Common mental disorders among people with origins in or immigrant from India and Pakistan

This paper reviews the literature on common mental disorders among Indian and Pakistani peoples in the UK. I briefly report on findings from India and Pakistan to contextualize contemporary hypotheses about culture and mental ill health in the UK. I then discuss the UK studies beginning with hospital based findings and then community and primary care based research. The latter is a special area of interest in the UK where the general practitioner manages the majority of common mental disorders by virtue of his or her frequent contact with local populations. There has been considerable controversy about primary care presentations of common mental disorders amongst 'Asians' for whom the concept of somatization as a process is often invoked to explain what might simply be a failure in emotional communication. These complexities are discussed alongside methodological problems in studies of Indian and Pakistani peoples to whom, in the UK, the term 'Asian' is usually applied. Some of the complexities of methodology and interpretation will be of relevant to other populations with different socio-cultural backgrounds. The review emphasizes 'Asian' specific and general issues in cross-cultural psychiatric research.