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Community Mental Health Journal

, Volume 43, Issue 4, pp 305–319 | Cite as

A Community Epidemiological Survey of Generalized Anxiety Disorder in Hong Kong

  • Sing LeeEmail author
  • Adley Tsang
  • Helena Chui
  • Kathleen Kwok
  • Emily Cheung
Article

Abstract

Generalized anxiety disorder (GAD) is understudied in Asian communities. There were 3,304 Chinese subjects (aged 15–60 years) randomly drawn from the general population of Hong Kong and successfully interviewed. The participation rate was 65.8%. The six-month prevalence of DSM-IV GAD was 4.1%. Over half of the GAD subjects reported palpitations and bowel symptoms. Comorbid depressive mood (65%) and substance use (35%) were common. Forty-one percent of GAD subjects sought help, usually from general practitioners who prescribed tranquilizers after negative physical investigations. Telephone-based surveys have limitations but provide an affordable and destigmatizing alternative to face-to-face surveys for communities with limited mental health resources.

Keywords

generalized anxiety disorder epidemiology help-seeking Chinese Hong Kong 

References

  1. Allen K., Cull A., Sharpe M. (2003) Diagnosing major depression in medical outpatients: Acceptability of telephone interviews. Journal of Psychosomatic Research 55:385–387CrossRefPubMedGoogle Scholar
  2. American Psychiatric Association. (2000) Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC, American Psychiatric Press, IncGoogle Scholar
  3. Bland R. C., Newman S. C., Orn H. (1997) Help-seeking for psychiatric disorders. Canadian Journal of Psychiatry 42:935–942Google Scholar
  4. Carter R. M., Robin M., Wittchen H. U., Pfister H., Kessler R. C. (2001) One year prevalence of subthreshold and threshold DSM-IV generalized anxiety disorder in a nationally representative sample. Depression and Anxiety 13:78–88CrossRefPubMedGoogle Scholar
  5. Chen C., Wong J., Lee N., Chan-Ho M., Lau J., Fung M. (1993) The Shatin Community Mental Health Survey in Hong Kong: II. Major Findings. Archives of General Psychiatry 50:125–133PubMedGoogle Scholar
  6. Demyttenaere K., Bruffaerts R., Posada-Villa J., Gasquet I., Kovess V., Lepine J. et al. (2004) Prevalence, severity and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. Journal of the American Medical Association 291:2581–2590CrossRefPubMedGoogle Scholar
  7. Hwu H., Yeh E., Chang L. (1989) Prevalence of psychiatric disorders in Taiwan defined by the Chinese diagnostic interview schedule. Acta Psychiatrica Scandinavica 79:136–147PubMedGoogle Scholar
  8. Johnson, T. P., & Fendrich, M. (2003). Survey response rate reporting in the professional literature. Paper presented at 58th Annual Meeting of the American Association for Public Opinion Research, Nashville. Retrieved May 11, 2005, from http://www.srl.uic.edu/publist/Conference/rr_reporting.pdf
  9. Kessler R. C., Brandenburg N., Lane M., Roy-Byrne P., Stang P. D., Stein D. J. et al. (2005) Rethinking the duration requirement for generalized anxiety disorder: evidence from the National Comorbidity Survey Replication. Psychological Medicine 35:1073–1082CrossRefPubMedGoogle Scholar
  10. Kessler R. C., Keller M., Wittchen H. (2001) The epidemiology of generalized anxiety disorder. Psychiatric Clinics of North America 24:19–39CrossRefPubMedGoogle Scholar
  11. Kessler R. C., Ormel J., Demler O., Stang P. (2003) Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: Results from the National Comorbidity Survey. Journal of Occupational and Environmental Medicine 45:1257–1266CrossRefPubMedGoogle Scholar
  12. Lee S., Chiu M. Y. L., Tsang A., Chui H., Kleinman A. (2006) Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong. Social Science and Medicine 62:1685–1696CrossRefPubMedGoogle Scholar
  13. Maier W., Gansicke M., Freyberger H. J., Linz M., Huen R. (2000) Generalized anxiety disorder (ICD-10) in primary care from a cross-cultural perspective: A valid diagnostic entity? Acta Psychiatrica Scandinavica 101:29–36PubMedGoogle Scholar
  14. Olfson M., Broadhead W. E., Weissman M. M., Leon A. C., Farber L., Hoven C. et al. (1996) Subthreshold psychiatric symptoms in a primary care group practice. Archives of General Psychiatry 53:880–886PubMedGoogle Scholar
  15. Parker G., Gladstone G., Chee K. (2004) Depression in the planet’s largest ethnic group: the Chinese. American Journal of Psychiatry 158:857–864Google Scholar
  16. Rickels K., Rynn M. A. (2001) What is generalized anxiety disorder? Journal of Clinical Psychiatry 62:4–12PubMedGoogle Scholar
  17. Ring A., Dowrick C. F., Humphris G. M., Davies J., Salmon P. (2005) The somatising effect of clinical consultation: What patients and doctors say and do not say when patients present medically unexplained physical symptoms. Social Science and Medicine 61:1505–1515CrossRefPubMedGoogle Scholar
  18. Ruscio A. M., Lane M., Roy-Byrne P., Stang P., Stein D., Wittchen H. U. et al. (2005) Should excessive worry be required for a diagnosis of generalized anxiety disorder? Results from the US National Comorbidity Survey Replication. Psychological Medicine 35:1761–1772CrossRefPubMedGoogle Scholar
  19. Shen Y. C., Zhang M. Y., Huang Y. Q., He Y. L., Liu Z. R., Cheng H. et al. (2006) Twelve Month Prevalence, Severity, and Unmet Need for Treatment of Mental Disorders in Metropolitan China. Psychological Medicine 36:257–267CrossRefPubMedGoogle Scholar
  20. Slade T., Andrew G. (2001) DSM-IV and ICD-10 generalized anxiety disorder: Discrepant diagnoses and associated disability. Social Psychiatry and Psychiatric Epidemiology 36:45–51CrossRefPubMedGoogle Scholar
  21. Stein M. B. (2004) Public health perspectives on generalized anxiety disorder. Journal of Clinical Psychiatry 65:3–7PubMedGoogle Scholar
  22. Wittchen H., Hoyer J. (2001) Generalized anxiety disorder: nature and course. Journal of Clinical Psychiatry 62:15–19PubMedGoogle Scholar
  23. World Health Organization (1992) The ICD-10 classification of mental and behaviour disorders – clinical descriptions and diagnostic guidelines. Geneva, W.H.OGoogle Scholar
  24. Zhang W. X., Shen Y. C., Li S. R., Chen C. W., Huang Y. Q., Wang J. R. et al. (1998) Epidemiological investigation on mental disorders in 7 areas of China. Chinese Journal of Psychiatry 31:69–71 (in Chinese)Google Scholar
  25. Zheng Y. P., Li K. M., Zhao J. P., Zhang M. Y. (1994) Comparative study of diagnostic systems: Chinese classification of Mental Disorders-Second Edition versus DSM-III-R. Comprehensive Psychiatry 35:441–449CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Sing Lee
    • 1
    • 2
    Email author
  • Adley Tsang
    • 2
  • Helena Chui
    • 2
  • Kathleen Kwok
    • 2
  • Emily Cheung
    • 2
  1. 1.Department of PsychiatryThe Chinese University of Hong KongShatin, NTHong Kong, P.R. China
  2. 2.Hong Kong Mood Disorders CenterPrince of Wales HospitalShatin, NTHong Kong, P.R. China

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