The metamorphosis of medical discourse and embedded cultural rationality: a content analysis of health reporting for neurasthenia and depressive disorder in China

Abstract

Neurasthenia (shenjing shuairuo) and depressive disorder are medical issues that have given rise to disputes in China for more than 20 years. Since the 1980s, the once ubiquitous diagnosis of neurasthenia in China was rapidly substituted by depressive disorder in the clinical context. Globally, the metamorphosis from neurasthenia to depressive disorder heralded the triumph of scientific rationality, which identifies neurasthenia as a categorical fallacy. In China, however, neurasthenia retained social and cultural significance; thus, it has become a contestable discourse in relation to depressive disorder. By examining the health reporting of both discourses over a decade, this study explicated how neurasthenia and depressive disorder were represented in a popular health newspaper in China. The content analysis showed that neurasthenia is a more culturally and everyday embedded discourse closely associated with Chinese medicine and laymen’s discourse, while depressive disorder is more associated with Western medicine and the professional discourse. The differentiation of two sets of medical discourse evinces that despite the ostensibly prevailing scientific rationality in media health reporting, cultural rationality is deeply embedded in communicating mental health issues with the lay public. It further suggests the significance of investigating the social and cultural expression of mental illnesses in China.