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The epidemiology of current depression in Macau, China: towards a plan for mental health action

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Abstract

Purpose

Macau is a Special Administrative Region in China that has experienced tremendous development in its gambling industry during its post-colonial years. To inform mental health planning, this study presents the first population estimates and correlates of the current depression in Macau.

Methods

A population-representative sample of 1068 Macau Chinese citizens aged 18 or above responded to a household telephone survey in January, 2015. The Patient Health Questionnaire-9 measured the current depression. Logistic regression models assessed the association between depression and potential correlates.

Results

Overall, 8.0% (95% CI 6.3–9.7) of persons reported the current depression. A higher but non-significant proportion of women reported depression than men (9.3 vs. 6.6%) and older women reported higher prevalence (13.4%) than other demographic groups. Persons who were unemployed (OR = 4.9, 2.3–10.5), separated or divorced (OR = 3.1, 1.1–8.9), and reported poor self-rated health (OR = 5.0, 2.8–9.0), low quality of life (OR = 6.2, 3.1–12.7), lower social standing (OR = 2.4, 1.4–4.0), lower community trust (OR = 1.9, 1.2–3.1), lower perceived fairness (OR = 2.3, 1.4–3.8), lower social cohesion (OR = 3.8, 2.3–6.2), and lower social integration (OR = 3.0, 1.9–5.0) had greater odds of depression than their comparison group.

Conclusions

The current study demonstrated the burden of depression among Macau adults disproportionately affects women during emerging adolescence and old age, and men during middle adulthood. Key strategies to improve mental health services in Macau are discussed.

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References

  1. Bromet E et al (2011) Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 9:90

    Article  PubMed  PubMed Central  Google Scholar 

  2. Strine TW et al (2008) Depression and anxiety in the United States: findings from the 2006 behavioral risk factor surveillance system. Psychiatr Serv 59(12):1383–1390

    Article  PubMed  Google Scholar 

  3. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (2016) Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet 388(10053):1545–1602

  4. Patel V. et al. (2016) The magnitude of and health system responses to the mental health treatment gap in adults in India and China. The Lancet

  5. Lee S et al (2009) The epidemiology of depression in metropolitan China. Psychol Med 39(5):735–747

    Article  CAS  PubMed  Google Scholar 

  6. Phillips MR et al (2009) Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–05: an epidemiological survey. Lancet 373(9680):2041–2053

    Article  PubMed  Google Scholar 

  7. Hoi CK et al (2015) The association between social resources and depressive symptoms among Chinese migrants and non-migrants living in Guangzhou, China. J Pacific Rim Psychol 9:120–129

    Article  Google Scholar 

  8. Lam LC-W et al (2015) Prevalence, psychosocial correlates and service utilization of depressive and anxiety disorders in Hong Kong: the Hong Kong Mental Morbidity Survey (HKMMS). Soc Psychiatry Psychiatr Epidemiol 50(9):1379–1388

    Article  PubMed  Google Scholar 

  9. Lee S, Tsang A, Kwok K (2007) Twelve-month prevalence, correlates, and treatment preference of adults with DSM-IV major depressive episode in Hong Kong. J Affect Disord 98(1–2):129–136

    Article  PubMed  Google Scholar 

  10. Hou WK et al (2015) Threat to democracy: physical and mental health impact of democracy movement in Hong Kong. J Affect Disord 186:74–82

    Article  PubMed  Google Scholar 

  11. Lau KM et al (2016) Social media and mental health in democracy movement in Hong Kong: a population-based study. Comput Hum Behav 64:656–662

    Article  Google Scholar 

  12. Chi I et al (2005) Prevalence of depression and its correlates in Hong Kong’s Chinese older adults. Am J Geriatric Psychiatry Off J Am Assoc Geriatric Psychiatry 13(5):409–416

    Article  Google Scholar 

  13. Zhou X et al (2014) The prevalence and risk factors for depression symptoms in a rural Chinese sample population. PLoS ONE 9(6):e99692

    Article  PubMed  PubMed Central  Google Scholar 

  14. Liu J et al (2015) Prevalence of major depressive disorder and socio-demographic correlates: results of a representative household epidemiological survey in Beijing, China. J Affect Disord 179:74–81

    Article  PubMed  Google Scholar 

  15. Zhong B-L et al (2015) Prevalence and correlates of major depressive disorder among rural-to-urban migrant workers in Shenzhen, China. J Affect Disord 183:1–9

    Article  PubMed  Google Scholar 

  16. Pan A et al (2008) Prevalence and geographic disparity of depressive symptoms among middle-aged and elderly in China. J Affect Disord 105(1):167–175

    Article  PubMed  Google Scholar 

  17. Operario D, Adler NE, Williams DR (2004) Subjective social status: reliability and predictive utility for global health. Psychol Health 19(2):237–246

    Article  Google Scholar 

  18. Hu P et al (2005) Relationship between subjective social status and measures of health in older Taiwanese persons. J Am Geriatr Soc 53(3):483–488

    Article  PubMed  Google Scholar 

  19. Wong SY et al (2008) The influence of multi-morbidity and self-reported socio-economic standing on the prevalence of depression in an elderly Hong Kong population. BMC Publ Health 8:119

    Article  Google Scholar 

  20. Papakostas GI et al (2004) Quality of life assessments in major depressive disorder: a review of the literature. Gen Hosp Psychiatry 26(1):13–17

    Article  PubMed  Google Scholar 

  21. De Silva MJ et al (2005) Social capital and mental illness: a systematic review. J Epidemiol Community Health 59(8):619–627

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wu TL et al (2016) The association between social capital and depression among Chinese older adults living in public housing. J Nerv Ment Dis 204(10):764–769

