses. Modified versions of established measures were used for assessing dimensions of perceived stress (recent life events, traumatic experiences, daily hassles, financial strains) and social support. Results: Sixty-three ''pure'' (non-comorbid) NT, 48 ''pure'' depression (DEP) and 24 ''pure'' anxiety disorders (ANX) cases were identified. Compared to normals, NT cases were significantly more likely to have experienced recent life events, job and financial hassles, chronic financial strains as well as poorer physical health. They also perceived significantly less support from spouse and friends. Compared to NTs, DEP cases were significantly more likely to have experienced traumatic life events or conflicts with relatives, and experienced lower levels of social support; ANX cases were more likely to have experienced interpersonal hassles, and to have heightened levels of conflicts with spouse and relatives. Subjects born or raised in the U.S. were more at risk for developing NT. Conclusion: Stress and support are significant mediating factors affecting the risks for NT, DEP and ANX. However, the strength and pattern of such influences vary across diagnostic categories, suggesting the existence of an interactive relationship between psychosocial attributes and psychopathology of people under distress.