Limited research has investigated whether clinicians around the world find diagnostic criteria for depression that were originally developed in the West are useful with diverse populations. Using an embedded mixed-methods design in India, we examined (a) clinicians’ and trainees’ (n = 143) ratings of the usefulness of the criteria for Major Depressive Disorder (MDD) outlined in two major diagnostic systems (Diagnostic and Statistical Manual of Mental Disorders-5; DSM-5 and International Classification of Mental and Behavioral Disorders-Tenth Edition; ICD-10), and (b) narrative descriptions of clinical cases of adolescent depression and usefulness of diagnostic and screening instruments in day-to-day practice using semi-structured interviews in a subsample of clinicians (n = 24). Qualitative findings demonstrated that Indian clinicians identified markers of depression that were consistent with the current diagnostic manuals (affective, cognitive, somatic symptoms), and the numeric ratings suggested that clinicians found a majority of DSM-5 and ICD-10 criteria for MDD to be useful. However, Indian clinicians also identified additional markers of adolescent depression (i.e., interpersonal conflicts and issues, impairment in school-related functioning, anger-based symptoms, anxiety-based symptoms, additional somatic complaints not included in DSM-5 or ICD-10), highlighting the need to modify existing diagnostic criteria to be more inclusive. The findings suggest the need for culturally informed diagnostic practices that consider a wide range of clinical presentations of depression among adolescents worldwide.

有限的研究调查了世界各地的临床医生是否发现最初在西方制定的抑郁症诊断标准对不同人群有用。在印度使用嵌入式混合方法设计，我们检查了 (a) 临床医生和受训人员 ( n  = 143) 对两个主要诊断系统（诊断和统计手册）中概述的重度抑郁症 (MDD) 标准有用性的评级精神障碍-5；DSM-5 和国际精神和行为障碍分类-第十版；ICD-10)，以及 (b) 青少年抑郁症临床病例的叙述性描述以及日常诊断和筛查工具的有用性在临床医生的子样本中使用半结构化访谈进行日间练习 ( n = 24）。定性研究结果表明，印度临床医生确定了与当前诊断手册（情感、认知、躯体症状）一致的抑郁症标志物，数字评级表明临床医生发现大多数 DSM-5 和 ICD-10 的 MDD 标准是有用。然而，印度临床医生还发现了青少年抑郁症的其他标志（即人际冲突和问题、与学校相关的功能受损、基于愤怒的症状、基于焦虑的症状、DSM-5 或 ICD-10 中未包括的其他躯体疾病） ，强调需要修改现有的诊断标准，使其更具包容性。研究结果表明，需要考虑到世界范围内青少年抑郁症的广泛临床表现的文化知识诊断实践。