Epidemiology of depression at Traditional Chinese Medicine Hospital in Shanghai, China.

BACKGROUND: Though Chinese Traditional Medicine (TCM) is one of the most important parts of health care system in China, studies on the epidemiology of depression in TCM are scarce and mental health issues in TCM have been neglected for longtime. METHODS: This was an interview-based survey. The prevalence of depression and suicidal risk in outpatients at a TCM hospital was identified by a one-stage diagnosing process using the Mini International Neuropsychiatric Interview. Associated risk factors, role impairment, and service utility were also assessed. RESULTS: A total of 2000 outpatients aged from 18 to 65years completed the survey with a response rate of 87.0%. The estimated prevalence of major depressive disorder was 13.2% for lifetime and 4.9% for current. No significant gender differences were found. Depression was more common in patients who lacked social support, experienced family economic burden and health burden, and underwent negative life events, poor self-rated health, or with moderate/severe sleep problem than in their correspondents; all with statistical significance (OR: 1.83-6.82). Patients with depression reported a mean of 82.7days and 99.3days of sick leave due to their physical and mental condition, respectively, which was much longer than those without depression (24.8days and 25.8days, respectively). Only 30.0% of patients with depression sought professional help from psychiatrists/psychologists or used antidepressants. LIMITATIONS: The recall bias could not be ruled out in this study and could have led to an underestimation of true prevalence and the unmet need for treatment. Since this study was cross-sectional, the causal relationships between sociodemographic factors and depression cannot be determined. CONCLUSIONS: Depression is common at TCM hospitals. The impairments due to depression are striking, and unmet needs for treatment are pervasive. Consequently, mental health services in TCM should not be neglected any longer.

Mental health literacy among residents in Shanghai.

BACKGROUND: The recent adoption of China's new national mental health law provides a good opportunity to obtain baseline information about community mental health literacy in the country. AIM: Assess knowledge and attitudes about mental disorders among residents in Shanghai. METHODS: A total of 1953 residents aged 15 or above selected from all 19 districts in Shanghai completed two self-report questionnaires - the Mental Health Knowledge Questionnaire (MHKQ) and the Case Assessment Questionnaire (CAQ). MHKQ total scores range from 0 to 20 (higher scores indicate better mental health literacy). The CAQ presents respondents with five case vignettes and possesses nine questions after each vignette measuring respondents' knowledge and attitudes towards these mental illnesses. RESULTS: Correct response rates for the 20 MHKQ items ranged from 26 to 98%, with a mean rate of 72%. The internal consistency (alpha) of the 20 items on the MHKQ was 0.69, but this decreased to 0.59 after removing four items about mental health promotion. A 5-factor model for the 20 items in the MHKQ was identified using exploratory factor analysis on one-half of the surveys, but the model was only partially validated in the confirmatory factor analysis using the second half of the surveys. On the CAQ, rates of correct recognition of mania, depression, schizophrenia with positive symptoms, schizophrenia with negative symptoms and anxiety were 42%, 35%, 30%, 19% and 21%, respectively. Work stress (37.3%), problems with thinking (30.0%) and negative life events (24.4%) were reported to be the three main causes of mental disorders. Seeing a counselor (34.2%) or a psychiatrist (33.3%) were the two most common suggestions for help-seeking. Higher education and younger age were related with better mental health literacy and higher rates of recognition of common mental disorders. CONCLUSIONS: Mental health literacy in Shanghai appears to be increasing, but the reliability and validity of the instruments used to assess mental health literacy (MHKQ and CAQ) have not been adequately assessed so this result must be considered preliminary. Further work, preferably including both qualitative and quantitative components, is needed to revise these instruments before they can be used to assess the effectiveness of mental health promotion campaigns.