The epidemiology of depression in metropolitan China

Background Previous surveys on depression in China focused on prevalence estimates without providing a detailed epidemiological profile. Method Face-to-face household interviews were conducted with a multi-stage household probability sample of 2633 adults (age ⩾18 years) in Beijing and 2568 in Shanghai between November 2001 and February 2002. The World Health Organization Composite International Diagnostic Interview (CIDI) was used to assess major depressive episode (MDE) according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria. Results The lifetime prevalence and 1-year prevalence estimates of DSM-IV/CIDI MDE were 3.6% [95% confidence interval (CI) 2.8–4.4%] and 1.8% (95% CI 1.2–2.4%) respectively. No significant gender difference was found in these estimates. Respondents born in 1967 or later were at elevated lifetime risk compared with respondents born in earlier cohorts. The mean age of onset was 30.3 years. Among those reporting 1-year MDE, 15.7, 51.8, 25.3 and 6.4% reported mild, moderate, severe and very severe symptoms respectively; 4.8, 2.6 and 3.2% reported suicidal ideation, plans, and recent attempts in the same year respectively. Respondents with 1-year MDE reported a mean of 27.5 days out of role owing to their depression in the year before interview. Significant co-morbidity was found between MDE and other mental disorders [odds ratio (OR) 22.0] and chronic physical disorders (OR 3.2). Only 22.7% of respondents with 1-year MDE sought treatment. Conclusions The low prevalence and insignificant gender difference, but not patterns of onset, course, co-morbidity, and impairment, distinguish the epidemiological profile of MDE in metropolitan China from those in other countries.

[1]  Olga V. Demler,et al.  The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). , 2003, JAMA.

[2]  B. Efron Logistic Regression, Survival Analysis, and the Kaplan-Meier Curve , 1988 .

[3]  Thomas J. Carmody,et al.  The Inventory of Depressive Symptomatology (IDS): Clinician (IDS‐C) and Self‐Report (IDS‐SR) ratings of depressive symptoms , 2000 .

[4]  M. Hamilton A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[5]  J. Markowitz,et al.  The 16-Item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression , 2003, Biological Psychiatry.

[6]  S. Sue,et al.  Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. , 1998, The American journal of psychiatry.

[7]  Yueqin Huang,et al.  Major depression in Kunming: prevalence, correlates and co-morbidity in a south-western city of China. , 2008, Journal of affective disorders.

[8]  I. Goodyer,et al.  Adrenal secretion and major depression in 8- to 16-year-olds, II. Influence of co-morbidity at presentation , 1996, Psychological Medicine.

[9]  H. Jeon,et al.  Cross-national difference in the prevalence of depression caused by the diagnostic threshold. , 2008, Journal of affective disorders.

[10]  T. B. Üstün,et al.  Mental disorders and service use in China. , 2008 .

[11]  M. Phillips,et al.  [Epidemiological survey of mental illnesses in the people aged 15 and older in Zhejiang Province, China]. , 2005, Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine].

[12]  H. Hwu,et al.  Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnostic Interview Schedule , 1989, Acta psychiatrica Scandinavica.

[13]  Josep Maria Haro,et al.  Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys , 2007, The Lancet.

[14]  The yield from national surveys of mental health , 2008, International psychiatry : bulletin of the Board of International Affairs of the Royal College of Psychiatrists.

[15]  Andrew C. Leon,et al.  Assessing Psychiatric Impairment in Primary Care with the Sheehan Disability Scale , 1997, International journal of psychiatry in medicine.

[16]  A. Rush,et al.  Gender differences in depression: findings from the STAR*D study. , 2005, Journal of affective disorders.

[17]  张艳萍,et al.  A cross-sectional study of depressive disorders in outpatients of 50 general hospitals in Beijing , 2006 .

[18]  A. Kleinman Neurasthenia and depression: A study of somatization and culture in China , 1982, Culture, medicine and psychiatry.

[19]  M. Thase,et al.  Comparisons of perceived quality of life across clinical states in bipolar disorder: data from the first 2000 Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) participants. , 2006, Comprehensive psychiatry.

[20]  R. Kessler,et al.  Lifetime prevalence and inter-cohort variation in DSM-IV disorders in metropolitan China , 2006, Psychological Medicine.

[21]  R. Kessler,et al.  Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. , 2004, JAMA.

[22]  J. Lau,et al.  The Shatin community mental health survey in Hong Kong. II. Major findings. , 1993, Archives of general psychiatry.

[23]  G. Schuler,et al.  Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: A randomized trial. , 2000, JAMA.

[24]  Sing Lee,et al.  Twelve-month prevalence, correlates, and treatment preference of adults with DSM-IV major depressive episode in Hong Kong. , 2007, Journal of affective disorders.

[25]  Olga V. Demler,et al.  Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[26]  Lower rates of depression in westernised Chinese in the US. , 2007, Journal of affective disorders.

[27]  A. Rush,et al.  The inventory of depressive symptomatology (IDS) , 1996 .

[28]  J. Swendsen,et al.  Psychiatric Comorbidity in Migraine: A Review , 2005, Cephalalgia : an international journal of headache.

[29]  Martin Keller,et al.  The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys , 2003, International journal of methods in psychiatric research.

[30]  B. Penninx,et al.  Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy. , 1996, Journal of clinical epidemiology.

[31]  R. Kessler,et al.  Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China , 2005, Psychological Medicine.

[32]  L. Horwood,et al.  How accurate is recall of key symptoms of depression? A comparison of recall and longitudinal reports , 2004, Psychological Medicine.

[33]  R. Kessler,et al.  Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. , 1996, Archives of general psychiatry.

[34]  T. B. Üstün,et al.  The WHO World Mental Health (WMH) Surveys , 2009, Die Psychiatrie.

[35]  Lynne Stokes Introduction to Variance Estimation , 2008 .

[36]  Olga V. Demler,et al.  The US National Comorbidity Survey Replication (NCS‐R): design and field procedures , 2004, International journal of methods in psychiatric research.

[37]  T. B. Üstün,et al.  The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) , 2004, International journal of methods in psychiatric research.

[38]  M. Weissman,et al.  Cross-national epidemiology of major depression and bipolar disorder. , 1996, JAMA.