Do you let me symptomatize? The potential role of cultural values in cross-national variability of mental disorders’ prevalence

Background: Mental disorders may show inherent cross-national variability in their prevalence. A considerable number of meta-analyses attribute this heterogeneity to the methodological diversity in published epidemiological studies. Cultural values are characteristically not assessed in meta-regression models as potential covariates.

Aim: Our aim was to conduct a meta-regression analysis to explore to what extent certain cultural values and immigration rates (as indicator of cultural diversity) might be associated with the cross-national heterogeneity of prevalence rates.

Method: To minimize methodological differences that may exert a confounding effect, prevalence rates were obtained from the World Health Organization’s (WHO) World Mental Health Survey Initiative. Cultural indices (overall emancipative values; overall secular values) were collected from the World Value Survey, while immigration rates were registered by utilizing the data of the United Nations’ World Population Policies 2005 report.

Results: Meta-regression analysis indicated that overall emancipative values (i.e. promoting self-expression, non-violent protest) showed significant connection with lifetime and last year prevalence of any mood disorders (Z = 4.71, p =.001; Z = 2.35, p =.02) and any internalizing disorders (a merged category that combined mood and anxiety disorders; Z = 2.82, p =.004; Z = 2.34, p =.02). Overall secular values (i.e. rejecting authority and obedience) were negatively associated with last year prevalence of depression (Z = −2.75, p =.06). Multistep regression analysis indicated that immigration rate moderated the connection between cultural values and mental disorders. Countries with higher immigration rates showed higher emancipative and secular values.

Conclusion: Our findings might function as potential foundation for formulating hypotheses regarding the cultural context’s influence on the population’s mental health.