    Article  PubMed  Google Scholar 

  23. Cao W et al (2015) Social capital and depression: evidence from urban elderly in China. Aging Mental Health 19(5):418–429

    Article  PubMed  Google Scholar 

  24. Yang LH, Kleinman A (2008) ‘Face’ and the embodiment of stigma in China: the cases of schizophrenia and AIDS. Soc Sci Med 67(3):398–408

    Article  PubMed  PubMed Central  Google Scholar 

  25. Zeng W, Chan MF (2010) Investigating factors related to depression among older persons in Macau. Macau Journal of Nursing 9(1)

  26. The American Association for Public Opinion Research, Standard definitions: final dispositions of case codes and outcome rates for surveys. 2016, AAPOR

  27. Yeung A et al (2008) Validation of the Patient Health Questionnaire-9 for depression screening among Chinese Americans. Compr Psychiatry 49(2):211–217

    Article  PubMed  Google Scholar 

  28. Nan H et al (2013) Effects of depressive symptoms and family satisfaction on health related quality of life: the Hong Kong family study. PLoS ONE 8(3):e58436

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Kawachi I et al (1997) Social capital, income inequality, and mortality. Am J Publ Health 87(9):1491–1498

    Article  CAS  Google Scholar 

  30. DeSalvo KB et al (2005) Predicting mortality and healthcare utilization with a single question. Health Serv Res 40(4):1234–1246

    Article  PubMed  PubMed Central  Google Scholar 

  31. Direcção dos Serviços de Estatística e Censos, Results of 2011 population census. 2011

  32. StataCorp, Stata Statistical Software: release 12. 2011, StataCorp LP: College Station, TX

  33. Lee S et al (2006) Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong. Soc Sci Med 62(7):1685–1696

    Article  PubMed  Google Scholar 

  34. Gu L et al (2013) Epidemiology of major depressive disorder in mainland china: a systematic review. PLoS ONE 8(6):e65356

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Hu SX et al (2016) Common chronic health problems and life satisfaction among Macau elderly people. Int J Nurs Sci 3(4):367–370

    Google Scholar 

  36. Sun WJ et al (2012) Depressive symptoms and suicide in 56,000 older Chinese: a Hong Kong cohort study. Soc Psychiatry Psychiatr Epidemiol 47(4):505–514

    Article  PubMed  Google Scholar 

  37. Shao J et al (2013) Birth cohort changes in the depressive symptoms of Chinese older adults: a cross-temporal meta-analysis. Int J Geriatr Psychiatry 28(11):1101–1108

    PubMed  Google Scholar 

  38. Hall BJ, Sou K, Chen W, Zhou F, Chang K, Latkin C (2016) An evaluation of the buffering effects of types and sources of support on depressive symptoms among natural disaster–exposed chinese adults. Psychiatry Interpers Biol Process 79:389–402

  39. Direcção dos Serviços de Correios e Telecomunicações. Major Telecommunication Service Statistics. 2015; Available from: http://telecommunications.ctt.gov.mo/web/en/generalinfo/statistics/mainstat/mainstat2015a

  40. Pew Research Center for the People and the Press (2006) The Cell Phone Challenge to Survey Research: National Polls Not Undermined by Growing Cell-Only Population

  41. Hobfoll SE et al (2011) Are community studies of psychological trauma’s impact accurate? A study among Jews and Palestinians. Psychol Assess 23(3):599

    Article  PubMed  PubMed Central  Google Scholar 

  42. Muskens EM et al (2014) Psychiatric diagnosis by telephone: is it an opportunity? Soc Psychiatry Psychiatr Epidemiol 49(10):1677–1689

    Article  PubMed  Google Scholar 

  43. Allen K, Cull A, Sharpe M (2003) Diagnosing major depression in medical outpatients: acceptability of telephone interviews. J Psychosom Res 55(4):385–387

    Article  PubMed  Google Scholar 

  44. Pridemore WA, Damphousse KR, Moore RK (2005) Obtaining sensitive information from a wary population: a comparison of telephone and face-to-face surveys of welfare recipients in the United States. Soc Sci Med 61(5):976–984

    Article  PubMed  Google Scholar 

  45. Hall BJ, Chang K, Chen W, Sou K, Latkin C, Yeung A (2017) Exploring the association between depression and shenjing shuairuo in a population representative epidemiological study of Chinese adults in Guangzhou, China

  46. Serviços de Saúde. Current registration status of medical professionals. 2014; Available from: http://www.gaes.gov.mo/counseling/images/activityinfo/2014/act2014-6/20140920.pdf. Accessed 10 Jan 2016

  47. Dawson KS et al (2015) Problem Management Plus (PM+): a WHO transdiagnostic psychological intervention for common mental health problems. World Psychiatry 14(3):354–357

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We thank Juliana Yuncg, Elenna Mo, Ray Wong, Emily Iong, Ung Hou Pang, Angela Ma and Jazz Cheong for their assistance with data collection.

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Correspondence to Brian J. Hall.

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Financial support

This work was supported by the Research and Development Affairs Office (R&DAO), University of Macau, under Grant MYRG2015-00124-FSS and MYRG2015-00109-FSS (PI: Hall). The funding source played no role in the conduct of this research.

Conflict of interest

The authors declare that there is no competing interest.

Ethical standards

The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

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Hall, B.J., Lam, A.I.F., Wu, T.L. et al. The epidemiology of current depression in Macau, China: towards a plan for mental health action. Soc Psychiatry Psychiatr Epidemiol 52, 1227–1235 (2017). https://doi.org/10.1007/s00127-017-1415-8

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  • DOI: https://doi.org/10.1007/s00127-017-1415-8

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